Stroke 101

Transcript

• 00:00Hi everyone, my name is Doctor Rachel Forman
• 00:02and I'm a member of the Yale Stroke team.
• 00:05Today we're going to be talking
• 00:07about the basics of stroke.
• 00:09Just a disclosure that the information
• 00:11provided today is general information about
• 00:13stroke and any specific questions that
• 00:15you have about your own health should be
• 00:17discussed with your health care provider.
• 00:20So first,
• 00:21we're going to talk about your brain.
• 00:23The brain is the main Control Center,
• 00:25and different locations control
• 00:27different parts of us.
• 00:28For example,
• 00:29certain locations control how we talk,
• 00:30how we move our body, how we see feel,
• 00:33and how we sleep and wake up,
• 00:36and nutrient rich blood is brought
• 00:38to the brain from the heart.
• 00:40And this is what supplies those areas of
• 00:42the brain to work the way that the blood
• 00:45gets from the heart up to the brain is
• 00:48through a couple of sets of arteries.
• 00:50One is called the carotid artery and
• 00:53we have one on the right and the left
• 00:55and then same thing and that supplies
• 00:57the back of the brain and these
• 00:59are called the vertebral arteries.
• 01:00So this blood is brought from the
• 01:02heart to the brain via these systems
• 01:05and supplies to different parts of
• 01:07the brain that controls everything
• 01:09that we do and think.
• 01:11Now let's talk about what a stroke is.
• 01:13I'm sure a lot of you have
• 01:15heard of the term stroke,
• 01:16or maybe even have had one yourself,
• 01:19or know someone that's had a stroke.
• 01:21So there are two types of strokes.
• 01:23The most common type is
• 01:24called an ischemic stroke,
• 01:25and this is when there's a blood clot
• 01:28that's preventing blood from getting
• 01:29to a certain area of the brain.
• 01:31It's blocking off that artery.
• 01:33The second type is called
• 01:34a hemorrhagic stroke.
• 01:35This is a lot less common,
• 01:37and this is one that blood vessel actually
• 01:39breaks, so those are the two types.
• 01:42And the mostly there are the blood clot type,
• 01:44the ischemic stroke.
• 01:45So that's probably the ones
• 01:47you've heard of most.
• 01:49So a couple of stroke facts.
• 01:51Unfortunately,
• 01:51stroke is extremely common in
• 01:53the world and our country every
• 01:5540 seconds someone has a stroke.
• 01:56The good news is,
• 01:58is that 80% of strokes are preventable.
• 02:00Stroke is also the number 5 leading
• 02:02cause of death in the country and
• 02:04a leading cause of disability.
• 02:06So it's a very important thing to
• 02:08discuss and to know about because
• 02:10it's extremely common and like.
• 02:12I just said, a lot of them are preventable.
• 02:15So talk to your health care
• 02:17provider about your stroke risk.
• 02:19The next thing we're going to discuss,
• 02:21our stroke risk factors.
• 02:22We classify these as modifiable
• 02:23or non modifiable.
• 02:24Modifiable means that these are things
• 02:26you can change that are in your control.
• 02:28The first thing is high blood pressure.
• 02:30Many of you have probably heard
• 02:32about high blood pressure or
• 02:34might even have it yourselves.
• 02:35The important thing is to
• 02:37find out if you have
• 02:38it in the 1st place, because a lot
• 02:40of times you don't feel any symptoms
• 02:42when you have high blood pressure.
• 02:44So people don't know that they have
• 02:46it the way that you find out is you
• 02:49go to your health care provider.
• 02:51Or are you going to check somewhere
• 02:53and then you discuss options with
• 02:55your doctor or health care provider?
• 02:57The other thing is smoking or
• 02:59tobacco use as many of you know,
• 03:01this can cause cancer heart disease.
• 03:03It can also cause stroke is a
• 03:05very strong stroke risk factor.
• 03:06We as health care providers know how
• 03:08difficult it is to quit smoking and
• 03:11we can provide you with different
• 03:12tools to help physical inactivity and
• 03:14obesity or other causes of stroke.
