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Source: University Hospitals Cleveland Medical Center  

May Is National Stroke Awareness Month. Here Are Nine Warning Signs To Look For From University Hospitals Cleveland Medical Center Neurologist Michael DeGeorgia

May is National Stroke Awareness month. Stroke is the third leading cause of death in the US and is responsible for more serious long-term disabilities than any other disease. Stroke can happen to anyone at anytime – so knowing the warning signs of this medical emergency is critical.

“If you experience sudden loss of balance or coordination, double or blurry vision, face drooping, arm weakness or numbness, and difficulty with speech, you should call 9-1-1 immediately,” says vascular neurologist Michael DeGeorgia, MD.

A stroke occurs when the flow of blood to a part of the brain is cut off. This can be due to a blood clot (ischemic stroke) or a burst blood vessel bleeding into the brain (hemorrhagic stroke). The nine warning signs of stroke are:

•Weakness or numbness of the face, arm or leg, especially on one side of the body
•Confusion or difficulty speaking or understanding
•Problems with vision, such as dimness or loss of vision in one or both eyes
•Dizziness or problems with balance or coordination
•Problems with movement or walking
•Severe headaches with no other known cause
•Sudden nausea, vomiting or fever not caused by a viral illness
•Brief loss or change of consciousness, such as fainting, confusion, seizures or coma
Transient ischemic attack (TIA) – or “mini-stroke”

Although stroke warning signs haven't changed in the past five years, the window of treatment has. In the past when someone had a stroke, the time frame for treatment with the clot-busting drug tPA was three to six hours. After that time, treatment options were few. Fortunately, that is no longer true.

“Due to a revolution in clot removal technology and advanced brain imaging, when a patient with an acute ischemic stroke gets to a UH emergency room within 24 hours of experiencing symptoms, they still have a good chance for a complete recovery when their MRI shows brain tissue is still salvageable,” says Dr. DeGeorgia. “At that point, we take the patient to the cath lab and open the blocked artery to remove the clot.”

This new stroke procedure – called mechanical thrombectomy – is now protocol at UH as the result of the DAWN study, of which UH was a major participant.

“The study showed that a stroke patient’s own physiological clock matters more than the clock on the wall,” Dr. DeGeorgia says.

In a thrombectomy, a doctor threads a catheter (thin, hollow tube) through an artery in the patient’s groin up to the brain. Once the catheter is in place, the doctor uses a tiny mechanical device to break up or remove the clot.

This potentially life-saving treatment is good news for older adults who are more likely to have a stroke “because the incidence of cardiovascular disease and metabolic disorders increase with age,” says Dr. DeGeorgia. “But stroke isn't an inevitable consequence of aging. If seniors exercise regularly, reduce their stress, don't smoke, get plenty of sleep and eat a healthy diet, their risk of stroke is not much different than that of a younger person.”

Dr. DeGeorgia adds that stroke patients can recover years after their stroke.

“We now know the brain is more resilient than we used to think,” he says. “With good physical and rehabilitative therapy, and sensible lifestyle choices, patients can recover many of their physical losses. I tell stroke patients, it might take time, but never give up.”

Michael DeGeorgia, MD is the director of the Neurocritical Care Center and Center for Music and Medicine at University Hospitals Cleveland Medical Center.

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