About 800,000 people in the United States will have a stroke this year. They’re the leading cause of disability in this country, and the fifth-leading cause of death. Unfortunately, they can happen to anyone, at absolutely any age.We see their most devastating effects on a daily basis. This is typically the result of patients having multiple risks factors and not recognizing their symptoms quickly enough to stabilize or potentially improve from the stroke.
First of all, strokes affect brain function. They result from a sudden interruption of blood flow to the brain. About 2 million nerve cells are lost every minute a stroke isn’t stabilized. A patient could lose years of functional life in minutes to hours, without the appropriate medical care.
There are two types of stroke:
- Ischemic, which results from blockages or blood clots. This is the most common type. About 87 percent of all strokes are ischemic.
- Hemorrhagic, caused by ruptures of blood vessels, which release blood into the brain. With this type of stroke, some people have brain aneurysms, arteriovenous malformations (AVM), or other cerebrovascular disorders, that if treated, reduces the risk of stroke.
Stroke symptoms include:
- Sudden weakness and/or numbness in the face, arm, or leg, especially on one side of the body
- Sudden trouble speaking, difficulty understanding speech, and/or confusion
- Sudden trouble seeing in one or both eyes
- Sudden onset of trouble walking, dizziness, loss of balance, and/or lack of coordination
- Sudden severe headache with no known cause
How to make the best decision about your stroke careIn general, patients and caregivers can make the most informed decision by following these steps:
- Know the symptoms and get help quickly — Call 911, if you or someone you know is having a stroke. Immediate medical attention is needed to stabilize a stroke. If the stroke is treated quickly, there may be options to stop the damage occurring to the brain, as well as reverse at least some of its impact.
- Know your options related to types of stroke — Hyperacute ischemic stroke therapy is most effective as early as possible, ideally between 3 and 4.5 hours. Some ischemic stroke patients may have up to 6 hours. Some hemorrhagic stroke patients have as long as 48 to 72 hours when they can still benefit from treatment. Asking the same question as posed above—“how soon do I have to make a decision”—can be of benefit here as well.
- Involve your family — Get your family involved early in the process. Family members might have additional questions, and they can help you remember details. They also can make sure your get a higher level of care once you’ve been stabilized after a stroke.
- Document questions — Write down your questions as you think of them. Otherwise, you may not think of all the relevant questions while meeting with your physician.
- Know about cerebrovascular conditions linked to stroke — If you’ve been diagnosed brain aneurysms, carotid artery disease, Moyamoya disease, atrial fibrillation, chronic high blood pressure, and/or other conditions that can cause stroke (as well as cardiovascular disorders), understand your diagnosis. You may have options to treat the condition, which could decrease your risk of having a stroke.
- Discuss options with your physician — Asking your physician questions can let you know treatment options available to you. You can also discuss the need for a referral to a comprehensive stroke
- Do your research — You may choose to look for answers online or in online support groups or blogs. That’s OK. But please keep in mind that not all information on the Internet is accurate. Your doctor can help evaluate the information you find.
- Know what you want — Each treatment option has its advantages and disadvantages. It’s important to understand the benefits and risks of the options available with respect to your current health, lifestyle and social support.
Patients have choices about stroke careWhenever possible, one suggestion we have is to secure the support of family or friends. Because strokes affect brain function, having someone else hear and participate in discussions with physicians can be helpful. Also, provide clear instructions to family members on where you want to be treated if you have a stroke.
Patients who experience a stroke may have choices about where to receive treatment. Our recommendation is to seek care at an advanced comprehensive stroke center where the patient can receive a full evaluation and have access to appropriate treatments. The highest level of certification for such a Comprehensive Stroke Center is provided by the Joint Commission that sets standards for most U.S. hospitals. UT Southwestern has achieved this level of certification.
This decision of where to get care can impact a person’s life after a stroke. For some patients, it can mean recovering brain function or preventing further loss of function. It can even impact your chances of survival.