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    Are You Having a Stroke?

    What you need to know to help yourself and others

    Stroke symptoms usually develop suddenly and without warning, or they may occur on and off for a day or two.

    The optimal window of treatment is about three hours from the onset of symptoms, so it's crucial to call 911 immediately if you suspect you or someone else is having a stroke. Although stroke treatment and survival rates have improved dramatically over the past decade, timing is essential.  

    "Wait-and-see should not be a part of the decision process," says Edward C. Jauch, M.D., of the Medical University of South Carolina. Some stroke victims may not be aware of their symptoms or may be unable to communicate, adds Jauch, who also is a member of the National Stroke Association's Professional Advisory Committee.

    Two kinds of stroke

    About 87 percent of all strokes are "ischemic," and occur when a blood clot blocks a blood vessel in the brain or an artery to the brain. If administered in time, clot-busting drugs can help reduce the damage from this kind of stroke, so getting treatment quickly is critical.

    The second type of stroke is "hemorrhagic," and occurs when a blood vessel in the brain breaks, causing bleeding in the brain. These strokes generally need to be treated in intensive care and may require surgery.

    A ministroke, or "transient ischemic attack," is caused when blood to the brain is temporarily disrupted. Symptoms, the same as for major strokes, last for only an hour or so, then vanish.

    "If this happens, call your doctor or go to an emergency clinic. Don't just forget about it," says Thomas Sweeney, M.D., of the Connecticut Vascular Center.

    A ministroke, he says, can signal that a full-blown stroke is imminent — maybe just hours away. After a ministroke, the risk of a major stroke can be reduced if you go for medical help, says Sweeney. Treatment might include blood thinners to combat clotting, surgery to clear a blocked artery or treatment plans for underlying disorders, such as high blood pressure, high cholesterol, heart disease and diabetes.

    Next page: When to call 911. »

    Strokes are the fourth-leading cause of death in the United States — according to the Centers for Disease Control and Prevention — and a major cause of long-term disability, so knowing the symptoms is important.

    Call 911 when one or more of these sudden symptoms occur:

    • Numbness or weakness of the limbs or face, especially on one side of the body
    • Facial paralysis (one side droops, drooling)
    • Trouble speaking or understanding speech
    • Mental confusion
    • Vision problems
    • Dizziness, difficulty walking
    • Extremely painful headache

    If you think someone is having a stroke:

    • Call 911
    • Do not give aspirin, which thins the blood. Without knowing which kind of stroke is occurring, taking aspirin could cause more damage, says Larry B. Goldstein, M.D., director of the Duke University Stroke Center in Durham, N.C.
    • Try to get the person to sit or lie down to prevent a fall
    • Check that the person's airways are clear
    • Do not give water or food — the stroke victim could choke
    • Write down when symptoms first appear to help the medical staff assess treatment

    Reduce your stroke risk

    Prevention does make a difference. There’s been a 40 percent decrease in the number of strokes in adults 65 and older in the last two decades, according to a recent study published in The American Journal of Medicine. Many risk factors for stroke are treatable, says Goldstein. "If you make these lifestyle changes, you reduce your stroke risk by 85 percent."

    You're at higher risk for stroke if you:

    • Are African American
    • Are male
    • Have a close relative who had a stroke before age 65
    • Are older: Stroke risk doubles for every decade after age 50
    • Have already had a stroke. "You are at 10 times higher risk of having a stroke if you've already had one," says Goldstein.

    Beth Levine is a freelance writer who lives in Stamford, Conn.

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