Stroke in Younger Adults with Deborah Lynchhttp://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=101Stroke is often seen as something that happens only to the elderly, but stroke can happen at any age. In fact, stroke in younger adults is on the rise. Deborah Lynch, an Advanced Practice Nurse, is the Stroke Coordinator at Evanston Hospital. She will answer your questions on stroke in younger adults, from risk factors and treatment to prognosis and prevention. Submit your questions early.Copyright 2014 NorthShore University HealthSystemPost at 3:22 PMBrenna: Our chat--Stroke in Younger Adults--will begin at 3:30. Please feel free to start submitting your questions now to Deborah Lynch, Stroke Coordinator at NorthShore's Evanston Hospital. As this is a popular chat, she might not be able to get to all your questions. Your understanding is greatly appreciated.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1013:22 PMPost at 3:36 PMStacey: Stacey (Glenview il) - 3:30 PM: Is the use of graduated compression stockings effective in the prevention of venous thromboembolism for post stroke victims or even to prevent risk of stroke?<br/><br/>Deborah Lynch (NorthShore): graduated compression stockings are used to help improve blood flow through the large veins in our legs. In the hospital we no longer use them because they often cause irritations and wounds on the skin. Strokes are mostly caused by problems in our arteries- not the veins; so these stockings are not a good stroke prevention measure.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1013:36 PMPost at 3:37 PMMatthew: My brother (28) is almost a year out from a stroke which happened after an arteriovenous malformation ruptured. The AVM was removed. He is doing fairly well. He can walk normally again and the outwards signs of the stroke aren’t many. He still has trouble remembering words, his speech is slow. Can you continue to improve even a year later?<br/><br/>Deborah Lynch (NorthShore): his recovery sounds good; yes improvement can occur after a year from stroke but the improvement is not as dramatic as during the first 3 -12 months. With that said, people who have language difficulties from stroke have been known to improve years afterwards.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1013:37 PMPost at 3:40 PMTina: 65 year old dad suffered a stroke a little over a year ago. He called 911 only when his arm went dead and he lost vision in his eye. He smokes and isn’t in great shape. He is working on both of those now. I have to think that there were signs, maybe smaller ones that he had ignored. What should he or me be looking for as far as early signs?<br/><br/>Deborah Lynch (NorthShore): Yes those are overt signs of stroke and we teach the public to be aware of those first and foremost. FAST- Facial droop, Arm/leg weakness/numbness, Speech-language difficulty and T is for timing (get to the ED as soon as possible). More subtle signs- would be similar to the ones listed about but possibly not as pronounced. For instance- if person notices sudden weakness of his arm and leg on the same side (even though he is able to use them)- that is a sign of stroke and warrants emergent medical attention. The real problem with stroke and public awareness is there usually is no pain associated with stroke so people wait and see if the symptoms will go away. Time is of essence!! for quick medical treatmenthttp://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1013:40 PMPost at 3:45 PMTed: I’m beginning to worry more about my family medical history. Heart disease and high blood pressure run in my family. My mom died of a stroke at 64. Her brother also died but younger, I think he was 57 or 58. Both had blockages in carotid artery. Aside from exercise and healthy eating, is there anything else I can be doing to prevent a stroke? I’m 47 now. Not currently on blood pressure medication but my doc did say it was on the higher end. Should I start having carotid artery checked?<br/><br/>Deborah Lynch (NorthShore): REgular aerobic exercise and healthy eating are terrific approaches to what we refer to as "primary stroke prevention"- (prevention before stroke). Hypertension or high blood pressure (typically greater than 130/85) is the #1 risk factor for stroke. So if you do have high blood pressure - make sure you treat this- don't delay on this. Hypertension is a "silent killer"-people don't feel any differently (usually) with high blood pressure. We do not advocate having carotid artery screening as we don't treat this disease unless there are stroke-like symptoms associted with severe narrowing. Better to focus on the above.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1013:45 PMPost at 3:50 PMThalia: What’s a mini stroke? Is there such a thing as a mini stroke? My mom said she had a mini stroke and that there's is nothing to worry about. Can it lead to an actual strokes?<br/><br/>Deborah Lynch (NorthShore): Mini stroke is a term we (in the stroke field) would like to do away with. It has been used in the past referring to TIA- transient ischemic attack. This is an event (stroke-like symptoms) that usually resolves within minutes. The problem with this term is it sounds almost cute and harmless. In actuality- it carries the same risk of future stroke as if one had an actual stroke (lasting symptoms). We take these events very seriously with main purpose- to identify a person's stroke risk factors and reduce them as best as possible so a stroke does not occur in the future.