The waterfall at the South Natick Dam/Photo by Douglas Flynn

A stroke is a medical emergency and one of the leading causes of death in the United States.

As described by the National Institutes of Health, a stroke occurs when the flow of oxygen-rich blood to a portion of the brain is blocked. Without oxygen, brain cells start to die after a few minutes. Sudden bleeding in the brain also can cause a stroke if it damages brain cells.

If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that these brain cells control. Stroke symptoms include sudden weakness, paralysis or numbness of the face, arms, or legs, trouble speaking or understanding speech and trouble seeing. A stroke can cause lasting brain damage, long-term disability or even death.

If you think you or someone else is having a stroke, call 911 right away. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. During a stroke, every minute counts.

What should caregivers know about strokes

  • There are two types of stroke. Ischemic strokes occur when an artery to the brain is blocked by a blood clot or build-up of plaque and fatty deposits. Most strokes, approximately 87 percent, are ischemic. Hemorrhagic strokes occur when a blood vessel in the brain bursts, causing bleeding within the brain. Only about 13 percent of strokes are hemorrhagic, but they account for more than 30 percent of all stroke deaths.
  • Stroke is the fifth-highest cause of death in the United States, killing over 133,000 people annually.
  • Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability.
  • Approximately 795,000 strokes occur each year, 610,000 striking new victims while 185,000 are recurrent strokes.
  • Some factors increasing the risk of stroke are beyond control. The risk of stroke increases with age, doubling each decade after 55. Gender and race are also factors, with 55,000 more women than men suffering strokes each year and African-Americans having almost twice the risk of suffering a first stroke as whites. African Americans are also twice as likely to die from stroke as Caucasians, while African-American stroke survivors are more likely to become disabled and experience difficulties with daily living and activities.
  • Family history can also play a role, with strokes more common for people who have a close relative who has suffered a stroke or a family history of heart disease.
  • Other conditions that can be controlled also affect the risk of stroke. High blood pressure or hypertension, high cholesterol, heart disease and diabetes all increase the risk of stroke, as do being overweight and smoking cigarettes.

Warning signs of a stroke

The FAST system is an easy tool to use to check for signs of a possible stroke. The National Stroke Association described the system in its “Stroke 101 Fact Sheet”.

F = Face – Ask the person to smile. Does one side of the face droop?
A = Arms – Ask the person to raise both arms. Does one arm drift downward?
S = Speech – Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?
T = Time – If you observe any of these signs (independently or together), call 9-1-1 immediately.

Detecting a stroke quickly is vital, and awareness of the symptoms is particularly important for caregivers. The National Stroke Association noted that of the 795,000 people in the United States who suffer a stroke each year, nearly a quarter (185,000) have had a previous stroke. Identifying risks factors to avoid a second stroke during the recovery process is an important responsibility for caregivers.

What MetroWest caregivers should know

Quality care for stroke victims is close at hand. In 2002, the Massachusetts Department of Public Health initiated a program with the goal of improving stroke care in Massachusetts by specifying the requirements for a hospital to become a designated Primary Stroke Services.

PSS designation requires that hospitals follow very specific stroke protocols for patient assessment and care and commit to continuous education of the public about warning signs and symptoms of stroke. As part of its PSS designation, a hospital must provide emergency diagnostic and therapeutic services 24 hours-a-day, seven days-a-week to patients presenting with symptoms of acute stroke.

There are currently 70 hospitals in the state that have earned PSS designation, including a half dozen in the MetroWest area. Those include the MetroWest Medical Center’s Framingham Union Hospital and Leonard Morse Hospital in Natick, Marlborough HospitalMilford Regional Medical CenterBeth Israel Deaconess Hospital in Needham and Newton-Wellesley Hospital.

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