Colusa Regional Medical Center,
Caring for our Community

Stroke – What You Should Know
Written by: Colusa Regional Medical Center

In the United States more than half a million people suffer a stroke each year requiring post-stroke rehabilitation.  Stroke is the third leading cause of death and the leading cause of disability in the United States.

There are several risk factors that increase your chances of having a stroke - high blood pressure, heart disease, smoking, diabetes and high cholesterol.  If you have any of these risk factors you should get them under control.  Keeping them under control will greatly reduce your chances of having a stroke.

A stroke happens when a part of the brain dies from a lack of blood either from a clogged or burst blood vessel.  The most common source of a stroke and disruption to the brain is a significant narrowing or blockage of the carotid arteries caused by excessive accumulation of fatty plaque buildup along the artery walls.  The carotid arteries are the main blood supply to the brain, and plaque buildup in these arteries is the leading cause of stroke.   Carotid artery and stroke screening uses painless and non-invasive ultrasound technology to provide images of the carotid arteries on both sides of your neck and measure the velocity of the blood flow through these vessels. 

Another source of stroke is when a clot forms in the heart.  The clot becomes dislodged and travels to the brain.  An Electrocardiogram test can help determine if a clot is present.

The types and degrees of disability that follow a stroke depend on which area of the brain is damaged.  Often the early symptoms of a stroke are ignored.  Warning signs can be:

       * Sudden numbness or weakness of the face, arm or one side of the body.
       * Sudden confusion, difficulty speaking or understanding.
       * Trouble seeing, walking, dizziness or loss of balance and coordination.
       * Sudden severe headache with no known cause.

FAST is an acronym for recognizing and responding to symptoms of stroke.  It stands for face, arms, speech and time.   A person may be having a stroke if they have difficulties performing these basic tasks:

• Face: ask the person to smile.  Does one side of the face droop?

• Arms: ask the person to raise both arms.  Does one arm drift downward?

• Speech: ask the person to repeat a simple sentence.  Are the words slurred? Can the person repeat the sentence correctly?

• Time: Get the affected person medical help as soon as possible by calling 911. 

Stroke is a medical emergency. Every minute counts when someone is having a stroke. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save people's lives and enhance their chances for successful recovery.  If you believe someone is having a stroke - if he or she suddenly loses the ability to speak, or move an arm or leg on one side, or experiences facial paralysis on one side - call 911 immediately.

The effects of a stroke can affect the entire body.  Generally stroke can involve disabilities involving movement or paralysis, sensory disturbances including pain, problems with speech and swallowing, problems with thinking and memory and emotional disturbances.  Patients may also experience pain or numbness after a stroke.

Rehabilitation helps stroke survivors relearn skills that are lost when the brain is damaged. The goals of rehabilitation are to help survivors become as independent as possible and to attain the best quality of life.  Although rehabilitation cannot “cure” stroke in that it does not reverse brain damage, it can significantly help people achieve the best possible function and long-term outcome.

Post-stroke rehabilitation involves physicians, nurses, physical therapists, occupational therapists, speech therapists and mental health professionals.  Physical therapists specialize in treating disabilities related to motor and sensory impairments.  They are trained in all aspects of anatomy and physiology related to normal function with an emphasis on mobility.  A stroke survivor’s strength, endurance, range of motion, gait and sensory deficits are assessed and an individualized program is designed, aimed to maximize motor function and mobility. 

Occupational therapists work with improving the ability to perform the activities of daily living such as dressing, bathing, meal preparation and housecleaning.  These activities are often the difference between dependence and independence in a patient’s life.  Speech therapists help stroke survivors with problems using or understanding language.  They can help patients relearn how to use language or develop alternative means of communication.  They also help people improve their ability to swallow using non-invasive imaging techniques to study swallow patterns and identify the exact source of their impairment.  All therapists help patients develop problem solving skills needed to cope with the aftereffects of a stroke.

Rehabilitation should begin as soon as the stroke patient is stable.  This can often be within 24 to 48 hours after a stroke.  The first stage of rehabilitation can start while the patient is still in the acute care hospital.  After the hospital, rehabilitation can continue in a skilled nursing facility, at home or the outpatient rehabilitation clinic.

For more information on stroke screening call the Colusa Regional Medical Center Cardiopulmonary Services at 458-5821 ext. 372 and for help with post-stroke rehabilitation call the Colusa Regional Medical Center Rehabilitation Department at 458-3287.