DRHOOK- Stroke warning: Spot TIA to avoid what's worse

the handsome doctor John Hong of Charlottesville

Stroke of luck. Have you had any lately? I don't know the last time I was affected by a stroke of luck. I golfed my entire childhood and always tried to keep my strokes down, but it seemed it was always the last three holes that destroyed my score. Michael Phelps had amazing strokes at the Beijing Olympics Pool, but his luck ran out when Corn Flakes dropped him as a spokesperson. (Sour milk.)

Are you at risk for a stroke?

Transient Ischemic Attacks (TIA) can be a big warning sign that a person is going to have a stroke. About 700,000 American die each year from cerebrovascular disease, making it the number-three killer in this country. There are about 240,000 TIAs a year, and one in three of those people will eventually have a full-blown stroke. About 20 percent of folks with a TIA will have a stroke within three months. Eek!

Ischemia means a lack of oxygen to body cells, so a TIA means that part of the brain isn't getting enough blood to feed it oxygen. (I think that happened to me the first time I took my SAT.) If the brain cells don't get enough blood flow, eventually they'll die– i.e. a stroke. 

With a TIA, blood flow is restored quickly enough that a full stroke doesn't occur. TIA symptoms last less than 24 hours. Symptoms longer than 24 hours mean a stroke has occurred. (Sorry, Kiefer Sutherland.)

Atherosclerosis means clogged arteries from cholesterol, and the best Liquid Plumber you can have to clean out the arteries is exercise, good diet, no tobacco, blood pressure control, and– if needed– medicines. Just as when you shower and the tub won't drain well, the blood flow to the brain can be slowed with the sludge of atherosclerosis. So if cholesterol plaques become inflamed, or if the blood pressure drops too much, the blood flow to the brain can dry up faster that Bernie Madoff working on bank accounts. There are many more causes of TIA, but I'll have to write a separate article on them.

TIA symptoms are the same as stroke symptoms. Numbness is probably the #1 symptom. Numbness can be parathesias (pins and needle prickling sensation) or no feeling at all. Numbness can be the entire side of the body including the face, or it can be localized to just a finger or just the leg. It depends on what part of the brain is afflicted.

Weakness often accompanies numbness, or it can be the sole symptom. A sense of heaviness in the leg or arm can be from weakness. A facial droop can cause one side of the mouth to sag and drool, and sometimes (rarely) the upper face droops as well. 

Cat got your tongue? Slurred speech, not able to talk, difficulty finding words or constructing sentences can all occur with TIA. Writing, reading, and math calculations can be affected. 

Doing tasks can become difficult, such as knowing how to tie your shoes, brush your teeth, etc. Double vision or not being able see everything can occur. Some folks get something called left neglect, in which they don't know or recognize anything on the left side (and not because they are right-winged). 

Some TIAs can cause vertigo (sense of spinning) or just plain old lightheadness. Some folks say they feel the room is tilted (and they aren't on the Titanic) and have a hard time with walking and balance. 

The sooner one is treated in the Emergency Department for TIA or stroke, the better the prognosis. So if you get TIA/stroke symptoms or recognize someone who has them, calling 911 to get to the ED makes complete sense. It might be your stroke of luck to do so.