Stroke
Each year in the United States, there are more than 700,000 strokes. Stroke is the third leading cause of death in the country. And stroke causes more serious long-term disabilities than any other disease. Nearly three-quarters of all strokes occur in people over the age of 65 and the risk of having a stroke more than doubles each decade after the age of 55.
For African Americans, stroke is more common and more deadly - even in young and middle-aged adults - than for any ethnic or other racial group in the United States.
Learning about stroke can help you act in time to save a co-worker, friend, or relative. And making changes in your lifestyle can help you prevent stroke.
Why is Stroke an Emergency?
New treatments are available that greatly reduce the damage caused by a stroke. But you need to arrive at the hospital within 60 minutes after symptoms start to prevent disability. Knowing stroke symptoms, calling 911 immediately, and getting to a hospital are critical.
What is a stroke?
A stroke is serious - just like a heart attack. A stroke is sometimes called a "brain attack." Most often, stroke occurs when blood flow to the brain stops because it is blocked by a clot. The brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function.
What causes a stroke?
There are two kinds of stroke. The most common kind of stroke, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind of stroke, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain.
What disabilities can result from a stroke?
Stroke damage in the brain can affect the entire body - resulting in mild to severe disabilities. These include paralysis, problems with thinking, problems with speaking, and emotional problems.
Know the Signs. Act in Time
Stroke Symptoms
Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body)
Sudden confusion, trouble speaking or understanding speech
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden severe headache with no known cause
What should you do?
Because stroke injures the brain, you may not realize that you are having a stroke. The people around you might not know it either. Your family, friends, or neighbors may think you are confused. You may not be able to call 911 on your own. That's why everyone should know the signs of stroke - and know how to act fast.
Don't wait for the symptoms to improve or worsen. If you believe you are having a stroke - or someone you know is having a stroke - call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability.
For African Americans, stroke is more common and more deadly - even in young and middle-aged adults - than for any ethnic or other racial group in the United States.
Learning about stroke can help you act in time to save a co-worker, friend, or relative. And making changes in your lifestyle can help you prevent stroke.
Why is Stroke an Emergency?
New treatments are available that greatly reduce the damage caused by a stroke. But you need to arrive at the hospital within 60 minutes after symptoms start to prevent disability. Knowing stroke symptoms, calling 911 immediately, and getting to a hospital are critical.
What is a stroke?
A stroke is serious - just like a heart attack. A stroke is sometimes called a "brain attack." Most often, stroke occurs when blood flow to the brain stops because it is blocked by a clot. The brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function.
What causes a stroke?
There are two kinds of stroke. The most common kind of stroke, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind of stroke, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain.
What disabilities can result from a stroke?
Stroke damage in the brain can affect the entire body - resulting in mild to severe disabilities. These include paralysis, problems with thinking, problems with speaking, and emotional problems.
Know the Signs. Act in Time
Stroke Symptoms
Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body)
Sudden confusion, trouble speaking or understanding speech
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden severe headache with no known cause
What should you do?
Because stroke injures the brain, you may not realize that you are having a stroke. The people around you might not know it either. Your family, friends, or neighbors may think you are confused. You may not be able to call 911 on your own. That's why everyone should know the signs of stroke - and know how to act fast.
Don't wait for the symptoms to improve or worsen. If you believe you are having a stroke - or someone you know is having a stroke - call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability.
What can you do to prevent a stroke?
While family history of stroke plays a role in your risk, there are many risk factors you can control.
If you have high blood pressure, work with your doctor to get it under control. Many people do not realize they have high blood pressure, which usually produces no symptoms but is a major risk factor for heart disease and stroke. Managing your high blood pressure is the most important thing you can do to avoid stroke.
If you smoke, quit.
If you have diabetes, learn how to manage it. As with high blood pressure, diabetes usually causes no symptoms but it increases the chance of stroke.
If you are overweight, start maintaining a healthy diet and exercising regularly.
WHY IS STROKE TREATMENT URGENT?
Every minute counts. The longer blood flow is cut off to the brain, the greater the damage. The most common kind of stroke, ischemic stroke, can be treated with a drug that dissolves clots blocking the blood flow. The window of opportunity to start treating stroke patients is three hours. But a person needs to be at the hospital within 60 minutes of having a stroke to be evaluated and receive treatment.
