Know the signs of stroke and lower your risk

May 18, 2022

Providence Neuroscience Team

[7-minute read]

May is Stroke Awareness Month. Learn how to lower your risk for stroke and recognize when someone is having a stroke.
One easy way to remember the signs of stroke is to use the F.A.S.T. acronym —Face drooping, Arm weakness, Slurred speech and Time to call 911.
The Providence Health Neuroscience Institute and Tele-Health program are helping stroke patients across the nation.

Stroke is a major health concern for people of all ages. It is the No. 5 leading cause of death in the United States and one of the top causes of disability. While many people think a stroke occurs in the heart because it is related to heart disease, it actually happens in the brain. During a stroke, a blood vessel that carries oxygen and nutrients to the brain becomes blocked or bursts, which means the brain cannot receive the oxygen it needs. May is Stroke Awareness Month, so it’s a good time to learn about the different types of stroke, stroke prevention, the signs of stroke, and how to seek treatment when you or someone you know suffers a stroke.

Types of stroke

There are two main types of stroke:

Ischemic stroke is the most common form and occurs when blood clots block blood flow to the brain. Fatty deposits, called plaque, can also cause such a blockage.
Hemorrhagic stroke is when an artery in the brain breaks open, which damages the brain cells.

Additionally, a transient ischemic attack (TIA) is considered a “mini-stroke.” This occurs when the blood flow to the brain becomes blocked, but only for a short time — usually five minutes or less.

Stroke prevention

While there are many different reasons why you may suffer a stroke, there are three major steps you can take to reduce your risk:

1. Adopt a healthy diet. The Mediterranean diet — which includes fruits, vegetables, nuts, beans, and small amounts of fish, poultry, and dairy products — has been shown to reduce the risk of stroke by about 20%.

2. Exercise regularly. Exercise helps lower high blood pressure, which is a major risk factor for stroke. It can also help you control obesity and high cholesterol, which put you at risk of having a stroke.

3. Control your risk factors. The top risk factors for stroke include high blood pressure, smoking, diabetes, obesity, illegal drug abuse, an abnormal heart rhythm (such as atrial fibrillation), and damaged heart valves. You can control some of these risk factors, such as smoking, by not engaging in the activity. With others, you can talk to your doctor about proper management. In the case of abnormal heart rhythm, you may be able to use a smartwatch to alert you when you have an irregular heartbeat.

“Time is brain”

Even when you take all the right precautions, however, you may still suffer a stroke. If that happens, it’s important to seek care as quickly as possible. Physicians use the expression “time is brain” to refer to what happens during an ischemic stroke. When a blood vessel becomes blocked, every part of the brain beyond it is at risk because it is not receiving oxygen. Researchers have determined you lose 1.9 million brain cells per minute when they are deprived of oxygen, so the quicker you receive care, the more brain cells you save.

Signs of stroke

Recognizing the warning signs of stroke can help you save your own life or that of someone you love. Stroke prevention advocates use the acronym F.A.S.T. to help people remember how to recognize when a stroke is occurring:

F = Face drooping – Is one side of the person’s face drooping?

A = Arm weakness – Is the person experiencing weakness in one or both of their arms?

S = Slurred speech – Is it difficult to understand the person?

T = Time to call 911 – If any of the above is occurring, call 911 right away. Tell them you think it’s a stroke so the local hospital can prepare its team.

Other stroke symptoms can include:

Trouble seeing
Trouble walking or dizziness
Confusion
Painful headache
Numbness on the face, arms, legs, or a specific side of the body

Getting stroke patients home faster

The first part of stroke prevention and recognition is getting to the hospital quickly. Once you arrive at the hospital, however, you’ll depend on the doctors and other caregivers to have the right treatment at the right time. The Providence Health Neuroscience Institute uses evidence-based research to provide comprehensive stroke treatment across the system.

In particular, the institute has been focusing on decreasing patients’ length of stay in the hospital, while giving them the care they need. This started in 2020, when COVID-19 patients required a high percentage of the intensive care unit (ICU) rooms. At Providence St. Vincent Medical Center in West Haven-Sylvan, Oregon, and Providence Portland Medical Center in Portland, Oregon, caregivers had to be innovative. After extensive research, both facilities began piloting programs in which they admitted less-sick stroke patients to an intermediate care unit instead of the ICU. “Patients still received the appropriate level of monitoring for their risk factors,” said James Robberson, executive director of the Neuroscience Institute. “But they required fewer of the high-intensity resources we needed to care for the COVID-19 patients.”

The pilot programs were big successes — when caregivers analyzed data about the patients’ outcomes, they found the programs to be safe and patient-centered. Other hospitals in the system have now adopted their own versions of the programs, including Providence Sacred Heart Medical Center in Spokane, Washington, and Providence St. Jude Medical Center in Fullerton, California.

Stroke data helps patients

Length of stay isn’t the only area in which Providence is excelling in stroke patient care. We have been collecting data on stroke patients for more than a decade and have information about more than 100,000 different strokes. We use this massive dataset to determine which of our hospitals have the best stroke programs, and why. The best stroke programs serve as models for the other hospitals and give them the tools they need to improve their own stroke treatment. For example, hospitals across the system have seen improvement to door-to-needle time, or the amount of time it takes doctors to administer life-saving medication to patients from the moment they walk in the door.

Get with the Guidelines® Stroke, an American Heart Association program that is a national authority for stroke care gave 32 of Providence’s 41 participating hospitals a Gold Plus designation for the quality of our stroke care.

Tele-Stroke saves lives

Thanks to Providence’s Tele-Stroke program, patients worldwide are now benefitting from our expert knowledge. For stroke patients, timing is important, so when hospitals become part of the Tele-Stroke network, their patients receive access to board-certified neurologists in less than 2 minutes. This rapid access improves the patients’ outcomes, reduces both the patients’ and the hospitals’ costs, and enhances both patient and caregiver satisfaction.

The Tele-stroke program has been so successful, that Providence has expanded it to other neurology services. We now offer tele-EEG and tele-emergent neurology, and in the future, we plan to provide virtual neuro-oncology, neurohospital, outpatient neurology, and cognitive-neurology services. The new services improve care for all Providence patients, regardless of their location, by giving them virtual access to highly specialized physicians from Providence’s largest neuroscience programs.

Strokes can be debilitating. But when you seek treatment quickly at a high-quality institution, you have a much better chance of making a full recovery.