What do you know about stroke?

Date JUNE 7, 2022

 

Did you know that June is Stroke Awareness Month?

June is dedicated to stroke awareness. It's an opportunity to make as many people as possible aware of the dangers of this serious condition and the importance of prompt intervention when it occurs. (Hayward, 2017)

 

Did you know that, according to the Montreal Neurological Hospital Institute, in Canada, a stroke occurs every 10 minutes? Of these, approximately 14,000 Canadians die each year, making it the third leading cause of death among Canadians. (Hayward, 2017)

 

What exactly is a stroke?

A stroke is a sudden neurological deficit of vascular origin caused by an infarction or hemorrhage in the brain. This stops the flow of blood to the brain. The term “accident” emphasizes the sudden or abrupt nature of the symptoms.

 

Blood flow to the brain is essential, because...

 

The brain needs a constant supply of oxygen and nutrients to function properly. (Johns Hopkins Medicine, n.d.) In turn, cell death can lead to lasting brain damage, long-term disability and even death. (Centers for Disease Control and Prevention, 2022)

 

Is there a difference between a stroke and a heart attack?

Yes, there is! Stroke and heart attack are two very different disorders, because they don't affect the same organ. Stroke is caused by a blockage or rupture of a blood vessel in the brain. Myocardial infarction (heart attack), on the other hand, is caused by blockage of the coronary arteries, preventing sufficient oxygen from reaching the heart (Brunet, n.d.).

 

Is there more than one type of stroke?

Yes, there are three types of stroke.

 

Ischemic stroke

Ischemia refers to the interruption of blood flow to an organ (OQLF, 1999). Stroke is considered ischemic when it is caused by a blood clot blocking a blood vessel in the brain. In fact, this is the most common type of stroke. (Heart and Stroke Foundation, n.d.(a))

 

Hemorrhagic stroke

Hemorrhage refers to a flow of blood out of the blood vessels. (OQLF, 2019) A stroke is therefore described as hemorrhagic when it is caused by a rupture of an artery in the brain. (Heart and Stroke Foundation, n.d.(a))

 

Mini stroke

Strictly speaking, a mini-stroke is not a stroke. Rather, it is a Transient Ischemic Attack (TIA). A TIA is an impairment of cerebral function due to a temporary interruption of blood supply to the brain, usually lasting less than an hour (Chong, 2020).

 

The causes and symptoms of TIA and ischemic stroke are identical. However, unlike stroke, TIA does not appear to cause permanent brain damage. Indeed, TIA symptoms disappear completely and rapidly, and the number of brain cells that die is very limited, if not non-existent. In other words, the clot blocks the artery for less than an hour, and circulation eventually re-establishes itself without the need for medical intervention.

 

It should not, however, be underestimated or ignored. TIA can be a premonitory sign of an impending ischemic stroke. Recognizing a TIA, identifying its cause and treating it can help prevent a stroke. (Chong, 2020)

 

What happens during a stroke?

The symptoms

The main signs and symptoms of stroke and TIA are the same for men and women. To identify them, ask yourself if the victim has one or more of the following signs:

 

Face - Is the face drooping? Is there a deformity of the mouth?

 

Incapacity - Can the victim raise both arms at the same time?

 

Speech impediment - Does the victim have a speech or pronunciation impediment?

 

Extreme urgency - Call pre-hospital emergency services (9-1-1) as soon as possible.

 

(Source: Heart and Stroke Foundation, 2021)

 

Although the VITE signs are the most common, they are not the only ones. The following signs are less common, but can also be precursors to a stroke or TIA:

  • Sudden, intense headaches with no apparent cause. They resemble sudden migraines and are accompanied by other symptoms.
  • Numbness or weakness generally localized on one side of the body, but may also be confined to the face or leg.
  • Blurred or double vision, or loss of vision in one or both eyes.
  • Dizziness causing sudden difficulty in walking, loss of balance or lack of coordination.

(Heart and Stroke Foundation, 2021)

 

In case of symptoms

  • Stop all activity, loosen clothing and place the victim in a comfortable position.
  • Cover with a warm blanket or aluminum foil.
  • Call 9-1-1 immediately.
  • Reassess vital signs regularly.
  • Whether symptoms are persistent (stroke) or disappear rapidly (TIA), it's essential to follow the same procedure.

 

Treatment

Stroke treatment begins as soon as the pre-hospital emergency services arrive at your home. On arrival at the hospital, the medical team has three objectives:

  • Stabilize your condition (breathing, heart function, blood pressure, bleeding, etc.)
  • Make a diagnosis (TIA, ischemic stroke or hemorrhagic stroke).
  • Implement treatment according to the type of stroke.

