Jan. 3, 2007

Strokes: Causes, Symptoms And Treatment

FYI: Learn More About The Causes Of And Medical Care For Strokes

  • Play CBS Video Video Rebounding From A Stroke

    Dr. Emily Senay talks with Harry Smith about a promising new rehab approach for stroke patients. Doctors restrain a patient's good hand to force the use of the hand debilitated by the stroke.

  • Video Recognizing Stroke Symptoms

    Early detection and getting help quickly in the case of a stroke can often mean the difference between life and death. Dr. Emily Senay shares details with Rene Syler.

  • Video Children At Risk For Strokes

    Studies show that about one in every 5,000 newborns has had a stroke. Dr. Lillian Beard tells Hannah Storm what causes strokes in children, how to recognize it, and the proper treatment.

  •  (iStockphoto)

  • Interactive Losing Memories

    Facts about Alzheimer's, help for caregivers and a look at sufferers who've put the disease in the spotlight.

  • Quiz Medical Exam

    Give your brain a checkup with these health quizzes.

(CBS)  During a stroke, a blood vessel supplying blood to the brain bursts or is blocked by a blood clot. Nerve cells in the affected area of the brain can be damaged within minutes and can die within hours. It is estimated that during a stroke, 2 million brain cells die every minute.

Strokes are the third-leading cause of death among Americans, behind heart disease and cancer, and are the No. 1 cause of adult disability, according to the National Stroke Association. More than 750,000 people suffer from strokes each year.

What Causes A Stroke?
An ischemic stroke is caused by a blood clot that blocks blood flow to the brain. A blood clot can develop in a narrowed artery that supplies the brain or can travel from the heart (or elsewhere in the body) to an artery that supplies the brain. About 80 percent of strokes are ischemic.

Blood clots can be caused by other body issues that affect the flow of blood, including:
  • Hardening of the arteries
  • Irregular heart rhythms
  • Certain heart valve problems, diseases or infections
  • Congenital heart defects
  • Vasculitis
  • Heart attack

    The other 20 percent of strokes are hemorrhagic — strokes that occur when a blood vessel breaks and blood leaks into the brain.

  • What Are The Symptoms?
  • Sudden numbness or weakness of the face, arm, or leg, especially if it occurs on one side of the body
  • Sudden confusion, trouble speaking, or understanding speech
  • Sudden trouble seeing in one or both eyes, or double vision
  • Sudden trouble walking, dizziness, loss of balance, or coordination
  • Sudden severe headache with no known cause
  • Drowsiness, nausea, or vomiting

    How a stroke patient is affected depends on the location in the brain where the stroke occurs. For example, someone who has a small stroke may experience only minor problems such as weakness of an arm or leg. People who have larger strokes may be paralyzed on one side or lose their ability to speak, according to the National Stroke Association.

    Anyone who has symptoms of a stroke needs emergency care. The sooner medical treatment begins after symptoms are noticed, the fewer brain cells may be damaged.

  • Can You Prevent A Stroke?
    Up to 80 percent of all strokes are preventable, according to the National Stroke Association. The basics of preventing a stroke are similar to the steps to having a healthy heart, including exercising regularly, not smoking, keeping cholesterol and blood pressure down and keeping a diet low in sodium and fat.

    A stroke can happen at any stage of life, even in fetuses and children, but it becomes more likely with age. Stroke occurs most often in people over age 65.

    How Do Doctors Treat Strokes?

    Strokes are treated in several different ways, including by surgery, medications, hospital care and rehabilitation. Strokes caused by blood clots might be treated with a surgery to remove artery plaque or an angioplasty surgery.

    A drug that dissolves blood clots might also be used. Called tissue plasminogen activator, or tPA, the drug dissolves the clot and can restore blood flow to the brain. TPA is usually effective only if administered promptly.

    To learn more about strokes:
    • Click here for a stroke guide from WebMD.
    The National Stroke Association has resources on strokes and prevention. Or call 1-800-STROKES.
    • Click here for resources from the American Stroke Association.
    • Check out the National Stroke Association’s stroke risk scorecard (.pdf).
    • See the AARP's information on strokes here.
    • Find out what’s happening in your neighborhood, from the American Stroke Association.



