In the United States, strokes kill almost 130,000 Americans a year, accounting for 1 in 18 deaths (Brain Injury Alliance of Colorado, 2018). Timewise, this amounts to every 4 minutes that one American dies from stroke (Brain Injury Alliance of Colorado, 2018). Stroke is the leading cause of serious long-term disability (Brain Injury Alliance of Colorado, 2018). That is to say that strokes, as with other brain injuries, are serious public health concerns.
Stroke and Acquired Brain Injuries
Strokes are acquired brain injuries – brain injuries received after birth and are not hereditary, congenital, or degenerative (Brain Injury Alliance of Colorado, 2018). Acquired brain injuries can include traumatic brain injury, or when external forces impact the head or neck, anoxic/hypoxic injuries (e.g., cardiac arrest, CO poisoning, hemorrhage, drowning), intracranial surgery, infectious diseases, seizure disorders, toxic exposure (substance use, inhalation of volatile agents), and vascular obstruction (Stroke) (Brain Injury Alliance of Colorado, 2018).
What is a Stroke?
Every year, more than 900,000 people in the United States have a stroke, or every 40 seconds, and the majority of these are due to first or new strokes. The rest are due to recurrent strokes (Pate Rehabilitation, 2020; Brain Injury Alliance of Colorado, 2018). A stroke occurs when a blood clot blocks an artery or when a blood vessel within our brain breaks. These interrupt blood flow to areas of the brain, causing brain cells to die and damage to occur (Brain Injury Alliance of Colorado, 2018). Cell death is serious due to its consequences: it results in the abilities of the area of the brain to be lost. These abilities can look like speech, movement, and memory capabilities. How a person is affected depends on where and how the brain has been damaged (Brain Injury Alliance of Colorado, 2018). Disability after stroke is a spectrum: people with small strokes may have weakness in their arms or legs, but people with larger strokes may be paralyzed on one side or lose their ability to speak (Brain Injury Alliance of Colorado, 2018). About 15% die shortly after, 25% have mild impairments, 40% have moderate to severe impairment requiring special care, and 10% require long-term care facilities (Pate Rehabilitation, 2020). Unfortunately, more than ⅔ of stroke survivors will have some sort of disability, and some people may never recover at all (Brain Injury Alliance of Colorado, 2018). Because of this, strokes have a high burden, not only to the survivor but also to caregivers and the medical system. It is estimated that strokes cost the United States $54 billion each year, including the cost of health care services, medications, and missed workdays (Brain Injury Alliance of Colorado, 2018).
Types of Strokes
There are different types of strokes:
1. Ischemic: Ischemic strokes, also known as “infarct” strokes, are the most common stroke type. They account for 87% of all strokes (Brain Injury Alliance of Colorado, 2018). These strokes occur when there is inadequate or blocked vessel blood flow to the brain, causing brain cells surrounding the vessel to die due to oxygen deprivation (Pate Rehabilitation, 2020).
Another subtype of ischemic strokes is transient ischemic attack (TIA) strokes or mini-strokes. During this type of ischemic stroke, the blockage in the blood vessel(s) is temporary, with symptoms residing within a few hours. These strokes still are serious because they indicate an underlying issue or condition within the body and can develop into a full stroke (Pate Rehabilitation, 2020). Emergency treatment is still necessary and must be administered within the first three hours to combat long-term stroke and lessen the extent of brain injury (Pate Rehabilitation, 2020).
2. Hemorrhagic: Hemorrhagic strokes account for 13% of all strokes. They occur when a brain blood vessel bursts and bleeds on surrounding brain tissue. This can be due to trauma or an aneurysm and arteriovenous malformations (Pate Rehabilitation, 2020; American Heart Association, 2021).
Stroke Warning Signs
The four main symptoms of a stroke are:
- Sudden weakness
- Paralysis or numbness of the face, arms, or legs
- Trouble speaking or understanding speech
- Trouble seeing (Centre for Neuro Skills, 2021)
A person experiencing a stroke will have a drooping face, making it difficult for them to smiles, the inability to fully lift their arms, difficulty speaking, and slurred speech (Headway, 20
21). If these symptoms are present, it is crucial to call 911.
Strokes, regardless of their severity, are medical conditions that require emergency care. An ambulance should be called so that medical personnel can conduct life-saving treatment because every minute counts with strokes. Getting care as soon as possible can curb the amount of brain damage, long-term disability, or the possibility of death (Centre for Neuro Skills, 2021).
Stroke Risk Factors
Risk factors for stroke include:
- Family history
- High blood pressure (hypertension)
- High cholesterol
- Heart disease
- Tobacco use
- Previous stroke or TIA
- Sickle cell disease
- Age (over age 65 males are at higher risk than females)
After a person has a stroke, rehabilitation is imperative. First, the person must be stabilized medically. After, they would undergo acute rehabilitation, which has been shown to increase recovery capabilities and minimize the probability of functional disability (Pate Rehabilitation, 2020). The length of stay in acute rehabilitation depends on the stroke severity (same for post-acute rehabilitation), motivation, treatment skills of practitioners, socio-support, and more (Pate Rehabilitation, 2020).
Power of Patients and Stroke Rehabilitation
If you or someone you can care for has had a stroke, Power of Patients can provide support during your rehabilitation and recovery process. Our free, personalized symptom tracker can help stroke patients track the progress of their symptoms and condition and provide user-controlled data to report back to their healthcare practitioners. What are you waiting for? Join the other stroke survivors and caregivers in getting closer to their recovery at powerofpatients.com.
American Heart Association. (2021). Hemorrhagic Strokes (bleeds). Retrieved May 10, 2021, from https://www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds
Brain Injury Alliance of Colorado. (2018, August 22). Brain injury Facts & Figures. Retrieved May 10, 2021, from https://biacolorado.org/brain-injury-facts-figures/
Centre for Neuro Skills. (2021). What is Stroke. Retrieved May 10, 2021, from https://www.neuroskills.com/brain-injury/stroke/what-is-stroke/
Headway. (2021). Stroke. Retrieved May 10, 2021, from https://www.headway.org.uk/about-brain-injury/individuals/types-of-brain-injury/stroke/
Pate Rehabilitation. (2020, November 30). Stroke and Brain Injury Facts. Retrieved May 10, 2021, from https://www.paterehab.com/about-abi/stroke-brain-injury/