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1013:50 PMPost at 3:56 PMKathy: My kids all play sports and the risk for head injury makes me so nervous. Are the signs of a stroke caused by a clot different from the signs of a stroke caused by a head injury? If you suffer a head injury playing sports, like lose consciousness or something, should you always go to the hospital to see if their might be bleeding?<br/><br/>Deborah Lynch (NorthShore): Stroke is an interruption of blood flow to the brain that is NOT traumatic. Head injuries and concussions do not fall in the same category as stroke. I really don't know what the correct answer is re: loss of consciousness following head injury. I imagine it would depend on amount of time that person has lost consciousness- if momentarily- would at least apprise pediatrician of the injury. If more prolonged- to the ED for further evaluation.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1013:56 PMPost at 4:02 PMChris: Is a younger stroke patient likely to recover better than someone who is older? My dad is still pretty young and had a stroke about four months ago. He’s doing rehabilition now. Uses a cane and speech is very difficult for him but he’s only 48.<br/><br/>Deborah Lynch (NorthShore): Age is relative but usually the younger one is, the less chronic illness. If you are in poor health before a stroke- it is more difficult to recover primarily because of less reserve. But I have seen quite large strokes in elderly population with good outcomes. The brain is a very complex organ and everyone really recovers differently. On the whole- after stroke, people improve. Where one can get to functionally remains unknown. Best wishes to your dad.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1014:02 PMPost at 4:09 PMRosi: I had a TIA about a year ago and really changed my lifestyle. In my 50s and exercising, watching what I eat. I have my blood suger under control - type 2 diabetes. Should I be on some sort of aspirin regimen?<br/><br/>Deborah Lynch (NorthShore): We recommend at least aspirin 81mg (baby aspirin) or plavix 75mg after a person has had a TIA, especially with history of diabetes, unless there is known contraindication. Congrats on your efforts for lifestyle changes- very difficult but can make a big difference!http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1014:09 PMPost at 4:14 PMPriya: After a severe ischemic stroke, my dad is still recovering in the hospital. What happens after this hospital phase? What is recovery and rehab like? How long should it go on? What will it involve? What more can we do to ensure he has best possible outcome? I’m not in state to help<br/><br/>Deborah Lynch (NorthShore): After the hospital phase and the patient is medically stable, the stroke patient will often go to either a subacute rehab facility or an in patient rehab facility as the next level of care. Both include physical and occupational therapy and speech therapy but the inpt rehab requires a pt can tolerate at least 3 hours of therapy in a given day. Often times patients who have alot of deficits are unable to withstand this level of therapy at the beginning. IN those cases, subacute rehab is the best next place - pts will be able to get up to 2.5h of therapy a day but it is much more dependent on pts endurance. Typical length of stay in SNF is 3-6 weeks; inpatient rehab 1-3 weeks. But these times are variable and depend on how well or poorly a pt is doing. As his daughter and living out of state- i would make sure to talk with his primary physician at least weekly to get an update on his progress and plan of care.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1014:14 PMPost at 4:22 PMBrenna: There are 10 minutes left in this chat. Please submit your final questions.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1014:22 PMPost at 4:23 PMEvan: A week ago I had a Tia. Wasn’t able to speak and could not move my left arm or leg. This went on for about an hour. Released after night in hospital. They said everything should go away. Still having bad head aches though and I get pain on my neck. Could you tell me how long these symptoms last?<br/><br/>Deborah Lynch (NorthShore): Headaches and neck pains are not stroke-like or TIA symptoms. I am uncertain about the cause of your headaches/neck pains so not sure about duration of these symptoms. However if you have persistent pains I would recommend checking in with your PCP or the neurologist who cared for you in the hospital to see what he/she thinks.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1014:23 PMPost at 4:28 PMNikki: My husband had a Hemorrhagic Stroke. More than a year ago. He has no feeling in this right side, he can walk, use his arm and hand but has no feeling. He complains of pain all the time in his right side. Is that normal? Will the pain stop?<br/><br/>Deborah Lynch (NorthShore): It sounds like his stroke may have been in the thalamus part of the brain. Often after damage (stroke) to this area, the brain confuses sensory signals and patient's numbness starts turning into burning or pain sensation. There are treatments to help alleviate these symptoms- please have him check with his stroke neurologist for options.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1014:28 PMPost at 4:30 PMBrenna: Thank you all for your participation in today's chat. A transcript of the chat will be made available later today. For more information on the Neurological Institute at Northshore, go to www.northshore.org/neurological-institute/. And during National Stroke Awareness Month and all year, remember that stroke is a medical emergency and you should call 911.http://www.northshore.org/communityandevents/chat.aspx?id=6004&chat_id=1014:30 PM