Life-Saving Knowledge–What A Tragic Stroke Death Can Teach Us

MUSC Health
March 08, 2019
Image depicts a written mnemonic device for remembering what the warning signs of stroke are: "Be FAST to stop a strok" B = balance loss, E = eyesight changes, F = Facial Drooping, A = Arm or Leg Weakness, S = Speech Difficulty, T = Time to call 911

Many people found Luke Perry's recent sudden death especially shocking because they were not aware that stroke can affect the young. Perry, a well-known Hollywood actor, was 52 years old when he died of a massive stroke. "Strokes can happen at any age. They're not just a disease of the elderly. What this really highlights is how important it is to get screened for your stroke risk factors," says Christine Holmstedt, DO, Associate Professor of Neurology and Emergency Medicine, Medical Director of Clinical Stroke Services, and Co-Director of the Comprehensive Stroke Center at MUSC Health. "Your primary care doctor should check your blood pressure, cholesterol, and blood sugar and, if any of these levels are high, you should be treated to bring them down," she says.

Screening is particularly important for people in the Southeastern US where stroke rates far exceed the national average. About a third of people who are hospitalized for a stroke in the US are younger than age 65 and, worldwide, 10-15% of strokes are in people under age 50. "In South Carolina, about half of the stroke patients we see are less than 60 years old. It's because our young people have more risk factors than young people in other areas of the country," says Holmstedt.

Not only are strokes more common among the young than many people realize, but they are also more deadly. AlejandroSpiotta, M.D., P.rofessor of Neurosurgery and Neuroendovascular Surgery at MUSC and Director of the Neuroendovascular Division explains, "Within 1 to 3 days of a large stroke that went untreated, there is swelling in the affected region of the brain. As the skull is an enclosed compartment, this leads to an enormous pressure on areas that may not have been affected by the original stroke. This rapid, dramatic compressive effect can reduce blood flow, damage the brain further, and cause death." In addition, this swelling is more dangerous for young patients than elderly patients because younger people have very little room to accommodate it. By contrast, most elderly patients have experienced some amount of age-related decrease in their brain mass which makes some space for the swelling to occur.

The good news is that there are two simple keys to saving your own life or the life of a friend or family member who is having a stroke. First, know the signs and symptoms of a stroke. Second, take immediate action to get medical help. "It's very important to recognize when a stroke is happening. If you experience or witness someone having sudden visual loss, difficulty speaking or understanding, confusion, severe headache, difficulty walking, slurred speech, poor coordination, or weakness in the arms or legs, call 9-1-1 right away," says Holmstedt. "Every minute counts. The faster you get treatment, the better the outcome."

It is vital that you get medical care right away. Often, people wait to see if their symptoms will go away but, with a stroke, that wastes precious time which can make the difference between recovery and serious disability or death. Also, do not drive yourself or have a family member or friend drive you to the hospital–dial 9-1-1 for an ambulance. In a car, you can have an accident, get stuck in traffic, or end up at a hospital where the care you need is not available. Not all hospitals are certified stroke centers and, especially in the case of a major stroke, you should receive advanced, specialized care as quickly as possible.

The Comprehensive Stroke Center at MUSC Heath has more diagnostic tools and treatment options than at any other center in South Carolina. In fact, it is among the top five busiest stroke centers in the country. "We intervene very quickly, especially in large strokes. We can open the artery blockage and restore blood flow to brain, and, if we can do this very soon after the event, we can reverse the stroke symptoms altogether and also prevent swelling and the brain can recover," says Spiotta.

In fact, physicians at the MUSC Health Comprehensive Stroke Center pioneered a safer way to remove stroke-causing blood clots using direct aspiration. This "direct aspiration as a first pass technique" (called ADAPT) restores blood flow to the brain faster than other methods by swiftly suctioning out large blood clots and research has shown it is the most rapid way to treat clots in stroke. This technique has also been shown to reduce the risk of the clot breaking up and blocking blood flow elsewhere in the brain. The MUSC Health team has one of the fastest times in the country for restoring blood flow to the brain and consistently exceeds national benchmarks for time to treatment.

References

1 Hall MJ, Levant S, DeFrances CJ. Hospitalization for stroke in U.S. hospitals, 1989–2009. NCHS data brief, No. 95. Hyattsville, MD: National Center for Health Statistics; 2012.

2 Smajlović, D. Strokes in young adults: Epidemiology and prevention. Vascular Health and Risk Management 2015:11;157-164.

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MUSC Health

Keywords: Patients and Families First, Healthy Communities, Stroke