Stroke is the fifth leading cause of death and a leading cause of disability among adults in the United States. A stroke can be devastating to patients and their families. Strokes can range from mild to severe and can happen at any age. They can occur in different parts of the brain and may affect different body functions.

A stroke, or “brain attack,” occurs when the blood supply stops flowing to a part of the brain. Brain cells die from the lack of oxygen. There are three main types of stroke:

Ischemic: An ischemic stroke occurs when a blood vessel that delivers blood to the brain is blocked by a blood clot. This is the most common type of stroke, making up about 87% of all strokes. Patients that have this type of stroke may be able to receive a medication that dissolves the clot called Tissue Plasminogen Activator (tPA). This medication can only be given within 4‑1/2 hours of when the stroke started so calling 911 with the first signs of stroke is vital.

Hemorrhagic: A hemorrhagic stroke occurs when a blood vessel in the brain ruptures and bleeds into the brain. This causes swelling, pressure and damage to the brain tissue. Hemorrhagic strokes are less common but are more likely to be fatal.

Transient Ischemic Attack (TIA): A TIA is a temporary blockage of a blood vessel in the brain that resolves within 24 hours of symptom onset. The underlying causes for a TIA are the same as an ischemic stroke and having a TIA is a serious warning sign of a future stroke. A large portion of patients with TIA will go on to have an actual stroke and many of those will have the stroke within the first few days after the TIA.

It is important to know the early signs of stroke. Call 911 immediately if you or someone you are with shows signs of having a stroke. Do not try to drive yourself to the hospital. It is important to get care quickly because you may be given a medicine that can reduce or even reverse damage caused by some strokes. It must be given soon after symptoms start. Treatment and recovery may depend on how soon you get care.

Stroke symptoms can vary. They can start slowly or come on quickly. You may wake up with the symptoms. Act quickly and call 911 immediately if these symptoms come on SUDDENLY:

• Numbness or weakness of the face, arm or leg, especially on one side of the body
• Confusion or trouble speaking or understanding
• Trouble seeing in one or both eyes
• Trouble walking, dizziness, or loss of balance or coordination
• Severe headache

A stroke can happen with just one of these symptoms. Sometimes people have stroke‑like symptoms that go away quickly (called a transient ischemic attack or TIA.) Do not ignore these signs! Many people who have these warning signs go on to have a stroke.

Stroke strikes fast. You should too. Call 911.

People at greater risk for stroke include the elderly, those who have had a stroke or stroke‑like symptoms, and people with a family history of stroke. Health conditions and behaviors that increase your risk for stroke include:

• High blood pressure
• Heart disease
• High cholesterol
• Diabetes
• Some types of irregular heartbeat, such as atrial fibrillation
• A high sodium diet or unhealthy eating habits
• Lack of exercise
• Smoking
• Some illegal drug or alcohol abuse

What should you do if you are at increased risk for stroke?

Talk to your doctor about your risks and how to lower them to help prevent a stroke. Know your blood pressure, cholesterol and blood sugar results. Ask what you can do to improve them. When talking to your doctor, write down the answers and make sure you understand what you are hearing. Do not be afraid to speak up or ask where you can find more information. Tell your doctor what medicines you are taking. Include prescriptions, over‑the‑counter medicines and herbal supplements. Also tell your doctor about any special diet you are following.

Be prepared by finding out where to get the best stroke care possible. The American Heart Association/American Stroke Association publishes a free locator of Joint Commission‑certified stroke centers. Antelope Valley Hospital is an Advanced Primary Stroke Center.

Ask a friend or relative to be your advocate. If you have a severe stroke, your advocate can be your eyes, ears, arms and legs if you are unable to do things for yourself.

Consider getting legal documents such as a healthcare proxy or a power of attorney, if you do not already have them. A stroke may cause you to be confused or unable to speak, so you may want to designate someone you trust to make decisions when you cannot.

What happens after a stroke?

After a stroke, you will probably have many questions about what happened and what treatments are available. If the stroke was severe, you may not be able to ask questions for yourself. You or your advocate should ask:

• What are the effects of having this type of stroke? Paralysis? Difficulty walking or talking?
• What can be done to improve your chance of recovery?
• Where in the brain did the stroke occur? Can the doctor draw a picture of the affected area or show you on a scan where it occurred?
• What tests are being done? What are the results? What do the results mean?
• What is being done to prevent other health problems, such as blood clots?
• What new medicines are recommended?
• What are the benefits and side effects of the new medicines?
• Will the new medicines interact with your current medicines, over‑the‑counter medicines, or dietary or herbal supplements? Make sure you or your advocate give the doctor a current list of your medicines and supplements.
• Can a medicine be changed if it costs too much or causes side effects?
• Will surgery or another type of treatment be necessary?
• When will rehabilitation (rehab) begin? Stroke rehab will help you achieve the best possible recovery and quality of life. Rehab should begin while you are in the hospital.

In the case of a severe stroke, your advocate can also:

• Remind caregivers that you have had a stroke. The advocate can tell caregivers what you can and cannot do.
• Remind visitors that you may not be able to speak, but you can still hear.
• Ask caregivers and visitors to wash their hands to prevent the spread of infection.

What can you expect in recovery?

No one can predict how long it will take to recover from a stroke, or how much you will recover. What is important is to prevent another stroke. If you have had a stroke, the chance of having another one increases. Speak up and tell your doctor you want to reduce your risk of having another stroke.

Before leaving the hospital, you and your advocate should work with the social worker and care team to determine how to continue your recovery. Ask:

• What is your long term outlook for work, daily activities, physical activity and mental function?
• What type of rehab will you need? Home care? Outpatient? Inpatient?
• Is rehab covered by your insurance? If not, ask the social worker what services are available in your area.
• Will you need long‑term rehab or lifelong exercises?
• How often should you see a doctor?
• What kinds of tests will be done to see if treatments or medicines are helping?
• What are your treatment goals? For example, what should your blood pressure be?
• Are there any alternative or complementary treatments, such as massage, that will help?
• What kinds of symptoms or changes should always be reported to a doctor?
• Should you join a support group?

During this time, it is important to:

• Be realistic about your abilities. Identify what you can do and build on it.
• Allow people to help you. If people ask, give them something specific to do.
• Talk to your doctor if you are feeling blue or fatigued. Do not ignore these symptoms. Make sure you are evaluated and treated, if necessary.
• Educate yourself. Learn about the stroke resources available in your community, online and at your local library.