• 03:16And again we recognize that these
• 03:18are difficult changes to make.
• 03:20Often people can afford certain
• 03:22healthy food choices or you don't
• 03:24have the means to go to the gym
• 03:26every day or to go exercise.
• 03:28But we can help you come up with
• 03:30small steps to make these changes
• 03:31and support you through the process.
• 03:33Having high cholesterol,
• 03:35diabetes,
• 03:35these are other stroke risk factors
• 03:37that you can talk to your health
• 03:39care provider about and ways to treat
• 03:41them and lower your risk for stroke.
• 03:42Atrial fibrillation is a certain
• 03:44type of heart arrhythmia or abnormal
• 03:47heart rhythm and the way that this
• 03:49causes a stroke is it causes your
• 03:51heart to not pump as effectively
• 03:53and the blood can pool there and
• 03:55cause blood clots to form that then
• 03:57travel to your brain so when you
• 03:59know people don't always know that
• 04:01they have this condition either.
• 04:03That's why it's important to go
• 04:05have your daughter listen to your
• 04:06heart and if you feel any heart
• 04:09palpitations or dizziness,
• 04:10any symptoms along those lines?
• 04:11You should just discuss it with your doctor.
• 04:14The final thing to talk about
• 04:16today is sleep apnea,
• 04:17and this is another thing
• 04:18where you know if you start.
• 04:20If you stop breathing while you're
• 04:22sleeping or your snoring very heavily,
• 04:24it's just an important thing
• 04:25to be evaluated for.
• 04:26This is another risk factor for stroke.
• 04:28I know we covered a lot of things right now,
• 04:31and I don't expect you to
• 04:32remember all of them.
• 04:34The important thing is is that you can
• 04:36modify your risk for having a stroke,
• 04:38and it's important to you find out
• 04:39in the first place if you have any
• 04:42of these conditions by talking
• 04:43to your healthcare provider.
• 04:44Next we'll talk about non
• 04:46modifiable risk factors.
• 04:47These are things that are not under
• 04:49our control, such as age, gender,
• 04:51ethnicity and family history.
• 04:52So if you know your mother or your
• 04:54father or your sibling had a stroke,
• 04:56you likely are at a higher
• 04:58risk for stroke and again,
• 05:00just because we can change is if you know
• 05:02that you have one of these risk factors,
• 05:05talk to your health care provider
• 05:06because you might be able to work on
• 05:09the modifiable risk factors and needs.
• 05:11Just help you know that you are
• 05:12at a higher risk for stroke,
• 05:14so just to hammer this point home,
• 05:16can you lower your risk of stroke?
• 05:19Yes, absolutely.
• 05:19Make an appointment to see your doctor
• 05:22talk about all of the risk factors and
• 05:24have them discuss these things with you.
• 05:26The next thing we'll discuss is how to
• 05:29tell if someone is having a stroke.
• 05:31It's really important to recognize
• 05:33stroke symptoms because then you
• 05:35can get yourself or your loved one.
• 05:37The care that they need.
• 05:38Very quickly.
• 05:39There's an acronym out there
• 05:41called Fast F AST.
• 05:42Don't worry about memorizing this at all,
• 05:44but once you're familiar with
• 05:46the idea of what these are,
• 05:48then I think you can help recognize a stroke.
• 05:51And if you remember the acronym,
• 05:53that's great.
• 05:53F stands for face drooping, A stands for.
• 05:56Arm Weakness S stands for speech difficulty.
• 05:58T is time to call 911 facial drooping.
• 06:01Having weakness on one side of the body.
• 06:04Any sort of speech problem
• 06:05whether that's slurred speech,
• 06:07not able to get the words out,
• 06:09not able to understand if someone's
• 06:12looking like they're confused
• 06:13not able to understand you these
• 06:15can all be signs of a stroke,
• 06:17a couple other things just to know
• 06:19that aren't in this acronym are vision
• 06:22loss or double vision and dizziness.
• 06:24So if you're not able to.