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    Add a Comment See all 18 Comments
    by katelau January 6, 2007 7:49 PM EST
    I find it ironic that CBS ran this series since the same network has had several storylines indayrime programming that included very unrealistic stories involving charactar's who had strokes. Specifically on the Bold & the Beautiful, Brooke Logan was blamed for causing Stephanie Forrester's stroke and the Maroni guy had a stroke and received something akin to stem cell therapy( not within the reach of average citizens) both charactars had miraculous recoveries. On As The World Turns, Lucinda Walsh had a stroke and years later was discovered to be able to walk despite her many months in a wheelchair implying she was faking her disability for personal gain. I like the more constructive way the network approached stroke in this special
    Reply to this comment
    by katelau January 6, 2007 7:23 PM EST
    I was only moderately impressed. Getting
    patients to a hospital quickly is only half the
    battle, ER staff and EMTs have to know how to respond
    appropriately.No where in America should be any
    further than a 45 minute transport to a comprehensive
    Stroke Center and HMOs have to be reasonable about
    referring stroke patients to one rather than insisting
    to keep $$ "in house". Any my biggest gripe more
    attention needs to be paid to custom designing patient
    sopecific independent home based therapy where
    countless hours of therapy can be done without anyone
    being billed

    If 80 % of strokes are preventable, 20% aren't. I would be interested in seeing stats on how many strokes were worsened by lack of appropriate medical treatment. I was told I needed to see a psychiatrist because my Dr assumed mt initial stroke symptoms were an emotional reaction to "empty nest syndrome" and I have heard from way too many younger people who were accused of drug abuse by ER/EMT personellwhen thry sought medical attention for stroke symptoms. It is good to educate the public on prevention strategies by highlighting the high % of possible prevention lays a sense of blame on the stroke patient whose stroke couldn't be prevented

