Little-Known Signs Of A Stroke

The subtle symptoms of a "brain attack" are easy to ignore--until it's too late.

A Philippine Business Executive wasn't as alert. He begun to experience numbness and weakness. A few hours later, his entire right side became weak and his speech flawed. Still, he ignored the symptoms. It was only when the weakness became more severe that he visited a hospital. By then it was too late. The mini-stroke became a full-fledged stroke, and he died as a result. Prompt medical attention might have allowed his doctors to give him an anti-coagulant, preventing the stroke.

A stroke should be seen as a "brain attack. " It is as urgent as a heart attack. It is as a heart attack. Lives might be saved and disability minimized if victims recognized the warning signs of stroke and took action--fast. It is urgent to get a stroke victim to a hospital as fast as possible. This usually can be delayed no longer than five to six hours. Yet few visit a hospital within this period.

Indeed, until recently few doctors worried about speedy intervention. Twenty years ago, stroke was considered virtually untreatable, either immediately or later. But during the past decades, that gloomy outlook has been revised dramatically. With new drugs, dramatic surgery and diagnostic technology, most strokes are treatable and subsequent attacks preventable-if action is taken soon enough.

There are two basic types of stroke. Hemorrhagic strokes occur when blood vessel ruptures in the brain, bleeding into the brain itself or into the space between the brain and skull, compressing other brain tissue.

Ischemic strokes result from an interruption in blood flow to part of the brain. The blockage may occur when a clot forms in one of the four major arteries supplying the brain or in their smaller branches. Or it may be caused by an embolism, which occurs when a fragment of plague breaks loose elsewhere in the body and becomes lodged in a vessel in the brain. The blockage robs cells of oxygenated blood needed to carry out their functions. Depending on the brain area, virtually any of the body's functions can be affected with symptoms ranging from momentary weakness to impaired vision. Permanent paralysis or death can occur.

About one-quarter of all strokes give warning signals. TIAs are brief episodes in which a clot or an embolism temporarily blocks blood flow, then dissolves without lasting damage. Though a TIA can last up to 24 hours, almost two-thirds end within five minutes. Thus the victim often ignores or misinterprets the ominous message. This is unfortunate, because one TIA victim in ten will have a major stroke within a year; three in ten within five years.

Certain people should be particularly alert to stroke's subtle warning. Hypertension is a factor in about half of all strokes; persons with untreated high blood pressure are five times more vulnerable. Also at high risk are smokers, diabetics, women who take oral contraceptives with a high estrogen content, and people with erratic heartbeats due to atrial fibrillation. Those who are overweight, don't exercise or have elevated blood cholesterol may also be at increased risk for stroke.

Men have more strokes than women. Although the threat of stroke rises with each year of age, younger people-even teenagers-are not immune.

If you are in a high-risk group for stroke, the most effective methods of prevention are simple. Your doctor may recommend that you lower blood pressure and cholesterol level by diet and exercise or with drugs. Blood thinning medications also reduce risk if you had a TIA.

The odds of defeating stroke are greatly enhanced when people are aware of the symptoms. Here are warning signs you should not ignore:

Pins and needles. The loss of sensation may be noticed first in one hand or foot, then the arm, leg, face or entire side of the body. Or it may be confined to a vague tingling in a few fingers. A doctor will be able to diagnose if it is a stroke. Numbness caused by "brain attack" usually occurs in combination with other symptoms, such as drooping of the muscles on one side of the face or slurred speech.

Losing your grip. Often a TIA announces itself when an object unexpectedly falls from a person's hand.

An unruly tongue. Some people temporarily can't talk, some make nonsense sounds, some don't understand what's being said to them.

A descending curtain. In a stroke or TIA, vision suddenly turns dark, dim or gray as though someone had set up a screen in front of you. Usually only one eye is temporarily blinded, while the other is perfectly normal. Or, depending on the location of the clot, the person may see may see blurred or double images side by side or one atop the other. The semi-blindness may be accompanied by drooping on the same side of the face. Then, slowly, the blindness may lift and the vision return to normal.

Rubber legs. An unsteady gait or lurching to one side usually indicates a clot affecting the balance centers in the brain stem. The gait disturbance is often preceded by vertigo.

The worst headache ever. Sudden, excruciating headache is the most prominent indication of a hemorrhagic stroke. The pain is usually constant rather than pulsating and is felt across the head, rather than being localized in the forehead. It is caused by inter cranial bleeding, as blood from the burst vessel crowds into the space between the skull and brain tissue.

If you or someone you know experiences any of these symptoms, what should you do?

First, take the symptoms seriously, even if they seem trivial or the episode ends quickly. Second, move fast. Don't wait. Those who have a TIA should receive prompt medical attention. If they do not, there is a good chance they will have a real stroke.

Third, describe your symptoms carefully. The more accurate the patient is, the easier it is for the doctors to make a correct diagnosis and offer correct therapy.

If you suffer a TIA, be sure to follow your doctor's recommendation to prevent a major stroke.

It is sad to see people who have had TIAs and who could have done more but did not.