While family history of stroke plays a role in your risk, there are many risk factors you can control.
If you have high blood pressure, work with your doctor to get it under control. Many people do not realize they have high blood pressure, which usually produces no symptoms but is a major risk factor for heart disease and stroke. Managing your high blood pressure is the most important thing you can do to avoid stroke.
If you smoke, quit.
If you have diabetes, learn how to manage it. As with high blood pressure, diabetes usually causes no symptoms but it increases the chance of stroke.
If you are overweight, start maintaining a healthy diet and exercising regularly.
WHY IS STROKE TREATMENT URGENT?
Every minute counts. The longer blood flow is cut off to the brain, the greater the damage. The most common kind of stroke, ischemic stroke, can be treated with a drug that dissolves clots blocking the blood flow. The window of opportunity to start treating stroke patients is three hours. But a person needs to be at the hospital within 60 minutes of having a stroke to be evaluated and receive treatment.
A study in the March 6, 2004, issue of The Lancet ¹ confirms the benefits of getting stroke patients to the hospital quickly for rapid thrombolytic treatment. The study provides the results of an extensive analysis of more than 2,700 stroke patients in six controlled clinical trials who were randomized for treatment with thrombolytic t-PA or a placebo.
While physicians have known since a breakthrough study in 1995 that early treatment with thrombolytics can improve a stroke patient's chance of a full recovery, only an estimated 2 to 5 percent of all eligible acute stroke patients in the U.S. are being treated with thrombolytics.
Stroke patients who were treated within 90 minutes of the onset of their symptoms showed the most improvement. The study suggests that t-PA given up to 4 hours after the onset of symptoms may be of benefit, but the authors caution that as time goes on there is a diminishing effect of treatment, and there is estimated to be almost no benefit when treatment is at 6 hours.
"Once again we learn that time is brain," said John R. Marler, M.D., one of the study authors and associate director for clinical trials at the National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health (NIH). "Although rapid stroke treatment presents a great challenge to physicians and may require substantial change in many health care systems, we now have stronger evidence that rapid early treatment offers the best chance of recovery for acute ischemic stroke patients."
Thrombolytics work as "clot busters," breaking up the clot that appears in the brain during an ischemic stroke, and allowing blood to flow freely again in the occluded or blocked artery. Patients must have computerized tomography (CT) scans of the brain taken before treatment begins to confirm that the stroke is caused by a clot. Seventy-five percent of patients who were treated within 60 minutes of stroke onset had the best chance of having a complete or partial reopening of the occluded artery.
Another significant finding reported by the authors is that severe stroke patients tend to present to the hospital earlier than patients with milder strokes, and those who were treated had much better recoveries than patients who were given a placebo. This means that the greatest effect of early treatment was seen in the group with the most to gain in terms of reducing long-term disability.
"This study confirms that door-to-needle time is just as critical in stroke as it is in heart attack. We need to work on breaking down the current barriers to rapid stroke treatment," said Story C. Landis, Ph.D., NINDS director.
The pooled data from the trials - two of which were sponsored by pharmaceutical companies and one that was by the NIH - represent the work of 16 teams of researchers and several statisticians around the world. "This scientific work is a good example of a cooperative effort between the Federal Government and the pharmaceutical industry," said NIH Director Elias A. Zerhouni, M.D. "By sharing these important data, the scientists have advanced our understanding of stroke treatment, which we hope will lead to significant improvements in treating this major disease."
In 1995, the NINDS t-PA Study Group published the results of two randomized clinical trials with more than 600 patients that showed a clear benefit of t-PA in stroke patients treated within 3 hours of onset and a diminishing effect for patients treated later than that. [The U.S. Food and Drug Administration (FDA) approved t-PA as a treatment for acute stroke in June of 1996, with the restriction that treatment begin within 3 hours of the stroke onset.]
