What Are MIIPs? / Stroke


What is a stroke?

A stroke is like a heart attack in the brain. Think of a stroke as a brain attack. A stroke happens when blood flow to part of the brain is cut off. The brain needs blood to bring it oxygen and nutrients to live. When the blood supply is cut off, the brain cells in that area start to die. The faster a stroke is treated, the more brain that can be saved. Remember, time is brain!!



What causes a stroke?

Most commonly, a stroke will happen after a blood clot blocks an artery to the brain (85%). Less commonly, a stroke will happen when an artery bursts and bleeds.

If a stroke happens but goes away by itself, it’s called a mini stroke. Don't ignore a mini stroke! It can be the warning of a bigger stroke to come.



How common are strokes?

  • About 800,000 people have stroke in the US each year, or 1 every 40 seconds.
  • Stroke is the 5th leading cause of death in the US. 1 American dies from stroke every 4 minutes.
  • Strokes cost the US ~ $34 billion every year in medical care and work disability



What are the symptoms of a stroke?

  • Sudden weakness or loss of feeling on one side of the body
  • Sudden confusion
  • Difficulty speaking or understanding speech
  • Dizziness
  • Loss of balance
  • Severe headache
  • Passing out



What causes these symptoms during a stroke?

Different areas of the brain control different body functions. For example, one area controls right arm movement. Another area controls speech. When a part of the brain suffers a stroke, it cannot do its job. If a stroke involves many parts of the brain, multiple functions can be lost.

But hold on, it’s also “opposite day” in the brain! One side of the brain actually controls the opposite side of the body. So a stroke in the right side of the brain can cause LEFT sided arm and leg weakness!



What should I do when someone has a stroke?

Stroke is a medical emergency! If you think someone maybe having a stroke, call 911! Get them to the emergency room as soon as possible. ER doctors will look for bleeding in the brain and signs of a stroke on medical imaging like a CT or an MRI.

Even if the symptoms go away like a mini-stroke, get them to a doctor, because the big stroke may be next!

Act “F-A-S-T” when you see signs of a stroke:

    • Facial droop
    • Arm weakness
    • Slurred speech
    • Time to call 911

Treatments for stroke are only helpful in the first few hours after symptoms started, so act F-A-S-T! Time is brain!



What are the treatments for a stroke?

Treatments for the rarer kind of stroke due to a burst blood vessel are medicines to control the symptoms and effects of the stroke. Unfortunately, they cannot fix the cause.

Treatments for strokes due to a blood clot focus on dissolving or removing the blood clot from the artery. Doctors can dissolve the blood clot with clot-busting medicines if:

    • there is no bleeding in the brain
    • less than 3 hours have passed since the symptoms started!

The clot-busting medicine can be given in 2 ways:

  • through an IV in a vein to the entire body OR

  • directly into the blocked artery through a minimally invasive, image-guided procedure (MIIP):
    1. the specialized doctor (usually a Neurointerventional Radiologist) numbs up the skin in the groin
    2. through a pinhole, the doctor inserts a tiny plastic tube into the artery in the groin
    3. using moving x-rays to see, the doctor sends the tiny plastic tube through the arteries in the body to the affected artery in the brain
    4. the doctor locates the blood clot by injecting dye into the artery
    5. the doctor uses a tiny tube to spray clot-busting medicines directly into the clot
    6. when the clot is gone, the blood can flow again to the starving part of the brain

There is also a MIIP to remove the blood clot. It can be used to treat strokes within the first 6 hours of stroke symptoms. Except for step 5, where the doctor can use the tiny tube to capture or suck out the blood clot, the steps are same as above.

When stroke is treated quickly, there is a better chance for brain recovery!



Time is brain...

Stroke patients who arrived at a hospital within 3 hours of symptoms have much less disability 3 months after stroke than those who wait to get care.



What happens after a stroke?

Some functions that are lost after a stroke may come back with physical therapy and rehabilitation. However, about 25% of stroke patients will have another stroke within 5 years. It is important to treat risk factors for stroke to prevent another stroke.



What are the risk factors for stroke?

The risk for stroke increases with age. The risk is higher for African Americans, Hispanics, and American Indians have a higher risk for stroke than the rest of the population. Other risk factors include:

    • Male gender
    • Ethnicity
    • High blood pressure
    • High cholesterol
    • Diabetes
    • Cigarette smoking
    • Irregular heart rate like atrial fibrillation
    • Sickle cell disease
    • Mini stroke (15% of patients who had a mini-stroke but did not get treated will have a major stroke within the next 3 months)

80% of stroke can be avoided with prevention!



Where can I find out more about stroke?

http://www.cdc.gov/stroke/about.htm 
http://www.ninds.nih.gov/disorders/stroke/stroke.htm (stroke organizations list)
http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/Types-of- Stroke_UCM_308531_SubHomePage.jsp
http://www.sirweb.org/patients/stroke/
http://www.brainattackcoalition.org/ 


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