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Act Fast: Stroke Symptoms & Treatment

March 6, 2019 2:30 PM with Dr. Shakeel Chowdhry

While they can seem unpredictable, there are a number of risk factors, including poor cardiovascular health and lifestyle choices, which can contribute to the chances of having a stroke.

When experiencing a stroke, your brain isn’t getting the blood it needs to properly function. If you or someone you know is experiencing a stroke, it’s important to get treatment as soon as possible to lower the chances of brain damage, disability or even death.

May is stroke awareness month, so take time to familiarize yourself with some of the key points in identifying stroke. Remember the word, “F.A.S.T”

F – Face: Ask the person to smile. Does one side of the face droop?

A – Arms: Ask the person to raise both arms. Does one arm drift downward?

S – Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T – Time: If you observe any of these signs, immediately call 911.

Recently, Dr. Shakeel Chowdhry, NorthShore Neurosurgeon answered questions and shared important information about stroke symptoms, prevention techniques, treatment options and NorthShore’s related innovations.

Kathryn (Moderator) - 04/02/18 2:30 PM:
Our stroke chat is now open; you can submit questions at any time during our chat.

Shakeel Chowdhry - 04/02/18 2:32 PM:
Welcome to our webchat on stroke. Feel free to ask any questions. For those unfamiliar with me, I am a cerebrovascular neurosurgeon here at NorthShore and perform interventions for acute stroke care.

  Lily (Chicago, IL) - 04/02/18 2:32 PM:
What percentage of Strokes/TIA's are caused by AFib? How does heart disease impact stroke?
Shakeel Chowdhry
Hi Lily. The number can vary, but about 15% of strokes can be attributed to atrial fibrillation. Heart disease in general is tied directly into cerebrovascular disease, and often many of the treatment regimens used for management and treatment of cardiovascular disease are applicable in the neurovascular space.

  Leslie (Barrington, IL) - 04/02/18 2:34 PM:
I was with a skew deviation. It's speculated I have a B1 deficiency due to ongoing GI issues, though current levels normal and gastroenterologist says only mild malabsorption. Could I have suffered a stroke during an intensive aerobic workout, as I did feel something pop in my head and noticed double vision on left gaze afterwards? Should I see a specialist?
Shakeel Chowdhry
Hello Leslie. Ischemic strokes are not generally accompanied by a noteable sensation such a "pop" While vision impairment can be caused by strokes (usually smaller ones known as lacunar strokes), an underlyling metabolic process or something abnormal in the structure of the eye or the brain can be reasonable. Given the new finding, I recommend seeing an eye doctor or neurologist to evaluate the vision changes, and they will order imaging of the brain as well.

  Raquel (Chicago, IL) - 04/02/18 2:37 PM:
Are there any good supplements/vitamins you would encourage patients/individuals to take for preventing strokes, besides the obvious lifestyle changes, exercise, etc? Thank you!
Shakeel Chowdhry
That is a good question, Raquel. Unfortunately, there is no good single supplement or vitamin that can prevent strokes. The balance of a healthy diet, exercise, disease modification/control (high blood pressure, cholesterol, etc.) is really our best treatment. A general multivitamin has iron and supplements that body needs and can be absent in our diet. As for things like prophylactic aspirin or large amount of tumeric, we cannot say that they would be beneficial for all people as a preventative measure.

  Robert (Northfield, IL) - 04/02/18 2:40 PM:
I recently had a "mild stroke" and was prescribed Lipitor 80 mg. Is there a recommended time for taking this (morning vs evening)? I have been having some dizziness with it.
Shakeel Chowdhry
sorry to hear that, Robert. In the setting of recent stroke, it is important to control problems with cholesterol to reduce the risk of additional strokes. Most people prefer taking lipitor at night as side effects can be better tolerated.

  Sanafatema (Chicago, IL) - 04/02/18 2:42 PM:
Can/should we perform CPR on a stroke victim? If someone is having a stroke, what is the best approach to first aid (besides calling 911)?
Shakeel Chowdhry
Hello. In generaly, patients suffering from an acute stroke has stable heart function and are able to ventilate. Therefore, they generally do not require CPR. If a heart beat or breath sounds are absent, then CPR is the best treatment. In addition to calling 911, you would want to make sure that the person suffering the stroke is seated or laying down (and may need to help them down). You would want to keep their head up to help them with respirations. Beyond that, it is critical for that person to get to the hospital as soon as possible (via ambulance) .

  Betsy (Highland Park, IL) - 04/02/18 2:44 PM:
What affects can stroke have on eyesight? I have a friend who recently had a stroke and has not recovered fully from visual disturbances.
Shakeel Chowdhry
Yes, Betsy. Strokes involving the occipital lobe or the visual fibers as they move from the front of the brain to the occipital lobe can affect vision. Usually, vision loss is affected the same part of BOTH eyes, which can be difficult to overcome (for example, seeing to the left in each eye). Depending upon the part of the brain involved, vision may be partly recovered. Other times, improvement can be minimal to none. If the disturbance is significant, occupational therapy can help to learn to cope with this new deficit.

  Harrison (Northfield, IL) - 04/02/18 2:47 PM:
Post stroke, I've been walking and doing light cardio and am generally feeling better, but when is it typically OK for patients to get back to "real" sports (e/g tennis)?
Shakeel Chowdhry
Hello, Harrison. The time period for recovery varies depending upon the general health of the patient and size/area of the stroke, as well as the cause of the stroke. In general, if it was a smaller event (and not due to dissection), and we are tolerating light exercise, we can increase in moderate or intense exercise.