    Reply to this comment
    by katelau January 6, 2007 7:15 PM EST
    As someone who has struggled with stroke aftermath for over 11 years, stroke is a subject I am passionate about. Getting a stroke patient to a hospital timely is only the first 1/3 of the battle. Having medical personel who know how to recognize and treat a stroke is the next 1/3, Reducing disability in those for whom stroke could not be prevented seems to be the hardest 1/3. Insurance companies and many Drs write us off after 6 months but in many cases appropriate therapy individualized for each patient could prevent the complications that enhance disability
    Reply to this comment
    by katelau January 6, 2007 7:08 PM EST
    It would seem sensible to me for AHA and NSA to lobby congress for funding to make sure that no one is further away than a 45 minute transport to a comprehensive stroke center and for HMOs to relax about sending patients to one rather than fighting to keep insurance $$$ in house. Similar lobbying should be done for therapists to devlop patient costumized home based therapy programs so stroke patients can get involved in as many hours of therapy learning to live smarter instead of harder without anyone getting a bill
    Reply to this comment
    by katelau January 6, 2007 4:12 PM EST
    While many advances have been made in detecting and preventing strokes precious little has been gained in advancing stroke revovery. Most of us are told thar 6 months is when improvement will end. And insurance companies use that milestone as an end point to cease funding rehab efforts yet recovery is a lifelong battle for survivors. Extending therapy could help us work smarter instead of harder at improving our skills
    Reply to this comment
    by bschacker January 6, 2007 1:30 AM EST
    "Rebuilding the Body After Stroke" is a guide to stroke recovery through better diet, special brain healing supplements and gentle exercises for people with one sided weakness or paralysis. The guide is written for families to help members of their family have better recoveries. Call toll free 877-835-3157 for free information and help or go to www.strokefamily.org. Also available: home speech practice kits designed to help families communicate with and help family members with aphasia. Some information is free. "What families can do in the hospital to help stroke survivors" and "How to Deal with a Stroke Emergency" are two of the free publications available at this web site. Unique and very helpful support and resources.
    Reply to this comment
    by blessed1ne January 5, 2007 6:01 PM EST
    Thank you Katie We are blessed to here anything on strokes. And being it is such a devastating thing that can happen to anyone even myself there really should be more and more available to help each of us. I myself had a stroke. I am a stroke survivor. I found out that some doctors are just clueless as to the affects of the disease. I learned that omega 3,s can help the brain. I learned to use alot of post it's. I put things in the same place so I won't have to look for it. I do things not in a rush but in a calm manner it keeps me from panic. I keep a light on when I cook so I remember I am in the Kitchen cooking. I remind people close to me to lend a hand so I don't over exert myself. And to take my mind off of me I help others. Sometimes I feel much better just doing that. I lost my speech for hours I prayed because even if no one else could here me God heard my prayer. And if I have any errors in this statement I am still working on independent training because I am helping myself in my recovery. God Bless you Katie,He sure has blessed me. Thank You Terrie
    Reply to this comment
    by txjamer January 5, 2007 5:58 PM EST
    Accurate info about strokes but you need to inform the public about central pain syndrome. It is estimated that 20% of survivors develop this horrific pain, meaning up to 150,000 a year develop it so over a million are living with it and little or no research being done to develop ways to treat this pain which does not respond to the usual pain meds.
    Reply to this comment
    by zooky11 January 5, 2007 12:46 PM EST
    Thank you for running this. I had a CVA in 1996 and can atest to it's being a long time for rehab. But, each day I find something that I can do today that I couldn't do yesterday, on-n-on.
    Reply to this comment
    by Ann0525 January 5, 2007 11:49 AM EST
    My husband at age 55 had a CVA 2 months after 9-11. He recovered well but now is in a steady decline. Probably more mini-strokes. Has been dumped from rehab by being termed at a plateau. I have him in physical theraphy 4 times a week with a fitness trainer and a Feldenkrais therapist. All of this is done through private pay. None covered by insurance. Seems all the doctors give is pallative treatment. No encouragement or new ideas. I constantly search the internet looking for new ideas and devices to encourage the brain to repair itself. Even using a vibration platform. This is such a devestating disease with little hope of recovery and the decline is the worst part. Even the psychiatrist told me that "he has had a stroke, he is now a child and you are the parent"
    Not an easy time here.
    Reply to this comment
    by jlennon931 January 4, 2007 11:05 PM EST
    excellent coverage but i'd love to see additional programs cover hemorrhagic bleeds which account for 20 percent of all strokes

