Questions and Answers About Stroke

Questions and answers about stroke with Ted Lowenkopf, M.D., and Lisa Yanase, M.D., Providence Brain and Spine Institute.

What is a stroke?
A stroke is a “brain attack,” an injury to the brain that occurs when blood flow to the brain is interrupted, resulting in the death of brain tissue. An ischemic stroke occurs when a blood clot blocks a blood vessel to the brain. This accounts for about 80 percent of all strokes. A hemorrhagic stroke occurs when a blood vessel in the brain ruptures and bleeds into the brain, damaging surrounding tissue.

What is a TIA (transient ischemic attack) or “mini-stroke?”
A TIA is a sudden but temporary interruption of the blood supply to the brain, resulting in symptoms that typically last for less than an hour. One should treat a TIA the same as a stroke—call 911 to get to the hospital quickly. If you have had a TIA in the past, you are at greater risk for permanent brain injury—a stroke.

What do I do if I see someone having a stroke?
Call 911 immediately to get them to the hospital quickly. Care must begin immediately.

What are the effects of stroke?
Depending on the location of the stroke, it can cause devastating damage, including paralysis, vision loss, difficulty in speaking or swallowing, memory loss and even death.

What are the warning signs of stroke?
If you or someone you know experiences any of the following symptoms, it may be a stroke:
  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause
Can early treatment reverse the effects of a stroke?
Very early treatment is the key. When the blood supply to the brain is interrupted, the brain tissue begins to die rapidly. The sooner treatment begins, the greater the chance of reducing or completely reversing the injury—time is brain. Treatment must be given within the first three hours of the start of a stroke. Most strokes are caused by a blood clot, so clot-busting drugs, if administered early, can reduce long-term disability from stroke. Your chances of walking away from a stroke greatly increase if you and those around you know how to recognize stroke symptoms and immediately call 911.

Can I fully recover from a stroke?
Yes. Recovery after the brain injury from a stroke generally occurs for up to one year. Rehabilitation involves different therapies that address a patient’s specific areas of disability. Aggressive rehabilitation can speed the recovery process and the return to a productive and independent life. Most stroke survivors are left with some disability, but many recover completely or have only mild impairments.

Who should be concerned about stroke?
Everyone should be aware of this disease, the third leading killer and the leading cause of adult disability in this country. Stroke can affect anyone, young or old, even if otherwise healthy, so it is important to recognize the warning signs of a stroke and call 911 should they occur. Some people are at higher risk for stroke, although “modifiable” risk factors can be controlled with the help of a physician:

Modifiable risk factors (those you can control):
  • High blood pressure
  • Heart disease, especially atrial fibrillation
  • Smoking
  • High cholesterol
  • Diabetes
Unmodifiable risk factors (those you cannot control):
  • Age greater than 55
  • A family history of stroke or heart disease
  • Previous history of stroke or TIA
  • Race: African-Americans and Hispanic people are at higher risk
How can I reduce my risk for stroke?
You can reduce your risk of stroke by controlling blood pressure, stopping smoking, keeping your cholesterol levels within healthy limits, maintaining a healthy weight, exercising regularly, and keeping diabetes under control. You should talk to your doctor or health care provider about whether you are at risk for stroke and how you can reduce the risk.

Is it true that Oregon has a high mortality rate from stroke?
The death rate in Oregon from stroke is the fifth highest in the nation. The reasons, as yet, are unclear. Since 2002, we have been collecting data to investigate how we care for stroke patients in Oregon and why Oregonians seem to be at higher risk. The Centers for Disease Control and Prevention (CDC) awarded us a grant to study this question. The hope is that the CDC will use data we’ve collected and the data collected by other states to create a national stroke registry.

Is there hope of some day reducing this death rate and the disability that stroke causes?
Yes. This is an exciting time, as stroke care is an area of medicine currently undergoing a revolution. New, promising treatments are emerging to treat stroke in the first hours after symptoms begin. We are gaining insight into how to prevent strokes from happening — they are largely preventable. Finally, we also are learning best to use rehabilitation to maximize recovery. Dr. Lowenkopf is the medical director of the Providence Stroke Center, based at Providence St. Vincent Medical Center. Dr. Yanase is the associate medical director of the Providence Stroke Center, based at Providence Portland Medical Center.