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May 7, 2007

A University of Michigan Health Minute update on important health issues.

What's your "stroke IQ"?

Most of us don't know enough about America's #3 killer and #1 cause of disability - or about how to protect ourselves

ANN ARBOR, MI – When it comes to stroke, America has a pretty low IQ.

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Stroke is the third largest cause of death, the top cause of disability, and the single biggest reason why people are admitted to nursing homes. But despite this, studies have shown that Americans don’t know enough about why strokes happen, what to do when they happen – or how to prevent strokes from happening in the first place. 

So, the University of Michigan Stroke Program is offering a test that can check anyone’s stroke IQ, and maybe bump it up a few points. Don’t worry, the test comes complete with answers, and explanations, from the U-M program’s director, Lewis Morgenstern, M.D., who has led national studies on how to improve knowledge about stroke. Share it with others, and help improve America’s stroke IQ!

Question 1: What is a stroke?
Answer: It’s a brain emergency. Just like a heart attack is a heart emergency, a stroke is a “brain attack.”
Dr. Morgenstern explains: “A stroke is what happens in the brain when blood does not get to a part of the brain, and that part of the brain dies. Both heart attack and stroke are diseases of the blood vessels.”

Question 2: Are all strokes the same?
Answer: No. Most are caused by blocked blood vessels in the brain, but some are caused by bleeding in the brain. But no matter what the cause, strokes are emergencies that can kill or disable someone within hours.
Dr. Morgenstern explains: “All strokes are not created equal. About 85 percent are ischemic strokes, which occur when a blood vessel in the brain is blocked by a clot or fatty buildup. Ten percent of strokes occur when a blood vessel bursts; that’s an intracerebral hemorrhage. And 5 percent of strokes occur when an aneurysm, or weak spot in a blood vessel, ruptures, or there’s other bleeding in the brain – that’s called a subarachnoid hemorrhage.”

Question 3: Are some people “destined” to have a stroke?
Answer: No. There’s a lot you can do throughout life to reduce your risk.
Dr. Morgenstern explains: “Stroke is the most preventable of all catastrophic conditions, and I think that’s very important for people to realize. Your destiny isn’t to have a stroke – the proper attitude is that your destiny is to prevent yourself from having a stroke.”

Question 4: What are the signs that someone is having a stroke?
Answer: Any sudden changes in thinking, feeling, moving, speaking, understanding or seeing. 
Dr. Morgenstern explains: “By definition, stroke symptoms occur all-of-a-sudden. They come on rapidly, and they can come and go. The most common symptoms are sudden onset of weakness or numbness on one side of the body, difficulty in speaking or understanding, and losing vision in an eye, like a shade coming down from above in one eye. Strokes can also cause unexplained clumsiness, make a person drop objects, or cause someone to fall.”

Question 5: What should you do if you think you, or someone near you, is having a stroke?

Answer:  Call 911 immediately.
Dr. Morgenstern explains: “A stroke is a brain attack, and the faster a person gets diagnosed and treated, the better their chances will be. Don’t wait, don’t call your doctor’s office first, don’t drive yourself to the hospital. Don’t think that it’s not a stroke just because you don’t have any of the risk factors. Get an ambulance, and fast.”

Question 6: Does having a stroke mean you’re definitely going to die or be disabled?
Answer: Not necessarily. Better and faster treatment is giving more people a chance to walk out of the hospital with minimal problems. Patients may do even better if they go to a hospital with an accredited stroke center, like U-M.
Dr. Morgenstern explains: “A percentage of the 720,000 Americans who suffer a stroke each year will die within hours or days after it occurs. And for those who survive it can be very disabling. But a sizable percentage of patients who have a stroke recover enough to function independently. Still, they will always have a higher-than-normal risk of a second stroke.”

Question 7: Do only elderly people have strokes?
Answer:  No. Although the risk of a stroke goes up with age, people of any age can suffer strokes.
Dr. Morgenstern explains: “Stroke is a disease that occurs more commonly in people as they get older, but I’ve taken care of children with stroke, and people in their teens, 20s, 30s, and 40s with stroke. It can occur anytime.”

Question 8: What makes someone more likely to have a stroke?
Answer:  High blood pressure, smoking, diabetes, being overweight, having an abnormal heart-rhythm condition or other heart disease, or being related to someone who has had a stroke are all risk factors that increase the chances a person will have a stroke. A person’s risk goes up with every additional risk factor he or she has.
Dr. Morgenstern explains: “The number one risk factor is hypertension, or high blood pressure. People who have atrial fibrillation, which is a very common form of abnormal heart rhythm, also have a high stroke risk. Smoking — or exposure to second-hand smoke — are important risk factors. Family history is important. If your mother, father, sister, brother or child has had a stroke, you’re at increased risk. People who are overweight, especially if they also have problems with blood sugar, blood pressure, and cholesterol, have a higher risk. And of course, people who have survived a stroke or had a “mini stroke”, also called a TIA, have a much higher risk.” 

Question 9: What can people do to cut their stroke risk? 
Answer:  Quit smoking, lose weight, exercise more, get your blood pressure and cholesterol checked, and keep your blood-sugar levels under control if you have diabetes. Talk to your doctor about other options, especially if you have atrial fibrillation or a family history of stroke.
Dr. Morgenstern explains: “Virtually all the risk factors for stroke are things that can be treated and limited. It’s really up to the individual to take control of their risk factors in order to prevent stroke. Heart rhythms, cholesterol, blood sugar, blood pressure, being overweight, and addiction to tobacco are all treatable. These risk factors are very much interrelated, but many of them can be taken care of by a lifestyle that is active, with regular exercise, and by watching your diet, and working with a physician for medication that might be needed. Even in people who have had a stroke or mini-stroke in the past, we can do a lot to prevent a second one from occurring.”

OK, pencils down! That’s the end of the Stroke IQ Test – how did you do? If you got all the way through it, you probably know more about stroke now than the vast majority of Americans do. Now, share this IQ test with everyone you know – especially if they have some of the risk factors like smoking, being overweight, or having diabetes.

Facts about stroke:

  • Stroke is the third leading cause of death in the United States, and kills over 160,000 Americans each year.
  • Stroke is also a leading cause of serious long–term disability in adults, and the leading reason for people to be admitted to nursing homes.
  • About 700,000 strokes occur in the United States each year, mostly in people who have never had a stroke before. 
  • Strokes can occur at any age. Nearly one-quarter of strokes are in people under age 65. The risk of having a stroke more than doubles for every decade of life after the age of 55.
  • Stroke death rates are higher for African Americans than for whites, even at younger ages.
  • According to the American Heart Association, stroke cost almost $57 billion in both direct and indirect costs in 2005.
  • If given in the first few hours after a stroke begins, a treatment called tPA can help decrease the long-term effects of stroke in many people who suffer the most common kind of stroke. But many people who could benefit from tPA never receive it.

Find more on the Web at:

University of Michigan Stroke Program
The U-M Stroke Program is part of the U-M CardiovascularCenter and was recently recognized by the American Stroke Association for high-quality stroke care.

Stroke Information from the Centers for Disease Control and Prevention

American Stroke Association

Certified Primary Stroke Centers
CertificationPrograms/PrimaryStrokeCenters
Find a hospital in your area that has made a special effort to give the best stroke care

Written by Kara Gavin

 

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