(Heart and Stroke Foundation, n.d.(c))

 

In case of ischemic stroke :

If the victim goes to hospital within three hours of the onset of the first symptoms, he or she can have a type of medication called a thrombolytic, which breaks up clots. Those who receive this medication are more likely to make a full recovery from the stroke, and are also less likely to need long-term care.

 

If the victim goes to hospital after three hours, professionals may administer other drugs, such as anticoagulants, or perform surgery to remove the clot.

 

(Centers for Disease Control and Prevention, 2022)

 

In case of hemorrhagic stroke:

Several treatments to stop the hemorrhage and save brain tissue can be provided, including medications, surgery or other procedures such as:

Endovascular procedures: these can help repair a weak spot or rupture in a blood vessel.

 

Surgical treatment: If the bleeding is caused by a ruptured aneurysm, a metal clip can be placed to stop the blood loss.

(Centers for Disease Control and Prevention, 2022)

 

Recovery

According to the Heart and Stroke Foundation, the after-effects of a stroke can range from mild to severe, and vary from person to person.

 

Severity depends on factors such as

  • Type of stroke (ischemic or hemorrhagic);
  • The hemisphere of the brain in which the stroke occurred (left or right);
  • The areas of the brain affected by the stroke;
  • The extent of the damaged brain region;
  • The body functions controlled by this region;
  • How long the blood flow to the affected part of the brain has been interrupted.

(Heart and Stroke Foundation, n.d.(a))

 

What are the risk factors?

Knowing the risk factors surrounding stroke is essential, as it enables you to make certain lifestyle choices that will help reduce them. Unfortunately, some of these risk factors are uncontrollable. However, knowing them helps you to be aware of your own risk, to be more attentive to your health and to watch out for warning signs.

 

Lifestyle habits

  • Adopting an unhealthy diet
  • Lack of exercise
  • Unhealthy weight
  • Smoking
  • A stressful lifestyle
  • Consumption of alcohol and recreational drugs
  • Health problems
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Vascular fibrillation
  • Vascular cognitive impairment
  • Mental health disorders, such as anxiety and depression

 

Uncontrollable factors

  • Gender: Because of their distinct cardiovascular physiology and the multiple hormonal changes they experience over the course of their lives, some risks are specific to women. For example, the risk increases after menopause.
  • Age: Risk increases with age.
  • Family and medical history
  • Aboriginal background: Unfortunately, “First Nations, Inuit and Métis people suffer more frequently from high blood pressure and diabetes”. (Heart and Stroke Foundation, n.d.(b))
  • African and South Asian origins: Like people of Aboriginal origin, people of African and South Asian origin are at greater risk of high blood pressure and diabetes.

 

Factors associated with pregnancy

Pregnancy and stroke can be indirectly linked through stress, weight gain and hormonal changes, which in turn can lead to problems that increase the risk of stroke, such as :

  • High blood pressure
  • pre-eclampsia
  • Gestational diabetes

Adopting good habits to stack the odds in your favor

 

Stroke can happen to anyone, at any age. However, there are a number of things you can do to reduce your chances. Actions such as watching your diet, limiting alcohol, avoiding tobacco and staying active are not recommended to keep you bored. Taking care of your body and mind by adopting healthy habits can make all the difference.

 

 

Article written by Laurie Lévesque, content creator for Académie Saint-Bernard.

Edited and formatted by Émilie Bédard, communications manager.

Illustrated and designed by Roxanne Duchesneau, Graphic and Motion Designer.

Brunet. S.d. “Cardiovascular Disease and Stroke.”  [Last accessed 06/10/2022]

Centers for Disease Control and Prevention. 2022. “About Stroke”.  [Last accessed 06/10/2022]

Chong, J. 2020. “Transient ischemic attacks (TIAs)”. The Merk Manual.  [Last accessed 06/10/2022]

Heart and Stroke Foundation. 2021. “Are there signs of stroke other than TIA?”.  [Last accessed 06/10/2022]

Heart and Stroke Foundation. S.d. (a). “Types of Stroke.”  [Last accessed 06/10/2022]

Heart and Stroke Foundation. S.d. (b). “Risk and Prevention”.  [Last accessed 06/10/2022]

Heart and Stroke Foundation. S.d. (c). “Treatments.” [Last accessed 06/10/2022]

Hayward, S. 2017. “June, stroke awareness month”. The Neuro.  [Last accessed 06/10/2022]

Johns Hopkins Medicine. S.d. “Health: Stroke”.  [Last accessed 06/10/2022]

Office québécoise de la langue française (OQLF). 1999. “Ischémie” [Grand dictionnaire terminologique]. Gouvernement du Québec.  [Last consulted on 10/06/2022]

Office québécoise de la langue française (OQLF). 2019. “Hemorrhage” [Grand dictionnaire terminologique]. Gouvernement du Québec.  [Last consulted on 06/10/2022]

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