By Islam Gomaa, MD
Emergency Medicine, Blanchard Valley Hospital

You may have heard the phrase “time is muscle,” which refers to being evaluated quickly for a heart attack in order to use a catheter to open a blocked blood vessel and prevent heart damage. Likewise, the same principle applies in the case of a stroke.

Strokes are caused by a blockage of an artery carrying oxygen to the brain. Prompt evaluation in many cases leads to the use of a thrombolytic or clot buster to open the blockage. The restoration of blood flow can allow prompt recovery of function of the brain and prevent permanent damage, paralysis or function.

Why do these blockages occur? The most common cause (around 85 percent of the time) is due to depositions of fats and cholesterol in the lining of an artery. This “hardening of the arteries” occurs as we age and is accelerated by high blood pressure, high blood sugars, smoking and high levels of blood fats. Control of these risk factors reduces the probability of developing blockages. 

Occasionally, obstructions occur from other causes, such as a blood clot traveling from another area of the body lodging in an artery to the brain. An example would be a clot forming in a patient with atrial fibrillation (afib) of the heart (the reason those with afib being prophylactically placed on blood thinners to prevent that occurring). Also, aneurysms or enlarged, weakened areas of an artery can rupture causing blockages at the site. These may be hereditary.

Symptoms of a stroke can be multiple, sometimes obvious while other times subtle. Weakness or numbness on one side of the body, problems with speech or sight, sudden imbalance or dizziness, difficulty walking or confusion with or without a headache can indicate a stroke in progress. 

Immediate evaluation in an emergency room may indicate the need for a computerized scan (CT or CAT scan) looking for blockages. Emergency rooms have developed processes to expedite the evaluation of those with stroke symptoms to save brain function. 

All members of our community are encouraged to be familiar with symptoms of a stroke and seek medical attention as soon as possible if these symptoms occur.