  Lily (Chicago, IL) - 04/02/18 2:52 PM:
What medicine protocol is best for stroke to avoid toxifying the liver?
Shakeel Chowdhry
Hi Lily, I suspect you are referring to medication that help to control cholesterol, many of which are cleared by the liver. If we have baseline liver function problems, there are other medications besides statins that can help control cholesterol, but they come with other side effects. These include medications like Ezetimibe. But in general, you would want to pick the right medication for you which would involve taking your entire medical history into account.

  Alana (Highland Park, IL) - 04/02/18 2:57 PM:
What's the difference between a stroke and a brain aneurysm? Can one cause the other?
Shakeel Chowdhry
Hello Alana. A stroke is essentially a problem with blood flow in the brain that causes brain damage. It can be caused by a blockage of blood flow (ischemic stroke) or a tear in a blood vessel (hemorrhagic stroke) or a bleed from a lesion inside the brain (like a tumor, AVM, or aneurysm). An aneurysm is a dilation of a blood vessel that often has weak spots on it - you can think of it like a balloon filled with air. If it ruptures or bursts, it can causes bleeding into the brain and around the brain. So, yes, a brain aneurysm that leaks can cause a type of stroke (hemorrhagic stroke).

  Mya (Evanston, IL) - 04/02/18 3:01 PM:
Why is the risk for stroke higher as we age? Can starting prevention in our 20s help lower that risk?
Shakeel Chowdhry
As our bodies age, we can develop build up of plaque, vessel narrowing, or even increased deposition of degradation products of support cells that can increase stroke risk. Not to mention, our heart and abnormal functioning of the heart, can increase stroke risk. Plaque build up in our vessels starts as early as our teenage years. Proper diet, exercise, and regular check ups can go a long way to reducing our risk of stroke later in life. It is never to early to start reducing our stroke risk!

  Mike (IL) - 04/02/18 3:05 PM:
Can a lot of stress cause a stroke? I get things like tension headaches, and am worried things could get worse...
Shakeel Chowdhry
In general, headaches do not cause stroke. However, headaches can cause fluctuations in blood pressure (particularly spikes in blood pressure), and these can be associated with stroke if we have high stroke risk factors. If we have underlying tension headaches from stress, dealing with and addressing our stressors with the help of professionals can reduce our risk.

  Kate (Wheeling, IL) - 04/02/18 3:06 PM:
Years ago, my mom was driving and suddenly felt completely out of it. Not in pain, but she had to pull over to be safe. She hasn't had this since...could that have possibly been a mini stroke? Are there recognizable symptoms for mini strokes?
Shakeel Chowdhry
Hello, Kate. In short, yes, that event could have been a mini-stroke, but it also could have been a number of other things (including stress related response, excessive sleep deprivation). Mini strokes can present a number of different ways with more classic symptoms of transient weakness, facial droop, and numbness, or with more rare symptoms like "feeling out of it." I would recommend that you encourage your mother to visit her doctor just to make sure that event is truly just a small isolated event.

  Rosie (Glenview, IL) - 04/02/18 3:10 PM:
If someone has had a stroke, what kind of things are done to make sure another one doesn't occur?
Shakeel Chowdhry
Hi Rosie. In general, after someone has recovered from a stroke, we can to assess that person's risk factors for stroke and then reduce those risk factors. That can include blood pressure control, antiplatelet medication, cholesterol management, etc. Sometimes there can be a structural concern (such as carotid stenosis) that may need a surgery, or cardiac cause (such as atrial fibrillation) that may need anticoagulation.

  Ted (Evanston, IL) - 04/02/18 3:17 PM:
Is it possible for a kid or a teen to have a stroke? Would it be genetic, or caused by something specific?
Shakeel Chowdhry
Hi Ted. Unfortunately, children can have strokes. It is rare for it to happen, and often there is a strong genetic predilcation or associated disease (for example, sickle cell disease or familial cholsterolemia). occasionally, trauma can lead to certain injuries that can causes strokes, but those are very rare.

  Viv (Chicago, IL) - 04/02/18 3:23 PM:
What exactly would someone having a stroke experience? Is it more of a pain, or is the vision problem the main symptom?
Shakeel Chowdhry
Hi Viv. Stroke symptoms can vary considerably. Ischemic strokes are often painless and we can have weakness, clumsiness, facial droop, slurred speech, and vision problems. Hemorrhagic strokes are often assocaited with pain but with a relatively slow onset. Subarachnoid hemorrhage (due to a ruptured aneurysm for example) presents with sudden severe headache and neck pain.

Kathryn (Moderator) - 04/02/18 3:25 PM:
We will take one more question.

  Daniela (Evanston, IL) - 04/02/18 3:29 PM:
Are there any new treatments for stroke or tests to catch it faster?
Shakeel Chowdhry
Treatments for stroke are continually under development, and most acute treatment have to do with better and more efficient ways to remove clot from blocked blood vessels. The issue tends not to be catching stroke faster but rather getting someone having a stroke more quickly to a place that they can be treated. In this regard, advances in emergency medicine have helped to get patients to treatment locations faster. With regards to imaging, there are now ambulances with CT scanners in the ambulance that can allow for earlier determination of ischemic stroke and may one day lead to earlier tPA administration and earlier stroke intervention.

Kathryn (Moderator) - 04/02/18 3:32 PM:
This will be the end of our chat. Thank you for your questions. For more information on stroke symptoms and prevention, or to schedule an appointment with a specialist like Dr. Chowdhry, contact the NorthShore Neurological Institute.

This chat has ended.

Thank you very much for your participation.