Time is brain so BEFAST to recognize stroke
May 22, 2018
May is National Stroke Awareness Month, and with 795,000 people suffering from a stroke each year in the United States, it is important to understand what a stroke truly is, what to do when it happens, and how to help prevent it. Nirav H. Shah, MD, Medical Director of Stroke at the Swedish Neuroscience Institute, breaks down what to expect when confronted with a stroke.
Be Ready, BEFAST
A stroke isn’t always as easy to recognize as some might think. There are times when a person having a stroke may collapse to the ground, but in many cases the symptoms are subtler. Dr. Shah says, “During a stroke, time is brain. In other words, a person loses 2 million neurons per minute when oxygen is not getting to the brain, so the faster they can get the care they need, the better chance they will have to recover.”
This is where BEFAST comes into play. Remembering the acronym is an easy way to determine when to call for help.
E: Eyes and Vision
Dr. Shah says, “Strokes are a sudden onset event that causes oxygen loss to the brain. So, if you witness symptoms that could be a sign of stroke like sudden face or arm weakness or numbness, speech or language difficulty, balance issues or vision issues without any other cause, call 91l immediately.”
A stroke is a sudden interruption of the blood supply and oxygen to the brain. There are two main types of strokes: A bleeding stroke (hemorrhagic stroke) or the most common, a blood clot stroke (ischemic stroke). When dealing with a blood clot stroke, there are two leading treatments that can be performed to return blood and oxygen to the brain. Both, however, are time sensitive.
If the patient is diagnosed in under 4½ hours from the initial stroke event, Dr. Shah may prescribe a medication known as alteplase. This medication was discovered in the body and acts as a natural clot dissolver. When administered to a patient with a blood clot stroke, alteplase will target the clot and break it up to allow blood flow back to the brain.
If the patient is diagnosed in under 24 hours, another option may be to remove the clot physically, with a procedure referred to as a catheter-based embolectomy. A small tube is guided into the clot site through a small incision, and special instruments are then used to remove the clot.
Both treatments result in blood supply returning to the brain, but in all instances, the faster the procedures are administered, the faster the brain will heal and recover from lack of blood flow.
After a stroke, the main focus is on rehabilitation. Dr. Shah explains that time and rehabilitation is crucial because it gives the brain a chance to recover naturally. “The brain itself will not regenerate, but it is able to rewire. Oftentimes, stroke patients will recover even after a serious impairment such as language loss, also known as aphasia.”
In addition to rehabilitation, stroke treatment includes helping families prepare for the future. Since 8 percent to 9 percent of all people who have had a stroke will have another within the first year, they may need skilled neurological nursing care to help identify impairment, recurrence, or new symptoms as soon as possible. In some instances, stroke patients may have difficulty with nutrition or medication management, or they may need 24-hour care. Your doctor and care team can help identify the necessary aftercare and navigate the path to recovery.
While there are many reasons why people have strokes, there are daily habits that you can practice in order to reduce your risk of stroke. Since many strokes are caused by high blood pressure (hypertension), diabetes and heart problems, managing diet and exercise is always a top preventative priority.
Dr. Shah states that, “the hypertension epidemic is one of the biggest risk factors for stroke that can be easily managed.” By making a few lifestyle changes and taking medications if necessary, you can reduce their risk of stroke and other health issues due to high blood pressure. These changes include: healthy diet, lessened sodium intake, no tobacco use, regular exercise, limited alcohol consumption, limited caffeine, and reduced stress.
Strokes can also be a result of underlying health issues such as cancer or heart disease. Cancer is a risk factor for stroke because it can cause you to become more likely to have blood clots (prothrombotic). Heart disease and stroke are mutual risk factors — if you have one, you are at risk for the other.
In combination with living a healthy lifestyle, it is important that you continue to visit your primary care doctor and schedule routine screenings to ensure that you can identify and manage health concerns at early stages.
Dr. Shah was drawn to neurology in part for the opportunity to hasten recovery and reduce mortality and disability for stroke patients. He says, “Swedish sends around 50 to 60 percent of patients who have had a stroke back home without needing advanced nursing care. It is really rewarding for me to be there from the beginning of their hospitalization when I meet them in the ER to the time they get discharged from the hospital with a good plan in place for recovery.”
Swedish is recognized for quality, award-winning stroke care. Learn more about the Swedish stroke program. Find a Swedish emergency room near you. Swedish also offers clinical anticoagulation management for patients receiving therapy to thin their blood and prevent clot formation.
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.