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Brain Attack Developed By: James R. Ginder, MS, NREMT,PI,CHES Health Education Specialist Hamilton County Health Department www.hamiltoncounty.in.gov ---PAGE BREAK--- The Reader Will Be Able To… Describe what a stroke is. List three risk factors of a stroke. Recall three of a stroke. Explain how to perform a FAST stroke exam. ---PAGE BREAK--- Stroke Information… Stroke is the third leading cause of death in the United States. About 137,000 Americans die of stroke every year. (CDC) When a stroke happens, it is important to recognize the call 9-1-1 right away, and get to a hospital quickly. ---PAGE BREAK--- What Is A Stroke? A stroke, sometimes called a brain attack, occurs when a clot blocks the blood supply to the brain or when a blood vessel in the brain bursts. ---PAGE BREAK--- Types Of Stroke… Ischemic Stroke: About 85% of all strokes are ischemic, in which blood flow to the brain is blocked by blood clots or fatty deposits called plaque in blood vessel linings. Hemorrhagic Stroke: The most common type of hemorrhagic stroke. It occurs when an artery in the brain bursts, flooding the surrounding tissue with blood. Ischemic Stroke Hemorrhagic Stroke A clot blocks flow to an area of the brain Bleeding occurs inside or around brain tissue ---PAGE BREAK--- Types Of Stroke… Subarachnoid hemorrhage: Bleeding in the area between the brain and the thin tissues that cover it. Transient ischemic attack (TIA): Is a "warning stroke" or a "mini-stroke" that results in no lasting damage. Recognizing and treating TIAs immediately can reduce your risk of a major stroke. ---PAGE BREAK--- Risk Factors For Stroke… Family history: Your stroke risk is greater if a parent, grandparent, sister or brother has had a stroke. . Age: The chance of having a stroke approximately doubles for each decade of life after age 55. While stroke is common among the elderly, a lot of people under 65 also have strokes. ---PAGE BREAK--- Risk Factors For Stroke… Gender: Stroke is more common in men than in women. In most age groups, more men than women will have a stroke in a given year. However, more than half of total stroke deaths occur in women. At all ages, more women than men die of stroke. Use of birth control pills and pregnancy pose special stroke risks for women. ---PAGE BREAK--- Risk Factors For Stroke… Race and ethnicity: African Americans have a much higher risk of death from a stroke than Caucasians do. This is due to American Americans having a higher incidence of high blood pressure, diabetes and obesity. ---PAGE BREAK--- Risk Factors For Stroke… High blood pressure: Can greatly increase your risk for stroke. Smoking cigarettes, eating a diet high in salt, and drinking too much alcohol can all raise your blood pressure. High blood cholesterol: Can build up fatty deposits (plaque) on blood vessel walls. The deposits can block blood flow to the brain, causing a stroke. Diet, exercise, and family history affect blood cholesterol levels. ---PAGE BREAK--- Blood Pressure Category Systolic mm Hg (upper Diastolic mm Hg (lower Normal less than 120 and less than 80 Prehypertension 120 – 139 or 80 – 89 High Blood Pressure (Hypertension) Stage 1 140 – 159 or 90 – 99 High Blood Pressure (Hypertension) Stage 2 160 or higher or 100 or higher Hypertensive Crisis (Emergency care needed) Higher than 180 or Higher than 110 Source: American Heart Association Blood Pressure Readings… ---PAGE BREAK--- Total Cholesterol Levels… Levels Risk Less than 200 mg/dL Ideal 200 mg/dL-239 mg/dL Borderline 240 mg/dL-Higher High Source: American Heart Association National Heart, Lung, and Blood Institute ---PAGE BREAK--- Risk Factors For Stroke… Heart disease: Coronary artery disease (CAD) increases your risk because a fatty substance called plaque blocks the arteries that bring blood to the heart. Other heart conditions, such as heart valve defects, irregular heartbeat and enlarged heart chambers, can cause blood clots that may break loose and cause a stroke. ---PAGE BREAK--- Risk Factors For Stroke… Peripheral artery disease: Is the narrowing of blood vessels carrying blood to leg and arm muscles. It's caused by fatty buildups of plaque in artery walls. People with peripheral artery disease have a higher risk of carotid artery disease, which raises their risk of stroke. ---PAGE BREAK--- Risk Factors For Stroke… Diabetes: High blood sugar tends to occur with high blood pressure and high cholesterol. Overweight and obesity: Being overweight or obese can raise total cholesterol levels, increase blood pressure, and promote the development of diabetes. ---PAGE BREAK--- Risk Factors For Stroke… Carotid or other artery disease: The carotid arteries in your neck supply blood to your brain. A carotid