Strokes are the fourth leading cause of death in the United States. In fact, 130,000 Americans die annually each year from stroke. 795,000 Americans experience a stroke yearly, and many of these stroke result in long-term disability.
A stroke is a brain injury. Our brains need oxygen. The brain comprises 2% of body weight, but requires 20% of available oxygen. That oxygen is delivered by the arteries of the body to all parts of the brain. An ischemic stroke occurs when an artery, large or small, is blocked. When the cells in the brain do not receive oxygen, they die within a few short minutes. This type of stroke accounts for 87% of all strokes.
Hemorrhagic strokes occur when a blood vessel within the brain ruptures, and as a result, the cells of the brain are damaged, by compromised blood flow, and by swelling.
The signs and symptoms of a stroke have been well publicized over recent years, primarily because there are effective treatments available to unblock the artery within a certain period of time, using clot-busting drugs known as thrombolytics. These drugs carry a risk of complications from hemorrhage, which is why they must be judiciously used during a period of time in which the potential benefits outweigh the potential risks. This is why rapid diagnosis and treatment are critical in patients with stroke.
Some signs and symptoms of stroke are sudden onset of numbness or weakness, in the face or extremities, and particularly if it is localized to one side of the body. Another sign is sudden difficulty with balance, coordination, or walking. Dizziness or confusion may occur. Difficulty speaking, or understanding speech is a sign of stroke. Victims of stroke may have sudden difficulty with vision. A severe headache, occurring suddenly with no cause may be a sign of a hemorrhagic stroke. If you or someone with you experiences any of these symptoms, call 911 immediately.
A short test to help you determine if someone may be having a stroke is known as the F.A.S.T. test. Perform the following if you are concerned someone if having a stroke:
- FACE: Ask the person to smile and note if one side of the face is drooping.
- ARMS: Ask the person to raise both arms and note if one arm drifts downward.
- SPEECH: As the person to repeat a simple phrase and notice any slurring or changes in their speech.
- TIME: Note the exact time of symptom onset and call 911 immediately.
The time of symptom onset is important, because some treatments can only be given within 3 hours of symptom onset. Always call the ambulance and do not attempt to drive yourself to the hospital.
A TIA or Transient Ischemic Attack appears with the same symptoms of a stroke, but they disappear, sometimes within minutes, and almost always within 24 hours. The key difference between a TIA and stroke is the reversible nature of ischemia, or failure of blood flow, with a TIA. If you have a TIA, you still require treatment and follow up, as a TIA is a sign that you have some problem with arterial blockage to the brain, and without treatment it will only get worse, resulting in a full stroke with long-lasting deficits. TIA is a risk factor for a recurrent stroke and require an urgent evaluation with immediate treatment.
It is because a TIA goes untreated that many patients end up with debilitating strokes. Failure to recognize and treat a TIA can occur with the patient, but, unfortunately, failure to recognize and/or treat a TIA appropriately may also occur in the healthcare setting.
If you have a TIA, your initial evaluation in the healthcare setting should consist of a careful medical history, a physical examination, an ECG, imaging studies of the brain (i.e. MRI or CT) and neurovascular studies, like CT angiography or Doppler studies of the carotid arteries to look for blockage. This can be done as an outpatient or as an inpatient. Treatment may consist of aspirin, other anti-platelet therapies, anticoagulant therapy in patients with atrial fibrillation, or carotid endarterectomy.
There are some guidelines, released by the American Heart Association and the American Stroke Association in 2009 that set some criteria for hospitalization. The criteria are based upon variances in age, blood pressure, clinical features of the stroke, duration of the symptoms and presence or absence of diabetes. The National Stroke Association recommended hospitalization for patients with increasing symptoms, symptoms lasting longer than an hour, a high stroke risk, a potential cardiac source of an embolism, like atrial fibrillation, and significant carotid artery stenosis. Patients with hypercoagulable blood should also be hospitalized.
Patients who are not admitted should be instructed to return immediately to the Emergency Department if symptoms recur. A stroke following a TIA is most likely to occur within 48 hours after the TIA. In one study, 5% of TIAs were followed by stroke within 24 hours, and other studies have shown that there is a 10% risk of stroke within 48 hours of a TIA.
If you have experienced a stroke, after a TIA, and you were not adequately evaluated or treated, you may be the victim of malpractice. Please contact the top-rated Chicago medical malpractice attorneys of Passen & Powell today at 312-527-4500 for a Free Consultation.