• 06:26Walk if you're walking on study
• 06:27or you have the sudden sensation
• 06:29at the room is spinning.
• 06:31These can all be signs of a stroke.
• 06:33And remember T for time.
• 06:34It's time to call 911.
• 06:36So what do you do if someone's
• 06:38having a stroke?
• 06:38As I just said, you need to call 911.
• 06:41You don't want to send a message
• 06:43to your doctor.
• 06:44You don't want to leave a
• 06:45voicemail for your doctor.
• 06:47You don't wanna take a nap.
• 06:48I can't tell you how many times I
• 06:50have seen patients arrive after
• 06:52trying to sleep off their symptoms.
• 06:54Call 911 it is imperative for you to get
• 06:57to the emergency room as soon as possible.
• 07:00The faster that you get there,
• 07:02the faster the team of stroke experts
• 07:04to evaluate you every minute or second.
• 07:07That goes by.
• 07:07There are as part of the brain
• 07:10dying off that can be irreversible.
• 07:12So the sooner you can be eligible
• 07:14to possibly get these treatments,
• 07:16the better,
• 07:17and you can really save someone's life
• 07:19and major disability by calling 911
• 07:21and getting them to the emergency room.
• 07:24Time is brain.
• 07:25As I said before,
• 07:27every second that goes by that
• 07:28there is not blood reaching the
• 07:30parts of the brain that supply
• 07:33in different parts of our body.
• 07:35This is going to be dying off and it
• 07:37could potentially be irreversible.
• 07:39Finally,
• 07:39we'll talk about a couple of stroke
• 07:42treatment options and this is this
• 07:44relates to the importance of time.
• 07:45These medications are time sensitive.
• 07:47Unfortunately so many people arrive
• 07:49to the emergency room outside
• 07:51of the time window because they
• 07:53did not know to
• 07:54call 911. They thought they would
• 07:56try to rest for a little while.
• 07:58They put a message into their
• 08:00doctor and unfortunately,
• 08:01the medications that weekend and procedures
• 08:03we can do our all time sensitive's.
• 08:05The first one is a clot busting medication
• 08:07called tissue plasminogen activator or TPA.
• 08:09And this is exactly what it sounds like.
• 08:12It goes in and it breaks up that
• 08:14blood clot and restores blood flow
• 08:16to that certain part of the brain.
• 08:18It doesn't always work,
• 08:20but it is an effective medication
• 08:22that we offer, and again,
• 08:23it people are only eligible if they
• 08:25arrive within a certain timeframe.
• 08:27It's either 3 hours,
• 08:284 1/2 hours depending on the person,
• 08:31and again you don't need
• 08:32to remember those times,
• 08:34you just know to call 911.
• 08:36The second thing is a
• 08:37mechanical thrombectomy.
• 08:38This is a surgical procedure
• 08:40where a trained specialist will go
• 08:42insert a catheter either through
• 08:43the groin or in different part and
• 08:46will actually go and remove that
• 08:48caught physically from the brain,
• 08:49restoring blood flow to that area.
• 08:51These are very effective treatment options,
• 08:53but the important thing for you to
• 08:55know is that there are time sensitive.
• 08:58And every second counts and a lot
• 09:00of people do arrive where it's too
• 09:03late to offer these treatments.
• 09:05Just a side note is if you have a
• 09:07hemorrhagic or a bleeding stroke.
• 09:09These treatments do not apply.
• 09:11There is a different set of
• 09:13treatments that people can get,
• 09:15and those are also time sensitive.
• 09:17If you want to learn more about stroke
• 09:19and how you can reduce your risk,
• 09:22you can go to
• 09:23theseresourcesstrokeassociation.org,
• 09:23the American Heart Association,
• 09:25an American Stroke Association
• 09:26are a great place for resources.
• 09:28I am not personally affiliated with these,
• 09:30but there are great place where
• 09:32you can learn more about stroke.
• 09:34And then get your personal risk,
• 09:37respect or assessment.
• 09:38So together we can UN stroke.
• 09:40Thank you so much for listening.
• 09:42Have a great day.