Saturday, April 23, 2011


Just recently at Eastside Family Health Center we diagnosed a previously healthy man in his mid-fifties with a stroke. This has been a life-changing event for him and for his family. I thought it would be good to review the topic of stroke on this blog.

Stroke is the term doctors use when a part of the brain dies because it goes without blood for too long. There are two main types of strokes: those caused by a blockage in a vessel in the brain and those caused by a bleeding in the brain or surrounding area.

In the USA there are about 700,000 strokes per year. Most of these are caused by a blockage in a blood vessel. Early treatment of stroke can reduce brain damage that occurs for this reason time is of the essence. Here, time equals brain lost or gained.

The symptoms of a stroke may begin suddenly or develop over hours or days. The damage from a stroke may be temporary or permanent.

Ischemic strokes are those caused by a blockage in one of the blood vessels that supply oxygen to the brain. If the blockage is not relieved after just a few minutes, the brain fed by that artery will become damaged.
Embolic strokes occurs when a blood clot travels from one part such as the heart to a smaller blood vessel in the brain. This is called an embolus. One of the most common causes of an embolus is an irregular heart rhythm called atrial fibrillation.

Intracerebral hemorrhage is bleeding in the brain. The blood is an irritant to the brain and puts pressure on the surrounding tissue. Some common causes of hemorrhage include: high blood pressure, injury, bleeding disorders, and deformities of blood vessels such as an aneurysm.

A subarachnoid hemorrhage occurs when a blood vessel on the surface of the brain ruptures. The blood pools in the space between two layers of tissue covering the brain (the subarachnoid space). The most common symptom of a subarachnoid hemorrhage is a severe headache called a thunderclap headache or the worst headache of one’s life.

There are a number of risk factors for ischemic stroke: age older than 40, heart disease, high blood pressure (defined as any blood pressure higher than 110/60 ) , smoking, diabetes, high cholesterol, illegal drug use, recent childbirth, TIAs( stroke symptoms but with no evidence via CT or MRI that resolve with 24 hours), obesity, or past history of blood clots.

Risks for hemorrhagic stroke include: high blood pressure, smoking, cocaine use or use of blood thinners such as warfarin.

As high blood pressure is a common risk factor here is an interesting graph showing the relationships between increasing blood pressures and age to stroke risk. You can’t slow down your aging but we all can watch our BP’s!

Classic symptoms of stroke can be remembered by the acronym FAST:
  • Face—sudden weakness or droopiness of the face or visual problems
  • Arm--- sudden weakness or numbness of one or both arms
  • Speech—difficulty speaking, slurred speech, or garbled speech or inability to speak
  • Time—Time is critical, the sooner the intervention the better the outcome.
A stroke is a medical emergency! Call 911. If it is an ischemic stroke and caught within a window of three hours, a medicine may be used to dissolve the clot. A brain scan will be done in the ER to help differentiate what type of stroke it is.


Dr. Frank Marinkovich owns and operates Eastside Family Health Center in Kirkland, WA. Serving Kirkland and the Eastside, Seattle, Bellevue, Renton and the surrounding local communities. Specializing in Primary Care, Automobile Accidents and FAA physicals. Visit them online at Eastside Family Health Center or call them at (425) 899-2525.
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