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‘Brain attacks’

A block in a brain blood vessel can stop blood flow, leading to a stroke. Stroke was the subject of a “Meet the Physicians” talk Wednesday at the Peter White Public Library. (Journal stock image)

MARQUETTE — The word “stroke” instills fear in many people, as well it should; it can result in a debilitating condition, and even death.

However, people can learn to recognize symptoms and ways they can reduce their risk of stroke.

Strokes were the subject of Wednesday’s “Meet the Physicians” series at the Peter White Public Library, with the speaker Dr. Brian MacFalda, neurologist and medical director at the Brain and Spine Center at UP Health System-Marquette as well as the hospital’s stroke program director.

His objectives were to help people understand the condition, which occurs when blood flow to part of the brain suddenly stops.

“The important thing is: Stroke is a medical emergency. It needs to be treated quickly,” MacFalda said. “So, I want you to understand the ‘act fast’ mnemonic so that you’ll understand and recognize stroke, not only in yourself but in those around you and know what to do when you see those signs.”

Dr. Brian MacFalda, neurologist and medical director of neurology for the Brain and Spine Center at UP Health System-Marquette, talks about stroke Wednesday at the "Meet the Physicians" session at the Peter White Public Library. He discussed symptoms and risk factors as well as ways to reduce the risk of stroke. (Journal photo by Christie Bleck)

First, a few facts.

Stroke is the leading cause of disability in the United States, he said.

“Eighty percent of all strokes, however, can be prevented by reducing your risks, and it’s important to understand that anyone at any age can have a stroke,” MacFalda said.

When blood flow to the brain stops due to a blocked or a burst blood vessel, oxygen can’t circulate to that area of the brain, and that area basically dies and is permanently damaged, he said.

In fact, he called a stroke a “brain attack,” and it should be treated as such.

Typically there are two types of strokes.

About 80 percent are ischemic strokes, which MacFalda said come in two types: embolic and thrombotic. An embolic stroke involves a blood clot that forms in the body and travels up to the brain while a thrombotic stroke involves fatty deposits lining the blood vessels or their walls, which narrow the vessels over time.

“This is like the plumbing in your house,” MacFalda said. “You live long enough in your house, there’s going to be crud that starts building up on the pipes, and that’s what happens in our body.”

Some of these vessels slowly start narrowing because of wear and tear from high blood pressure, high cholesterol and smoking, and as the vessels shrink, less blood gets to the brain.

“When they completely close off, stroke can happen,” MacFalda said.

Hemorrhagic strokes — which occur when there’s a bleed in the brain, with blood exerting pressure and causing the strokes — make up the remainder, he said. An intracerebral hemorrhage involves the bursting of a blood vessel, while a subarachnoid hemorrhage involves blood vessels near the brain’s surface being damaged, causing bleeding and also exerting pressure.

MacFalda also mentioned transient ischemic attacks or “mini-strokes,” which although have the same symptoms of a stroke, usually last just an hour or less. They also don’t usually cause permanent damage.

That doesn’t mean they should be ignored.

“The importance about this type of event is that it’s a harbinger or a warning sign that a stroke may occur,” MacFalda said, with 40 percent of TIA victims having a future stroke.

The risk is greater in the first 30 days after that TIA occurs, so MacFalda stressed it’s important for people who experience stroke-like symptoms to be evaluated by a medical professional so action can be taken to avoid a stroke.

The crux of MacFalda’s talk, though, was recognizing stroke-like symptoms.

They include:

• any sudden numbness or paralysis of the face, arm or legs;

• sudden confusion, trouble speaking or trouble understanding what’s being spoken;

• vision changes in one or both eyes;

• trouble walking, dizziness or loss of balance; and

• a bad headache, which is suggestive of a brain bleed.

“Ask a person to smile,” MacFalda said. “Does one side of the face droop?”

If a person is asked to hold up their arms, does he or she have trouble holding up one arm the same as the other? Can they speak intelligently?

Once a symptom is recognized, MacFalda had a strong piece of advice: Act quickly and call 911 as soon as possible to get the person to a medical facility. After all, with the average stroke, a patient loses 32,000 brain cells every second.

“If we catch a stroke early enough and somebody meets the right criteria there is a clot-busting medication that can be given,” said MacFalda, who noted tissue plasminogen activator – tPA — has a 3¢- to 4-hour window of administration.

Also, the sooner tPA is given, the better.

“If you get it at hour 1 instead of hour 4, you’re likely to be better off if you get it at hour 1,” MacFalda said.

Other methods of dealing with a stroke include clot-removal devices to mechanically remove clots in people with ischemic strokes, and clipping and coiling for victims of hemorrhagic stroke, he said.

As with just about any medical condition, though, it’s better to not have it in the first place.

Regarding strokes, MacFalda listed the main risk factors as high blood pressure, cholesterol and sugars, with high blood pressure the main culprit. So, getting those conditions under control, along with not smoking and getting in good daily physical activity, is a big goal.

Even walking as little as 5 minutes four times a day could make a difference, MacFalda said.

Keep in mind too that strokes also don’t necessarily strike only senior citizens.

“It’s important to remember that any age can have a stroke,” MacFalda said.

With patients who have had a stroke, MacFalda noted physical, occupational and speech therapy can help them cope with potential problems like balance issues.

“These are things, especially early on, they’re going to help dictate and help frame your recovery,” MacFalda said. “Most of the recovery after stroke is going to happen within the first 6 months, but it can take up to a year or longer for that total recovery to take place.

“So, this is like a marathon, not a sprint.”

Charles Richardson, 66, has some experience with that. After suffering a stroke, he recently broke a leg while having balance problems.

Richardson attended MacFalda’s talk to learn more about strokes and recovery issues that have affected him.

“Who knows? Maybe it will help,” Richardson said.

For more information on strokes, contact the Brain and Spine Center, 580 W. College Ave., at 906-225-4575

Christie Bleck can be reached at 906-228-2500, ext. 250. Her email address is cbleck@miningjournal.net.

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