Understanding the Alarming Prevalence of Strokes in the United States
Strokes stand as a leading cause of death across the United States, with nearly 800,000 individuals experiencing one each year. On average, a stroke occurs every 40 seconds in the country, making these statistics both jarring and frightening. This is especially true for people with a family history of stroke or those who have risk factors such as high blood pressure and certain heart conditions.
However, you can empower yourself with knowledge to recognize stroke symptoms, understand the associated risk factors, and ultimately take steps to protect yourself from experiencing one altogether. According to Dr. Brandon Giglio, the director of vascular neurology at NYU Langone Hospital—Brooklyn, approximately 85% of strokes in the United States are ischemic strokes, meaning they result from a lack of blood flow to the brain. About 15% are hemorrhagic strokes, which occur when a blood vessel ruptures in the brain.
Among those who suffer strokes, many also experience what is known as a warning stroke in the days, weeks, or months beforehand. Here is what you need to know about these critical precursors.
What Exactly Are Warning Strokes?
Warning strokes are medically referred to as transient ischemic attacks. Unbeknownst to most people outside the medical field, warning strokes are a fleeting yet very dangerous medical condition that can serve as precursors to full-blown strokes.
In fact, up to 1 in 5 individuals who experience a warning stroke could have a stroke within 90 days if they do not receive medical attention, according to Dr. Ahmed Itrat, the stroke medical director at Cleveland Clinic Akron General.
So, what precisely is a warning stroke? Medically, it is defined as a transient ischemic attack that causes sudden-onset transient symptoms of neurological injury which resolve on their own, as explained by Dr. Itrat. These symptoms may be similar to what one would consider a stroke, but the only difference is they do not lead to a permanent neurological injury.
In other words, transient ischemic attacks come on quickly, last for a short time, and do not result in the type of brain damage associated with full-fledged strokes. However, the lack of potential brain damage does not mean you should ignore a transient ischemic attack. It is still a medical condition that needs to be taken seriously, Dr. Giglio emphasized. It really is a harbinger in many people for someone who is going to have a stroke even within the next 48 hours and certainly within the next seven, 30, 90 days, he said.
The Importance of Terminology and Recognizing Symptoms
Transient ischemic attacks are also commonly referred to as ministrokes. But Dr. Joshua Willey, a stroke neurology expert at Columbia University’s Vagelos College of Physicians and Surgeons, noted that this problematic term minimizes the emergent nature of the condition. The phrase warning strokes, on the other hand, highlights that this condition is an emergency, just like a regular stroke, he explained. The signs of transient ischemic attacks and strokes are identical.
I would say that basically all the same signs and symptoms of a stroke are the signs and symptoms of a transient ischemic attack, Dr. Giglio stated.
All three experts who spoke with HuffPost referred to BE FAST as a widely accepted mnemonic device detailing the signs of stroke. And as the acronym suggests, these symptoms come on quickly, Dr. Giglio added.
Here is what BE FAST means:
- Balance — changes in balance or a loss of balance.
- Eyesight — changes in vision, such as blurriness, loss of sight, or double vision.
- Facial droop — drooping of the face or an uneven smile.
- Arm — arm weakness on one side of the body.
- Speech — changes in speech, like slurring words or speaking gibberish.
- Time — it is time to call emergency services. According to Dr. Willey, the t can also stand for the terrible headache that comes on fast.
You could have all of those symptoms, you could have one of those symptoms or any mixture in between, Dr. Giglio said. So, do not wait around for more than one sign. If you notice any of these issues, go to the emergency room immediately.
Why Symptoms Are Often Dismissed and the Urgency of Action
Many people dismiss the signs of a transient ischemic attack because of how quickly they go away, according to all three experts. But it is crucial to take these symptoms seriously, no matter their brevity. While there is no hard-and-fast rule for exactly how long they might persist, there are general guidelines. Typically, we have come to recognize that transient ischemic attacks probably last, at most, 5 minutes [or] 10 minutes and certainly less than an hour, Dr. Willey said. He added that warning strokes could last for just 30 to 60 seconds.
That means you should not minimize a minute of arm soreness or blurred vision. Even though, by definition, transient ischemic attacks are transient, when a person is having symptoms there is no way to predict whether that is going to be resolving down the road or the symptoms are going to persist and lead to a disability, Dr. Itrat explained.
You should call for help if you experience any symptoms. As soon as you notice any signs, you should call emergency medical services rather than wait for the symptoms to go away—because they may not resolve. If someone has any of those signs and they were abrupt in onset, I would advise them to go to the nearest emergency room, Dr. Giglio stated.
Dr. Willey added that once you are there, you should escalate your situation and let the medical staff know that you think you may have had a stroke. In other words, do not beat around the bush or discount your symptoms. A warning stroke is an emergency and should be treated as such. Communicating with nurses and doctors effectively will let them know you need to be treated quickly.
Additionally, Dr. Willey said if you do not feel comfortable going to the emergency room, you should see your doctor or cardiologist as soon as possible. And that does not mean in a week; it means, truly, as soon as possible. It is important to remember that many people who experience a transient ischemic attack will have a stroke within 48 hours, so waiting any amount of time is not ideal.
Reducing Your Risk of Stroke and Warning Strokes
Conditions like high cholesterol and uncontrolled diabetes put you at increased risk for stroke, according to Dr. Itrat. It is essential to talk to your doctor if you have any of these conditions and ensure you are managing them effectively. This could mean making some lifestyle changes, Dr. Giglio added.
You may need to increase your physical activity, quit smoking, alter your diet, or take medications for issues like high blood pressure, as recommended by the Centers for Disease Control and Prevention.
If you do find yourself experiencing any of the relevant symptoms, it is vital not to ignore them. There is an urgent need for the public to understand the signs and symptoms of stroke, and what to do, Dr. Willey emphasized. Unfortunately, he added, many people wait too long to seek treatment for stroke and warning stroke.
Strokes are very common in the U.S., so be sure to understand the symptoms and immediately alert a medical professional if you or a loved one suffers from a transient ischemic attack.
