Mike Terry, Deseret News
Strokes have been striking "at younger ages overall" during the last decade, according to a Utah County neurologist, who says experts are not sure why.
"There's some suspicion it may have to do with obesity, not living healthy lifestyles, stress. We think some are blowing off non-symptomatic disease processes" like high blood pressure," said Dr. Kevin Call, a neurologist at Utah Valley Regional Medical Center.
Call and Kelly Anderson, a registered nurse who is the stroke program coordinator at Intermountain Medical Center and Alta View, LDS and Riverton hospitals, are featured experts on Saturday's Deseret News/Intermountain Healthcare Hotline. From 10 a.m. to noon, they'll take phoned-in questions regarding all aspects of stroke, from prevention to treatments. The number is 1-800-925-8177. You can also post questions on the Deseret News Facebook page during that same time period.
"We could probably prevent about 60 percent of all strokes if everybody had normal blood pressure," Call said. "Blood pressure is a problem here in Utah."
Stroke is the third-leading cause of death in the United States, but it's the top source of disability.
In recent months, Call has treated a patient who was 20 and one who was 92, with every age in between, he said.
It's incredibly important, once you note stroke symptoms, Anderson and Call said, to call 911 and get to the hospital. For some, there's a three- to four-hour window to get a clot-busting treatment that may reverse damage. And speed is always important. For every minute a stroke goes untreated, 1.9 million brain cells die.
But a surprising number of people don't recognize what's happening, said Anderson, who noted that some people try to "sleep through" a massive headache that is really a stroke.
There are actually two types of strokes. An ischemic stroke is caused by a blockage. As many as 80 percent are ischemic. In hemorrhagic stroke, a blood vessel ruptures. The former may be treated with a powerful blood thinner. The latter must not be. That's why they do a CT scan at the hospital to see if it's a bleeding or clot stroke.
Like all strokes, damage depends on where in the brain it happens. In the speech center, speech is affected, for instance.
Call said to protect the brain stem and deeper areas, you guard against processes that cause smaller strokes. Eat right, exercise well, don't smoke, control your blood pressure and try to avoid atherosclerosis, fat buildup in the arteries. Atherosclerosis also contributes to big strokes. Heart disease and atrial fibrillation are among causes of big strokes. Living heart-healthy and preventing blood vessel disease is important, as is maintaining a healthy weight.
It is vital, Anderson said, that women who use birth control pills not smoke. That's a major risk factor for stroke, especially after age 35. "It can be deadly for young women of childbearing age," she said.
To teach symptoms, Anderson offers "FAST" — face, arm, speech, time. Look for drooping on one side of the face or numbness or tingling. Is one arm weak or useless? Are words slurred so they can't be understood, or does the individual not understand what others are saying? "Time" is a reminder that survival depends on speed.
Other symptoms include trouble seeing in one or both eyes, lost peripheral vision, even floaties. With ministrokes, called transient ischemic attacks, a small blood clot gets stuck somewhere and "You start to lose that part, but then it dislodges and you get it back. That's a warning sign, " Anderson said. "It tells you there's a problem somewhere. Don't ignore that." It's almost like a dress rehearsal for something bad.
The classic sign of a hemorrhagic stroke, Anderson said, "is the worst headache of your life. Even people who have migraines say this headache is different."
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