artery narrowed by fatty deposits from atherosclerosis (plaque buildups in artery walls) may become blocked by a blood clot. Carotid artery disease is also called carotid artery stenosis. ---PAGE BREAK--- Risk Factors For Stroke… Sickle cell disease: This is a genetic disorder that mainly affects African-American and Hispanic children. "Sickled" red blood cells are less able to carry oxygen to the body's tissues and organs. These cells also tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke. Normal Red Blood Cell Sickled ---PAGE BREAK--- Risk Factors For Stroke… Previous stroke or transient ischemic attack (TIA): The risk of stroke for someone who has already had one is many times that of a person who has not. Transient ischemic attacks (TIAs) are "warning strokes" that produce stroke- like but no lasting damage. TIAs are strong predictors of stroke. ---PAGE BREAK--- Risk Factors For Stroke… Tobacco Use: Smoking injures blood vessels and speeds up the hardening of the arteries. The carbon monoxide in cigarette smoke reduces the amount of oxygen that your blood can carry. Secondhand smoke can increase the risk of stroke for nonsmokers. Alcohol Use: Drinking too much alcohol raises your blood pressure, which increases the risk for stroke. It also increases levels of triglycerides, a form of cholesterol, which can harden your arteries. ---PAGE BREAK--- Risk Factors For Stroke… Physical Inactivity: Not getting enough exercise can make you gain weight, which can lead to increased blood pressure and cholesterol levels. Inactivity also is a risk factor for diabetes. ---PAGE BREAK--- Risk Factors For Stroke… Drug abuse: Drug addiction is often a chronic relapsing disorder associated with a number of societal and health-related problems. Drugs that are abused, including cocaine, amphetamines and heroin, have been associated with an increased risk of stroke. Strokes caused by drug abuse are often seen in a younger population. ---PAGE BREAK--- How To Lower Your Risk… Eat a healthy diet: Choosing healthful meal and snack options can help you avoid stroke and its complications. Be sure to eat plenty of fresh fruits and vegetables. Eating foods low in saturated fat and cholesterol and high in fiber can help prevent high blood cholesterol. Limiting salt or sodium in your diet can also lower your blood pressure. ---PAGE BREAK--- How To Lower Your Risk… Maintain a healthy weight: Being overweight or obese can increase your risk for stroke. Be active: Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends that adults should engage in moderate- intensity exercise for at least 30 minutes on most days of the week. ---PAGE BREAK--- How To Lower Your Risk… Don't smoke: Cigarette smoking greatly increases your risk for stroke. Limit alcohol use: Avoid drinking too much alcohol, which causes high blood pressure. ---PAGE BREAK--- How To Lower Your Risk… Have your cholesterol checked: Your health care provider should test your cholesterol level every year. Monitor your blood pressure: High blood pressure has no so be sure to have it checked on a regular basis. Manage your diabetes: If you have diabetes, closely monitor your blood sugar levels. ---PAGE BREAK--- How To Lower Your Risk… Take your medicine: If you're taking medication to treat high cholesterol, high blood pressure, or diabetes, follow your doctor's instructions carefully. Always ask questions if you don't understand something. ---PAGE BREAK--- How To Lower Your Risk… Talk with your health care provider: You and your doctor can work together to prevent or treat the medical conditions that lead to heart disease. Discuss your treatment plan regularly and bring a list of questions to your appointments. ---PAGE BREAK--- Of 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 ---PAGE BREAK--- Of A Stroke… Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden, severe headache with no known cause ---PAGE BREAK--- Act FAST… FACE Ask the person to smile. Does the face look uneven? ARM Ask the person To raise both arms. Does one arm drift down? SPEECH Ask the person to Repeat a simple phrase such as," the grass is green.” Does their speech Sound strange? TIME Call 9-1-1 if any of these signs are observed. If you notice any of these signs, it’s time to call 9-1-1 Source: Nebraska Dept. Of Health ---PAGE BREAK--- What To Do… Immediately call 9-1-1: Do not drive the person to the hospital. Check the time: So you'll know when the first appeared. It's very important to take immediate action. If given within 3 hours of the start of a clot-busting drug called tissue plasminogen activator (tPA) may reduce long-term disability for the most common type of stroke. ---PAGE BREAK--- Source… American Heart Association Center For Disease Control National Stroke Foundation