Physician Corner
Your Questions - Answered
Dr. Dara Jamieson, a neurologist at Weill Medical College of Cornell University
and stroke expert answers questions regarding stroke/TIA, secondary
stroke
prevention and treatments.
Question
I recently had some numbness in my left arm, followed by a dizzy spell. I was disoriented for a few minutes and the numbness went away in a few hours. I'm fine now - do I really need to get this checked out? Show Answer
Answer
YES! Immediate medical attention is needed for anyone experiencing
these symptoms. You may have suffered a transient ischemic (iz-KEE-mik)
attack (TIA), also known as "mini stroke." TIA produces stroke-like symptoms
that are temporary in nature, usually resolve within 24 hours
and generally do not cause permanent brain damage. Even so,
TIA's are a serious
warning sign of stroke19 and should not be ignored!
Seek emergency medical care if you experience any or all of the following symptoms:
- Sudden numbness or weakness of face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble walking, dizziness, loss of balance or coordination20
Question
I'm a healthy, 42 year-old male. I've never had any major health problems, but my father and grandfather have suffered fatal strokes. Is there anything I can do now to prevent having a stroke in the future? Show Answer
Answer
While family history is a stroke risk factor that you cannot
change, there are many risk factors you can control, which
in turn can help reduce the impact of those you can't. Lifestyle
choices, such as healthy eating habits and regular exercise,
along with maintenance of blood pressure and cholesterol
are important. Keeping alcohol consumption in moderation
can also reduce your stroke risk. Smoking doubles the risk
of stroke21 – so
if you smoke, quit!
Question
My wife recently had a serious stroke, which left her partially disabled (both physically and cognitively). I know she has a higher risk of having a second stroke – are there any medications she can take to help prevent this? Show Answer
Answer
Preventing a second stroke can be helped with proper medical treatment; however, it is important to discuss this treatment with your doctor to determine what will work best for you, or, in this case, your wife. If your doctor decides that medication is right, he will most likely prescribe an antithrombotic, which prevents the formation of blood clots. They are the most commonly used treatments for secondary stroke prevention. There are two types of antithrombotics (an-tee-throm-BOT-ik):
Anticoagulants – reduce the clotting property of blood and have been shown to prevent cardioembolic TIAs and stroke (e.g., strokes caused by a clot originating in the heart, usually caused by an underlying cardiac disease)
Antiplatelets – reduce platelet activity to prevent
the formation of clots associated with ischemic strokes; they are recommended
for non-cardioembolic stroke (also know as thrombotic stroke, in which a
clot forms in a blood vessel)
- Non-cardioembolic strokes are most commonly ischemic and a daily regimen of antiplatelet medications is advocated for secondary stroke prevention22
Question
A loved one is at high risk for experiencing a stroke. How can I tell if they are having one? Show Answer
Answer
Doctors say a bystander can recognize a stroke by acting F.A.S.T.23
- Face: Ask the individual to smile. Does one side of the face droop?
- Arms: Ask him or her to raise both arms. Does one arm drift downwards?
- Speech: Ask the person to speak a simple sentence. Are the words slurred? Can he/she repeat the sentence correctly?
- Time: If the person shows any of these symptoms, time is important. Call 911 or get to the hospital fast. Brain cells are dying.