    i also think coverage of the advances in physical therapy for stroke recovery would benefit the millions living with post stroke disabilities.and help doctors and survivors alike to realize there can be functional life after this trauma.
    Reply to this comment
    by slonanci January 4, 2007 9:29 PM EST
    As a four year stroke survivior I am absolutely amazed lack of knowledge in both many medical professionals & the general public when it comes to the of stroke/ or stroke recovery! Speaking from experience it's hard enough for a stroke victim to cope with the situation at hand, but even more difficult when your loved ones can't seem to find right support to make sure the stroke victim continues onto a progressive path of recovery through therapy. There's so much more we all need to learn about strokes and stroke recovery. I certainly hope that people like those at CBS can open many minds in educating all that are willing to listen-- about strokes. We found out about strokes the hard way--by personally experiencing one. Thanks to making the public more aware through insight like yours, it won't come down to that. Hats off to Katie and CBS for tackling this subject of STROKE!
    Reply to this comment
    by latheena January 4, 2007 4:35 PM EST
    * Caution: Investigational device. Limited by Federal (or United States) law to investigational use.
    Reply to this comment
    by vickievw January 4, 2007 4:29 PM EST
    As a caregiver for my stroke survivor father...there is NOT enough research, resources for those whose lives are forever changed by a stroke. No one stops to think..when the person has their stroke...their family and friends are affected, too. My father had a massive stroke and was in surgery within 3 hours having a craniotomy. He laid in a coma for 8 days and in an Intensive Care Unit for 30 days. From there he went into a regular room for 3 months, followed by a 45 stay in a rehab nursing home. Medical personnel told us to place him in a nursing home. In their opinion, he would not be able to do anything. His family was determined to take him home. He did very well and made progress that could be considered a miracle. For 3 years, my Mother was his caregiver with my daily assistance. Sadly, my Mother passed away...mainly due to the stress of caregiving. I arranged for my Father to move into my home and was able to keep him with me until his behavior became violent and aggressive. All due the damage of the brain caused by the stroke. He now resided in a nursing home and continues to have bad behaviors and is very difficult at times.There are limited resources for those with disabilites caused by a stroke. And...if you are elderly, it creates another set of issues. Whatever it takes whether it be....news ...celebrities..critics...the "stroke world" needs the attention is deserves. As a leading cause of disabilites and death...it should be a top priority.
    sincerely, Vickie Warner
    Reply to this comment
    by unclephred January 4, 2007 3:12 PM EST
    As the husband of a stroke survivor, I continue to be amazed at how little support there is out there for stroke survivors. On August 25th,2004 Holly was camping and hiking with a church group, I was doing disaster recovery for a fortune 500 firm, a day later, we were both in a hospital in Westchester NY, and she did not know my name. Our home on LI is gone, my job is gone, soon the COBRA insurance will end, and we will have to figure out how to pay for a new insurance policy.
    The word the insurance industry uses to limit their responsibility to those whose lives have been blasted by stroke, is Plateau. Whenever the PT,OT,ST rehab specialist does not see significant progress, the plateau word gets used, and rehab benefits stop.
    In my wile's case, she was left handed, that arm and hand no longer work. The left part of each eye was mostly lost, though much of that has returned. Speech was severely disrupted, and very slowly returns. Her left leg is in a articulated brace, and she uses a cane. memory is a problem, and I now run the finances.
    Many stroke survivors loose spouses, family, friends, not so with us, but true for many others, if death is the worse case scenario, this is the next worse.
    Reply to this comment
    by jlennon931 January 4, 2007 2:45 PM EST
    thank you for your informative news story on stroke interventions. i'll be sure to tune in to watch the second installment.
    Reply to this comment
    by strokesurv January 4, 2007 1:07 AM EST
    Stroke is a completely underserved area. Thank you for this-- Glad you are talking about it. If Katie can do for stroke what she did for Colon cancer awareness we might start to understand that Stroke happens at all ages even though many people think it is a disease of the old. Stroke is the leading cause of disability and the # 3 cause of death behind all types of cancer and heart disease!
    There are other things beyond tPA
    Did you know that Reneuron has applied for FDA approval to do stem cell transplants?
    There is much to be done in stroke-- you didn't mention the Merci Retriever, there are lots of good things happening in stroke recovery-- constraint therapy -- Taub ua UAB but there is Also Dr. Prochaska and Dr. Stein at the University of Alberta-- WalkAide and Glove for hand recovery, Dr. Milos Popovic is doing fabulous work at the University of Toronto.
    There are good things going on in Aphasia as well-- but there is very little funding for rehabilitation research. In Canada the Heart and Stroke Foundation spends about 2.2% of its budget on stroke rehab research-- and of that budget much is spent on reviews --not new research.
    Sincererly Sharon Anderson
    Stroke Survivors Association of Ottawa
    www.strokesurvivors.ca
    www.strokeconference.ca
    Reply to this comment
    by ronsjems January 3, 2007 10:26 PM EST
    TPA can be Deadly! If a patient has a head injury, say for example from a fall when they have a stroke or heart attack, the drug can be given only after a CT scan has been performed on the head. Many times a patient falls at home during such an event and if TPA is given the clot in the brain will dissolve causing a bleed in the brain. Other clots in the brain causing the stroke or clot in heart from cardiac arrest dissolves however the patient is sure to die if there is a head injury. The injury may be as small as a bump on the back of the head with no visable sign of bleeding.
    Reply to this comment
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