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Am Fam Physician. 2009;80(1):online

See related article on stroke.

What are stroke and transient (TRAN-see-ent) ischemic (eh-SKEE-mick) attack?

A stroke is like a “brain attack.” In a heart attack, not enough blood gets to the heart. In a stroke, not enough blood gets to the brain. Parts of the brain can die during a stroke if blood is cut off for more than a couple of hours. If the blood is cut off for a shorter time, stroke symptoms like weakness, numbness, or trouble speaking may clear up within a few hours. This is called a transient ischemic attack (TIA), rather than a stroke.

Who gets them and why?

Stroke and TIA happen when a part of the brain doesn't get enough oxygen and nutrients. Most people with stroke or TIA have a blockage in one of their blood vessels that stops the flow of blood to part of their brain, usually because of a blood clot. Some of the things that increase your risk of stroke and TIA include smoking, diabetes, high blood pressure, high cholesterol, an abnormal heart rhythm, being older than 55 years, and a family history of stroke or TIA.

What are the signs and symptoms?

The following guide can help you figure out if someone is having a stroke: “Give Me 5 for Stroke: Walk, Talk, Reach, See, and Feel.”

  • Walk: Is the person's balance off?

  • Talk: Is the person's speech slurred or face droopy?

  • Reach: Is one side of the body weak or numb?

  • See: Is the person's vision all or partially lost?

  • Feel: Is the person's headache severe?

You should also remember the five sudden warning signs of stroke:

  • Sudden numbness or weakness of face, arm, or leg, especially on one side of the body

  • Sudden confusion, trouble speaking, or understanding

  • Sudden trouble seeing in one or both eyes

  • Sudden trouble walking, dizziness, or loss of balance or coordination

  • Sudden severe headache with no known cause

If you think you or a loved may be having a stroke, call 9-1-1 right away. Your doctor will examine you and may order more tests.

How is it treated?

The goals for treating stroke and TIA are to restore normal blood flow to the brain, stop complications, and prevent another stroke.

If you are treated within three hours after your symptoms start, you could get a medicine to dissolve the blood clot in your brain. This treatment can help reverse symptoms of stroke, but it does have a risk of too much bleeding. You may also receive medicine to decrease blood clotting, to lower your cholesterol, and to lower your blood pressure.

Most people will get better after stroke and TIA, especially with early treatment. If your stroke is severe enough, you may need physical and speech therapy at home or in a hospital. After stroke, you may need extra help at home with normal activities and with driving.

Where can I get more information?

American Academy of Family Physicians

National Institute of Neurological Disorders and Stroke

The Stroke Collaborative

  • Web site: http://www.giveme5forstroke.com

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