THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 567.6 Guest: Dr. Harold Adams, Director, Stroke Center, Univ. of Iowa Topic: Stroke dangers and warning signs Producer/Host: Steve Girard

NEMA: We want to get a few words in today about stroke. How you can know the warning signs and how to take action toward treatment and recovery... which are very closely tied. With us is Dr. Harold Adams, Director of the Stroke Center in the Department of Neurology at the University of Iowa....

ADAMS: Stroke is an important public health problem. It is a leading cause of death and disability in the country. And we now have therapies where we can, A)...prevent, lower the risk of stroke in high risk individuals....and B)...treat people that are having the acute symptoms of stroke. But the key parts of both of these strategies is early recognition, and this is something that the public needs to be appraised of. The symptoms and signs of stroke are kind of protean, they can be many different presentations, depending upon what part of the brain is affected, and whether or not the stroke involves bleeding into or around the brain... or a blood clot in an artery. Now, one of the very important group of symptoms are transient, ischemic attacks... or warning symptoms of stroke. These are, in fact, minor strokes that completely resolve in a matter of 5, 10...15 minutes. And these can be a forewarning, or an ominous warning that another, more severe, potentially non-reversible stroke can occur.

NEMA: Let's get into the symptoms....

ADAMS: The symptoms of the TIA are basically the same as the other strokes...and let's go over them step by step. The sudden onset of difficulty using part of the body: numbness, weakness, heaviness...part of the body being clumsy, not working right. An episode where part of the body is heavy, dead, asleep, numb, loss of feeling...usually involving one half of the body...either the right or the left side. Most commonly involving the hand more than any other body part. An episode where there's uncoordination, or trouble with balance or staggering, or sensation of whirling or spinning. An episode where the speech is slurred or thick, or people have trouble finding words or understanding language... where there's some disorder in communication. An episode where there's sudden loss of vision, in particular, if it's sudden and painless, involving one eye. Or sometimes it can be involvement of both eyes simultaneously. An episode where there's difficulty with swallowing or double vision. Or the sudden onset of a very severe headache...one that is very atypical than other headaches... sometimes described as the worst headache of one's life.

NEMA: What should we do if we feel signs of stroke, or see them in someone around us...?

ADAMS: These are the most common symptoms of stroke, and the response should be that if these symptoms occur, to seek medical attention quickly. Particularly if the symptoms are not resolving, because with some of the new treatment for stroke, treatment must begin in the matter of a few hours... even under three hours. And if the person stays home waiting for the symptoms to resolve or not... or not be sure whether to seek medical attention, by the time they arrive to the hospital, it may be too late to receive some of these new therapies. So, the response is to seek medical attention, either go by ambulance - call 911....or get to the emergency room quickly to be evaluated. And we recommend that, rather than go to the doctor's office, mainly because time is so critical.

NEMA: The key to surviving stroke, and having a chance at full recovery, is to know the signs, and take action toward treatment. Thanks to Dr. Harold Adams for his help today....

Up next, we'll talk about keeping your kids safe in a home full of potential poisons.

SPOT: 15 years in the prevention of heart disease, stroke and trauma - The National Emergency Medicine Association. This show is just part of what NEMA does. We send out millions of pieces of prevention information to people around the country, give grants to organizations in research, public information and emergency services, and have been instrumental in the creation and expansion of the Chest Pain Emergency Room movement. To play a role, call 800-332-6362.