Two other groups have conducted large randomized trials of t-PA for stroke, using longer windows of treatment. The European Cooperative Acute Stroke Study (ECASS) conducted two trials using a 6-hour window and the Alteplase ThromboLysis for Acute Noninterventional Therapy in Ischemic Stroke (ATLANTIS) investigators conducted two trials with treatment windows of 5 and 6 hours each. The investigators from the three studies collaborated to test the hypothesis that pooling their patient data would show the importance of time to treatment, and their results appear in The Lancet .
To measure favorable outcome at 3 months, investigators used various neurological scales to measure post-stroke disability. They also looked at the occurrence of hemorrhage, the primary risk of t-PA use. The final analysis included 2,775 patients treated at 300 hospitals from 18 countries. The median age was 68 years and the median time of "onset to treatment" was 243 minutes. Substantial intracerebral hemorrhage occurred in 5.9% of the treated patients as compared to 1.1% of placebo patients.
Although the data in The Lancet paper suggest that the beneficial effect of t-PA may extend beyond 3 hours (from 181 to 270 minutes), the authors caution that large prospective randomized trials would be required to confirm this finding and that this does not justify any delays in treatment. The ATLANTIS trial enrolled 79% of patients in the 4-5 hour window and failed to demonstrate efficacy.
"The most appropriate interval for beginning thrombolytic treatment remains to be clarified," the authors write in The Lancet ; however they urge those in the health care system, from paramedics to physicians, to set a target of 1 hour after arrival in the emergency room to begin intravenous thrombolytic treatment for patients with acute ischemic stroke.
The ATLANTIS trial was funded by Genentech, Inc., the makers of t-PA. The ECASS trial was funded by Boehringer Ingelheim Pharmaceuticals, which markets t-PA in Europe. The NINDS trials were funded by the NIH. Genentech provided the study drug and additional study monitoring as required by the FDA.
The NINDS is a component of the National Institutes of Health within the Department of Health and Human Services and is the nation's primary supporter of biomedical research on the brain and nervous system.
¹Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials." Authors: The ATLANTIS, ECASS and NINDS r-t-PA Study Group Investigators. The Lancet , March 6, 2004, Vol. 363, pp. 768-774.
While physicians have known since a breakthrough study in 1995 that early treatment with thrombolytics can improve a stroke patient's chance of a full recovery, only an estimated 2 to 5 percent of all eligible acute stroke patients in the U.S. are being treated with thrombolytics.
Stroke patients who were treated within 90 minutes of the onset of their symptoms showed the most improvement. The study suggests that t-PA given up to 4 hours after the onset of symptoms may be of benefit, but the authors caution that as time goes on there is a diminishing effect of treatment, and there is estimated to be almost no benefit when treatment is at 6 hours.
"Once again we learn that time is brain," said John R. Marler, M.D., one of the study authors and associate director for clinical trials at the National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health (NIH). "Although rapid stroke treatment presents a great challenge to physicians and may require substantial change in many health care systems, we now have stronger evidence that rapid early treatment offers the best chance of recovery for acute ischemic stroke patients."
Thrombolytics work as "clot busters," breaking up the clot that appears in the brain during an ischemic stroke, and allowing blood to flow freely again in the occluded or blocked artery. Patients must have computerized tomography (CT) scans of the brain taken before treatment begins to confirm that the stroke is caused by a clot. Seventy-five percent of patients who were treated within 60 minutes of stroke onset had the best chance of having a complete or partial reopening of the occluded artery.
Another significant finding reported by the authors is that severe stroke patients tend to present to the hospital earlier than patients with milder strokes, and those who were treated had much better recoveries than patients who were given a placebo. This means that the greatest effect of early treatment was seen in the group with the most to gain in terms of reducing long-term disability.
"This study confirms that door-to-needle time is just as critical in stroke as it is in heart attack. We need to work on breaking down the current barriers to rapid stroke treatment," said Story C. Landis, Ph.D., NINDS director.
The pooled data from the trials - two of which were sponsored by pharmaceutical companies and one that was by the NIH - represent the work of 16 teams of researchers and several statisticians around the world. "This scientific work is a good example of a cooperative effort between the Federal Government and the pharmaceutical industry," said NIH Director Elias A. Zerhouni, M.D. "By sharing these important data, the scientists have advanced our understanding of stroke treatment, which we hope will lead to significant improvements in treating this major disease."
