Ahead of International Stroke Day – Everything You Need to Know

A stroke is a medical emergency where there is a disruption in the blood supply to the brain, potentially causing neurological damage. The area of the brain affected determines the nature of symptoms and the impact of the stroke. Today, it is one of the leading causes of death in Israel and worldwide and a major cause of disability in adults.

Who is at risk for a stroke?

High blood pressure – People with a medical history of high blood pressure are 2.5 times more likely to suffer a stroke than those without such a history.

Atrial fibrillation – Atrial fibrillation can appear in adults of any age but becomes more common with age (prevalent in about 10% of adults aged 75 and older). Without monitoring or treatment, it can lead to severe medical complications such as heart failure and stroke. This is because the irregular heartbeat causes blood to pool in the atrial appendages of the heart, potentially forming a blood clot that can travel to the brain’s blood vessels, disrupting blood flow and causing a stroke. In Israel, there are 20,000 stroke cases annually, with about 4,000 due to atrial fibrillation. For these patients, a medical assessment called CHADS-VASC helps diagnose their stroke risk and appropriate blood-thinning preventive treatment. The assessment considers risk factors like age, with attention to younger patients, high blood pressure, diabetes, previous stroke events, and assigns scores by also considering cardiovascular diseases and gender.

Smokers – Smoking promotes the development of atherosclerosis, increases blood clotting factors, and exacerbates damage to the walls of arteries in the neck and brain. Therefore, smokers have double the risk of stroke compared to non-smokers.

Diabetes – Uncontrolled diabetes can cause blockage in small blood vessels in various organs like the intestines and kidneys, and lead to blockage in brain vessels leading to a stroke.

Overweight – The risk of stroke is higher among overweight individuals. The highest risk exists among those prone to central obesity, where there is a large belly compared to narrow hips.

What are the stroke symptoms?
Symptoms of a stroke can appear days and weeks or just minutes before the stroke, including weakness in the arm, leg, or face, sensory disturbances, sudden speech difficulties or trouble understanding words, sudden blurred vision, dizziness, sudden walking difficulties, loss of balance, and drooping of the mouth corner. If you notice one or more of these symptoms, seek immediate hospital care. In such cases, quick arrival is crucial to providing effective treatment to minimize damage. Often, there are no clear sings of a stroke, necessitating imaging tests including a CT brain scan with contrast to examine brain vessels, Carotid Duplex – a type of ultrasound that measures blood flow in the carotid artery supplying the brain, and additional tests including ECG, blood tests and if needed, an MRI.

Dr. David Orion is a brain catheterization specialist and neurologist, director of the stroke center at Sheba Medical Center.