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A Primer on Stroke

A stroke or "brain attack" occurs when a blood clot blocks a blood vessel or artery, or when a blood vessel breaks, interrupting blood flow to an area of the brain. When a stroke occurs, it kills brain cells in the immediate area. Doctors call this area of dead cells an infarct. These cells usually die within minutes to a few hours after the stroke starts.

When brain cells in the infarct die, they release chemicals that set off a chain reaction called the "ischemic cascade." This chain reaction endangers brain cells in a larger, surrounding area of brain tissue for which the blood supply is compromised but not completely cut off. Without prompt medical treatment this larger area of brain cells, called the penumbra, will also die. Given the rapid pace of the ischemic cascade, the "window of opportunity" for interventional treatment is about six hours. Beyond this window, reestablishment of blood flow and administration of neuroprotective agents may fail to help and can potentially cause further damage.

When brain cells die, control of abilities which that area of the brain once controlled are lost. This includes functions such as speech, movement, and memory. The specific abilities lost or affected depend on where in the brain the stroke occurs and on the size of the stroke (i.e., the extent of brain cell death). For example, someone who has a small stroke may experience only minor effects such as weakness of an arm or leg. On the other hand, someone who has a larger stroke may be left paralyzed on one side or lose his/her ability to express and process language. Some people recover completely from less serious strokes, while other individuals lose their lives to very severe strokes.

Brain Attack!

Why Use the Term Brain Attack?

The origination of the term "brain attack" and its application to stroke are credited to Vladimir C. Hachinski, M.D., and John Norris, M.D., both world-renowned neurologists from Canada. NSA began to champion the term in 1990 because it characterizes the medical condition and communicates the actual event more clearly to the public than does the word "stroke." The brain is the most delicate organ in the body. "To give the best chance of limiting damage, brain attacks should be heeded even more urgently than heart attacks," said Dr. Hachinski.

The symptoms of stroke should have the same alarming significance in identifying a brain attack that acute chest pain has in identifying a heart attack.

The public misperception that nothing can be done about stroke has prevailed for too long. With the use of the term "brain attack," we give stroke a definitive name and a unique face for the first time. Of all the images we use to identify stroke, "brain attack" is the most descriptive, realistic and powerful call to action. The appropriate response to a brain attack is emergency action, both by the person it strikes and the medical community.

Brain Attack Means Medical Emergency

Educating the public to treat stroke as a brain attack and to seek emergency treatment is crucial because every minute lost, from the onset of symptoms to the time of emergency contact, cuts into the limited window of opportunity for intervention. The majority of patients don't report to the emergency room until more than 24 hours after the onset of stroke symptoms. The longer the delay in patient presentation, the more damage a stroke can do and the less recovery can be achieved.

One of the largest obstacles to emergency treatment is that many people don't even know it when they are having a stroke. The University of Cincinnati reported that 52 percent of their acute stroke patients were unaware they were experiencing a stroke. Another factor in time of presentation is where people are when they have strokes. Those who have a brain attack in a public place where others may recognize the symptoms or see that something is wrong tend to report to the emergency room sooner. That is why it is critical for everyone to "Be Stroke Smart" and learn the 3 Rs of stroke: Reduce risk, Recognize symptoms, Respond by calling 911.

Changing the Perception of Stroke

Myth
Reality
Stroke is unpreventable Stroke is largely preventable
Stroke cannot be treated Stroke requires emergency treatment
Stroke only strikes the elderly Stroke can happen to anyone
Stroke happens to the heart Stroke is a "Brain Attack"
Stroke recovery only happens for a few months after a stroke Stroke recovery continues throughout life





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