Young, old should know signs of stroke

Every year, nearly 800,000 people in the U.S. have a stroke.

That means a person has a stroke every four minutes nationwide, and a person dies of stroke every 3 minutes and 14 seconds, according to the Centers for Disease Control and Prevention.

Stroke is the leading cause of serious long-term disability, in addition to being the cause of reduced mobility in more than half of stroke survivors over the age of 65.

May is Stroke Awareness Month. Dr. Omar Tanweer, associate professor of neurosurgery and director of cerebrovascular neurosurgery at Baylor College of Medicine, shares who is most at-risk for stroke and what new stroke research says.

Who is most at risk for stroke?

Anyone can be at risk for a stroke, but there are high-risk conditions that are most associated with stroke. The biggest risk factors include older age, high blood pressure, diabetes, smoking, high cholesterol, obesity, atrial fibrillation (an abnormal heart rhythm), sleep apnea and a prior history of stroke or transient ischemic attack (TIA, often called a “mini-stroke”).

Family history and genetics also can play a role.

It can happen with the conditions mentioned above but can happen randomly to younger patients as well. In younger patients, we sometimes see strokes caused by less common issues such as blood vessel dissections, autoimmune disease, clotting disorders, migraines with certain risk factors or structural heart abnormalities.

Can a stroke happen to a person with no preexisting conditions?

Yes, although it is less common. We occasionally see strokes in people who appear otherwise healthy and have no obvious medical history. Sometimes this is due to a hidden cause that has not yet been diagnosed, such as an abnormal heart rhythm, a hole in the heart (patent foramen ovale, or PFO), a blood clotting condition or a tear in an artery that can occur even after seemingly minor neck trauma.
There are also strokes that remain “cryptogenic,” meaning that despite an extensive workup, we cannot identify a clear cause.

Can anyone have a stroke, even if they exercise, eat well and are otherwise, healthy?

Unfortunately, yes. A healthy lifestyle dramatically lowers the risk of stroke, but it does not reduce the risk to zero. I have cared for marathon runners, younger adults and otherwise healthy individuals who experienced a stroke. However, healthy habits, remain the best way to prevent or reduce your stroke risk.

Can you explain what F.A.S.T. refers to?

F.A.S.T. is an easy way for people to recognize the warning signs of stroke and act quickly. Here’s what it stands for:

• F – Face drooping
  • One side of the face may droop or feel numb. Ask the person to smile and see if it looks uneven.
• A – Arm weakness
  • One arm may feel weak or numb. Ask the person to raise both arms and see if one drifts downward.
• S – Speech difficulty
  • Speech may become slurred, garbled or difficult to understand. The person may suddenly struggle to find words.
• T – Time to call 911
  • Time is critical. Stroke treatments are highly time-sensitive, and every minute matters because brain tissue is at risk.

Is there new research happening that may lead to new ways to treat and prevent strokes?
Absolutely. Stroke care has evolved tremendously over the past decade, and research continues to move quickly.
One major advance has been the expansion of minimally invasive procedures called thrombectomy, where specialists, like myself, can physically remove large blood clots from brain arteries. We continue to refine which patients benefit and how far out from symptom onset treatment can still be effective.
There is also significant research into:
• Better blood thinners and antiplatelet medications tailored to individual risk
• Advanced imaging to identify which patients may still benefit from treatment beyond traditional time windows
• Artificial intelligence-assisted imaging to help identify stroke faster
• Neuroprotection strategies aimed at preserving brain tissue during a stroke
• Better prevention strategies for atrial fibrillation and carotid artery disease

How can people with no preexisting conditions prevent the possibility of having a stroke?

• Check blood pressure, cholesterol and blood sugar regularly
• Exercise regularly
• Avoid smoking or nicotine products
• Maintain a healthy weight and diet
• Prioritize sleep
• Limit excessive alcohol and avoid illicit drugs
• Know the signs of stroke

By Julie Garcia