Ask the Expert: Recognizing the signs and preventing strokes

Sean Savitz, MD, professor and director of the UTHealth Houston Institute for Stroke and Cerebrovascular Diseases. (Photo by UTHealth Houston)

Welcome to "Ask the Expert," a UTHealth Houston newsroom series where our leading physicians examine pressing health challenges. In this edition, we address stroke symptoms and prevention. 

May marks Stroke Awareness Month, a time to educate the public about recognizing the signs of stroke as well as how people can lower their stroke risk. 

More than 795,000 people in the United States have a stroke each year, according to the Centers for Disease Control and Prevention. But many strokes are highly treatable and preventable.  

What is a stroke?

A stroke happens when a blood vessel to the brain becomes blocked, which is known as an ischemic stroke, or when a blood vessel to the brain ruptures, which is known as a bleeding stroke. During a stroke, brain cells are injured and specific areas of the brain are damaged. As a leading cause of disability and death, stroke is a major public health problem.

What are the symptoms of a stroke?  

The symptoms of a stroke depend on the location in the brain, or where the injury occurs. For example, a stroke on the left side of the brain in the frontal lobe typically can cause right-sided body weakness and difficulty speaking, while a stroke on the right side of the brain in the frontal lobe typically can cause left-sided body weakness and lack of awareness of the left side of space. A stroke in the back of the brain in the occipital lobe causes visual loss. 

BEFAST is an acronym to promote awareness of the symptoms and signs of a stroke:

B–Balance loss

E–Eyesight changes

F–Facial drooping

A–Arm weakness

S–Speech difficulty

T–Time to call 911

UTHealth Houston created the Spanish acronym RÁPIDO for the same goal to promote awareness among Hispanic American communities.

R–Rostro caído

Á–Alteración del equilibrio

P-Pérdida de fuerza en un brazo o una pierna

I–Impedimento visual repentino

D–Dificultad para hablar

O–Obten ayuda, llama al 911

What are the risk factors of stroke? 

People at risk for stroke have comorbidities such as high blood pressure, diabetes, high cholesterol, smoking, obesity, and sleep apnea. There are other medical conditions that place people at risk for stroke, including an irregular rhythm, or atrial fibrillation. A small hole in the heart and a tear in an artery are other causes of stroke in younger adults. There are also less common stroke disorders caused by genetic mutations. 

How are strokes treated? 

A stroke is a medical emergency. Anyone with the symptoms of a stroke needs to be taken to the emergency department. Treatments are time dependent. When a blood vessel is blocked, patients need to be urgently evaluated for treatment that opens the vessel. When a blood vessel ruptures, causing blood to spill in the brain, patients need to be seen for surgical evacuation and other urgent procedures.

How can you prevent strokes? 

Discuss with your primary care provider any risk factors, such as high blood pressure, diabetes, or elevated cholesterol, and how to best manage them to reduce the risk of a stroke. Nutrition is essential. Consider the Mediterranean or DASH diets. Aerobic exercise, proper sleep, and smoking cessation are also very important preventive measures. 

Is recovery possible after a stroke? 

People can improve after a stroke. The brain has the capacity for repair. The goal of rehabilitation is to enhance repair, reduce impairments, regain the ability to perform activities of daily living, and improve quality of life. Therefore, it is very important that patients have access to rehabilitation services. The UTHealth Houston Institute for Stroke and Cerebrovascular Diseases is developing new treatments to promote brain repair and enhance recovery after stroke. We also help and educate caregivers on how to optimize healthcare for stroke patients.

Sean Savitz, MD | Professor, director of the UTHealth Houston Institute for Stroke and Cerebrovascular Diseases, and the Frank M. Yatsu, MD, Chair in Neurology with McGovern Medical School at UTHealth Houston. All quotes should be attributed to him. 

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