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With strokes, "time saved is brain saved"


While time is often a major factor in determining how much damage a medical ailment can cause, it is especially true with strokes. Under the right conditions, the reversibility of stroke symptoms can decrease by the minute. But why is the saying “time saved is brain saved” so important when it comes to strokes?

This week on Take Care, Dr. Larry Goldstein, discusses how to recognize a stroke, and why time is of the essence when it comes to treating them. Dr. Goldstein is a professor of neurology at Duke University and director of the Duke Comprehensive Stroke Center in North Carolina.

Click 'Read More' to hear our interview with Dr. Goldstein.

There are two major types of strokes: ischemic and hemorrhagic. Ischemic strokes occur when a blood vessel to or within the brain is closed off. This starves the brain of blood and oxygen, which can cause brain cells to die. Hemorrhagic strokes occur when there is bleeding within or around the brain, and is often caused by an aneurysm.

While Dr. Goldstein says that 80 percent of strokes are ischemic, “there’s no way to be absolutely sure, without a brain imaging test, as to what the type of stroke is.” Because of this, Dr. Goldstein points out that having a stroke is completely different than having a heart attack, even though people sometimes equate the two. Dr. Goldstein says patients should stay away from aspirin when a stroke happens.

“Aspirin affects blood clotting, and if the person is actually having a bleeding kind of stroke, it could actually make things much worse,” he says.

Being able to identify the symptoms of stroke is important in distinguishing it from a heart attack, and could also save precious time in getting it treated.

Dr. Goldstein says the symptoms to look for in identifying a stroke can be summed up by “walk, talk, reach, see, feel.”

  • Walk -- Is there an abrupt onset of walking difficulties?
  • Talk -- Is there an abrupt difficulty with speech or understanding speech?
  • Reach -- Is an arm feeling either weak or numb?
  • See -- Is there a loss of vision in one or both eyes, or problems seeing on one side?
  • Feel -- Is there a severe, unusual headache that came on abruptly?

In order to successfully treat a stroke, much has to be done from a medical standpoint. The problem though is that all of this has to be done in a very brief period of time, especially when it comes to ischemic strokes, because “the longer the brain goes without brain and oxygen, the more likely the damage is to be irreversible,” says Dr. Goldstein.
Because the first hour is the most critical once symptoms begin to appear, Dr. Goldstein recommends acting quickly, and to call 911 and rely on an ambulance to get to the hospital.

“Large amounts of research data shows patients that arrive at the hospital via 911 are evaluated much quicker than patients that drive up themselves,” he says.

While certain hereditary and biological factors have a large role in determining somebody’s risk of stroke, Dr. Goldstein suggests five lifestyle changes that can significantly lower somebody’s risk.

  • Exercise for at least thirty minutes most days of the week.
  • Have a healthy diet that’s low in sodium and high in potassium, and be sure to eat three to five servings of fruits and vegetables daily.
  • Don’t smoke and stay away from environmental tobacco smoke.
  • Work to get your Body Mass Index underneath 25.
  • If you’re a woman, stick to no more than one alcoholic drink a day, and if you’re a man, stick to no more than two.

“What we found is that people who follow these five healthy lifestyle habits, have an eighty percent lower risk of having a first stroke compared to others who don’t follow those healthy lifestyles,” says Dr. Goldstein.