In 1995, the NINDS t-PA Study Group published the results of two randomized clinical trials with more than 600 patients that showed a clear benefit of t-PA in stroke patients treated within 3 hours of onset and a diminishing effect for patients treated later than that. [The U.S. Food and Drug Administration (FDA) approved t-PA as a treatment for acute stroke in June of 1996, with the restriction that treatment begin within 3 hours of the stroke onset.]
Two other groups have conducted large randomized trials of t-PA for stroke, using longer windows of treatment. The European Cooperative Acute Stroke Study (ECASS) conducted two trials using a 6-hour window and the Alteplase ThromboLysis for Acute Noninterventional Therapy in Ischemic Stroke (ATLANTIS) investigators conducted two trials with treatment windows of 5 and 6 hours each. The investigators from the three studies collaborated to test the hypothesis that pooling their patient data would show the importance of time to treatment, and their results appear in The Lancet .
To measure favorable outcome at 3 months, investigators used various neurological scales to measure post-stroke disability. They also looked at the occurrence of hemorrhage, the primary risk of t-PA use. The final analysis included 2,775 patients treated at 300 hospitals from 18 countries. The median age was 68 years and the median time of "onset to treatment" was 243 minutes. Substantial intracerebral hemorrhage occurred in 5.9% of the treated patients as compared to 1.1% of placebo patients.
Although the data in The Lancet paper suggest that the beneficial effect of t-PA may extend beyond 3 hours (from 181 to 270 minutes), the authors caution that large prospective randomized trials would be required to confirm this finding and that this does not justify any delays in treatment. The ATLANTIS trial enrolled 79% of patients in the 4-5 hour window and failed to demonstrate efficacy.
"The most appropriate interval for beginning thrombolytic treatment remains to be clarified," the authors write in The Lancet ; however they urge those in the health care system, from paramedics to physicians, to set a target of 1 hour after arrival in the emergency room to begin intravenous thrombolytic treatment for patients with acute ischemic stroke.
The ATLANTIS trial was funded by Genentech, Inc., the makers of t-PA. The ECASS trial was funded by Boehringer Ingelheim Pharmaceuticals, which markets t-PA in Europe. The NINDS trials were funded by the NIH. Genentech provided the study drug and additional study monitoring as required by the FDA.
The NINDS is a component of the National Institutes of Health within the Department of Health and Human Services and is the nation's primary supporter of biomedical research on the brain and nervous system.
¹Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials." Authors: The ATLANTIS, ECASS and NINDS r-t-PA Study Group Investigators. The Lancet , March 6, 2004, Vol. 363, pp. 768-774.
2 comments:
My son 23 has been a victim of Chronic SCHIZENCEPHALY for many years. I am excited to share this testimony as i have been sad and confused for the past 23 years of my son been a victim of SCHIZENCEPHALY. Anti-psychotic medicine they induce psychosis, never helped rather worsened the situation, Homeopathy medication is good but has a lot of limitation too. I looked for solution everywhere all to no avail until I contacted a Herbal Doctor whose medicine works perfectly for him, my son situation has greatly improved which is what I have always wanted. If you have related problem, don't lose hope, contact him (ronniemd70@gmail.com)
I don’t want people to feel sorry for me, that’s not why I am writing this post. My child six years ago, was born with Bi-lateral closed lip schizepcephaly, which is even more unique than the regular cases. Due to this disability, she also developed Cerebral Palsy affecting the left side of her body. We’ve learned the part of her brain which has been affected has also impaired her ability to reason. We’ve been lucky so far though it affects everyone differently and she had been on the very mild side of everything. Another thing we had to dealt with much are seizures. She was highly prone to having one or multiples and we’ve seemed to look out with some petite mals when she was younger and they occurred in her sleep more than any other time.
Luckily, everything seemed to be okay after she took an Herbal Medicine. I wish I could say that’s the end of it because she havn't had any symptoms since then.
Having a child with special needs is difficult. You sit living in fear of the reality your child may face, never really knowing what will happen until it does. Do not expose yourself to more danger, use a herbal remedy that is safe and effective. If interested contact him:
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