Stroke: A Speaker’s Outline

1. Stroke: A Speaker’s Outline Developed by: The American Stroke Association Updated 4.19.2011

2. What Is a Stroke? A brain injury caused when a blood vessel to the brain becomes blocked our bursts, cutting off blood flow

3. What Is Stroke’s Impact? • Stroke is the third leading cause of death in the United States • About 795,000 Americans suffer a stroke each year (that’s a stroke every 40 seconds) • 77% are new strokes and 23% are recurrent strokes • Stroke kills more than 137,000 people in a year. ( that’s a death every 4 minutes)

4. What Is Stroke’s Impact? (cont’d) • Stroke is a leading cause of serious, long-term disability • 40% of Stroke deaths occur in males, and 60% in females. • Americans paid about $73.7 billion for stroke-related medical costs in 2010

5. What Are the Types of Stroke? • Ischemic (Blockage) 87% Caused by a blockage in the blood vessels to the brain • Hemorrhagic (Bleeding) 13% Caused by burst or leaking blood vessels in the brain

6. What Causes Ischemic Stroke ? • Fatty deposits line the blood vessel wall • Thrombus: A blood clot forms at the fatty deposit • Embolus: A travelingparticle gets stuck in a small vessel

7. Clot-caused Stroke by Age, Sex and Race Annual rate of first cerebral infarction by age, sex and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94). Source: Unpublished data from the GC/NKSS; Kissela et al., Stroke. 2004;35:426-31.

8. What Causes Hemorrhagic Strokes? A weakened blood vessel ruptures • Aneurysms: Ballooning of a weakened spot of a blood vessel • Arteriovenous Malformations (AVMs): Cluster of abnormal blood vessels

9. Hemorrhagic Stroke by Age, Sex and Race Annual rate of first intracerebral hemorrhage by age, sex and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94).Source: Kissela et al., Stroke. 2004;35:426-31.

10. What Parts of theBrain Can Stroke Affect?

11. What Are the Effects of Stroke? • Right Brain

12. What Are the Effects of Stroke? • Left Brain

13. Stroke Warning Signs • Sudden weakness or numbness of the face, arm or leg, especially on one sideof the body • Sudden confusion, trouble speaking or understanding • Sudden trouble seeing in one or both eyes • Sudden trouble walking, dizziness, loss of balance or coordination • Sudden, severe headaches with no known cause

14. Learn to recognize a stroke.Time lost is brain lost. • If you notice one or more of the stroke warning signs, GET HELP IMMEDIATELY! • Stroke is an emergency – CALL 9-1-1.

15. Transient Ischemic Attacks(TIAs) • TIAs are “warning strokes” that can happen before a major stroke • They occur when blood flow through a brain artery is briefly blocked or reduced

16. Transient Ischemic Attacks(TIAs) • TIA symptoms are temporary but similar to those of a full-fledged stroke • A person who has a TIA is 9.5 times more likely to have a stroke • A TIA is a medical emergency

17. Age Heredity (family history) and race Sex (gender) Prior stroke, TIA or heart attack Stroke Risk Factors That Cannot Be Treated

18. Stroke Prevalence by Age & Sex Prevalence of stroke by age and sex(NHANES: 1999-2004). Source: NCHS and NHLBI.

19. Stroke Risk FactorsThat Can Be Treated • High blood pressure • Tobacco use • Diabetes • Carotid or other artery disease • Atrial fibrillation • Other heart disease

20. Stroke Risk FactorsThat Can Be Treated (cont’d) • Sickle Cell Disease (Sickle Cell Anemia) • High blood cholesterol • Poor diet • Physical inactivity • Obesity

21. Stroke Risk by Levelsof Risk Factors A B C D E F Systolic BP* 95-105 130-148 130-148 130-148 130-148 130-148 Diabetes No No Yes Yes Yes Yes Cigarettes No No No Yes Yes Yes Prior Atrial Fib. No No No No Yes Yes Prior CVD No No No No No Yes Estimated 10-year stroke risk in 55-year-old adults according to levels of various risk factors (FHS). Source: Wolf et al., Stroke.1991;22:312-318.

22. Less Well-Documented Stroke Risk Factors • Geographical location • Socioeconomic factors • Excessive alcohol intake • Certain kinds of drug abuse

23. How Can You ReduceYour Risk of Stroke? • Control high blood pressure • Don’t smoke • Consume less sodium • Lower cholesterol • Lose excess weight • Be physically active

24. Other Actions That Will ProbablyReduce Stroke Risk • Limit alcohol intake • Don’t use illicit drugs • Women who smoke or have a history of blood clots should not take oral contraceptives • Look for signs of sleep-disordered breathing

25. How Are Strokes Treated? • Ischemic Stroke • Acute treatment • Clot-buster, e.g., t-PA • Interventional procedures • Preventive treatment • Anticoagulants (warfarin) • Antiplatelet agents (aspirin) • Carotid endarterectomy • Angioplasty/stents • Hemorrhagic Stroke • Surgery • Endovascular procedures, e.g., “coils”

26. Rehabilitation • If you have a stroke, start a rehabilitation program as soonas you can • Rehabilitation may focus on: • Self-care • Mobility      • Communication • Cognitive skills • Social skills

27. Types of Rehabilitation Programs • Acute care and rehabilitation hospitals • Long-term nursing care facilities    • At home, through home health agencies          • Outpatient facilities

28. Physicians Rehabilitation nurses Physical therapists Speech/language therapists Rehabilitation Specialists

29. Rehabilitation Specialists (cont’d) • Audiologists • Occupational therapists • Physiatrists • Psychologists / psychiatrists

30. Are you a stroke survivor, caregiver, family member or healthcare provider who needs information about stroke?

31. Subscribe to Stroke Connection Magazine Call 1-888-4-STROKE or visit strokeassociation.org for a FREE subscription.

32. To Learn More About Stroke… CALL 1-888-4-STROKE (1-888-478-7653) Or visit us online at StrokeAssociation.org