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Winning the War on Stroke

People can help lower death toll by knowing symptoms, getting help fast

SATURDAY, March 13, 2004 (HealthDayNews) -- Stroke: It's the third leading cause of death in the United States, with 700,000 new or recurrent attacks occurring annually.

But the death toll wouldn't be that high, doctors say, if people would educate themselves about the warning signs and, when they occur, get themselves or their loved ones medical care as soon as possible.

"There are medications that can help dissolve a clot that is causing a stroke," explains Dr. William Buxton, a staff neurologist at the Santa Monica-UCLA Medical Center. Tissue plasminogen activator (tPA) is the clot-busting drug most commonly given.

"But the vast majority of drugs can only be used in the first three hours from the last time the patient was known to be well," he adds.

That means getting to the hospital quickly, because part of that three-hour window will be eaten up by an exam and tests to confirm the patient did indeed suffer a stroke.

Getting to the hospital faster hinges on people becoming more aware of what might signal a stroke. Among the common symptoms: sudden numbness or weakness of the face, arm or leg, especially on one side of the body only; sudden confusion or trouble speaking or understanding words; sudden vision problems in either one or both eyes; sudden trouble walking or lack of coordination; sudden severe headache for no apparent reason.

When taught these warning signs, the public can make a big difference, some recent studies show.

For instance, researchers from the University of Michigan reported late last year in the Archives of Internal Medicine on a community-based program to educate the public about stroke. In five rural Texas counties, they tested a campaign that used news articles, public service announcements, brochures and other means to boost awareness of stroke symptoms and the benefits of rapid treatment.

In the six months after the program ended, 11 percent of patients in counties with the campaign got to the hospital quickly enough to receive tPA, but only 1 percent of those who lived in five other counties without the campaign did.

And another study, conducted last year at the University of North Carolina, found people can be taught quickly to recognize the signs of stroke.

Even schoolchildren are probably capable of recognizing the warning signs of a stroke, says study author Dr. Jane Brice, an assistant professor of emergency medicine at the University of North Carolina. She says since children are already taught to do cardiopulmonary resuscitation (CPR), recognizing strokes and calling 911 would be just as easy or even easier for them to learn.

The biggest mistake people make, Brice says, is to wait to see if the symptoms will go away before calling 911. "They don't want to come to the emergency department for 'nothing,' " she says. "This is a mistake. In order to have access to the most sophisticated therapies, the person must come immediately."

Most experts agree that people are becoming more aware of stroke. "Loved ones are 'fairly accurate' in detecting strokes," Buxton says. "They might notice they are walking differently than they normally would or their speech is a little slurred."

"Sometimes the patients themselves recognize it," Buxton adds. "They might feel a little clumsy or have a sudden change in vision."

"In the eight years I have worked with stroke patients, every year I see less and less procrastination," Buxton says. "If you have any sudden onset of neurological symptoms, you should call 911 immediately to get the process in motion for evaluation for possible stroke."

Public awareness has improved, but could improve more, Brice says.

"We need to talk about stroke more," Brice says. "I think people need to review the warning signs and symptoms of stroke with their friends and relatives. Educating your neighbors, friends and relatives may save your life."

More information

For information on stroke, including the common symptoms, visit the American Stroke Association or the National Institute of Neurological Disorders and Stroke.

SOURCES: Jane Brice, M.D., assistant professor, emergency medicine, University of North Carolina School of Medicine, Chapel Hill; William Buxton, M.D., staff neurologist, Santa Monica-UCLA Medical Center, and assistant clinical professor, David Geffen School of Medicine, University of California, Los Angeles
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