Time is Brain!

I've spent the last several days talking about how to prevent strokes.  But what if you're not so lucky?  Or rather your luck is bad rather than good?  Would you know you were having a stroke if you had one?  You need to think fast! Or in this situation, act FAST!  

F = face.  Is your face droopy or asymmetric, especially if you try to smile or raise your eyebrow?  Or perhaps one side is quite numb & tingly as if you just returned from the dentist full of Novacaine(r).

A = arms.  Does one drift or appear significantly weaker than ordinary?  Is one numb & tingly?

S = speech.  Is your speech slurred?  Are you having difficulty making yourself understood?

T = time.  Time is most important because if you notice any or all of the above, you need to call 911 to get yourself to your emergency department as soon as possible (ideally within 3 hours of any of the above - so don't dilly-dally waiting to see if you're going to get better).  Preferably, your emergency department would also be a certified stroke center, where they'd be prepared to take you in for neuroimaging as soon as you rolled thru the doors and then get you set up for thrombolysis immediately afterwards (ideally within 60 minutes of your arrival).

Why is time so important?  Think of a stroke as a brain attack, similar in nature to a heart attack.  We all know that time is of the essence when someone is suffering from a heart attack.  For all intents & purposes, most (80%) strokes are similar in nature to heart attacks and are due to clot formation.  So we perform a head CT to prove that the stroke isn't due to a ruptured blood vessel (20%) and then start medication to break up the clot if we're within a specific time frame (3 hours, sometimes more depending upon newer European guidelines).  After all, just like time is myocardium (heart tissue), time is brain, too.  So the sooner we can break up the clot and get blood flowing, the better your chances of surviving the ischemic stroke w/minimal long-term disability.

Unfortunately, in a study just published online yesterday and announced at the American Stroke Association's annual conference, only one out of four patients who even received thrombolysis (remember, most didn't get to the hospital in time!) got therapy within 60 minutes of arrival.  We need to do better than that.  But you also need to know where to go (quickly)!  So while you're exercising, eating right, and controlling your blood pressure, look around and know which of your nearest emergency departments is a certified stroke center.