Nurse's Notes
2003
BEWARE THE BRAIN ATTACK!
I have been teaching first aid and first responder courses for a
long time. Years ago, when discussing what we now call a “brain
attack” (stroke), I would tell folks to call the doctor and perhaps
take the patient to the hospital, but there was nothing much that
could be done.
How things have changed! And for the good! Now a stroke (or brain
attack) is a 9-1-1 emergency, because there are things that can be
done in the immediate time following the brain insult, which may
result in complete reversal of or the minimalizing of any brain
damage. No longer do we have the luxury of merely calling the doctor
or driving the patient to the hospital ourselves. Time is of the
essence.
Basically there are two kinds of stroke—one is caused by a clot or
embolus, either from fatty buildup and constriction in the brain
arteries themselves or something that has traveled from another part
of the body. The second cause is hemorrhagic (bleeding)—the most
severe type and most commonly caused by high blood pressure. (I
wrote about hypertension, or high blood pressure in the March, 2001,
issue of VIEW). Some folks separate the first type of stroke into
two parts, depending on the cause, but essentially they are the same
thing.
Initially following a stroke, a brain scan will be done to determine
the cause, and if the cause is a clot, medicine will be given to
dissolve it, just as is done with a heart attack. Obviously this is
a simplification of what happens and there are a lot of variables,
but time is of the essence, as the window of opportunity for
treatment is about four hours. If the stroke is caused by bleeding,
totally different treatments are called for, some equally emergent.
No matter what, the best stroke medicine is prevention. There are
some risk factors that can’t be helped—age over 55, race (African
Americans are more at risk), family history. But there are things
one can do such as having blood pressure checked regularly and
complying with any treatment a doctor prescribes. (Compliance is a
major issue in health care!). Other preventive measures include not
smoking, regular exercise, eating a healthy diet (especially
watching fat intake), and managing chronic diseases, such as
diabetes or heart disease.
Signs of a brain attack include sudden loss of control on one side
(which may only be a droopy face), sudden change of vision, total or
partial loss of speech or comprehension, sudden extremely severe
headache, or confusion and loss of coordination. Any of these
require immediate evaluation by a physician.
I can’t emphasize enough that early treatment is essential. Of the 3
million stroke survivors living in the United States today, 70
percent are able to remain independent and 10 percent have recovered
almost completely.
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