Subtle signs of a stroke

MOST people have come to associate strokes with major symptoms such as a sudden inability to move limbs, or loss of speech. However, medical internist Dr Samantha Nicholson-Spence said that there are several less dramatic symptoms such as facial weakness, numbness or tingling, and even dizziness and nausea that could signal a stroke.

“Unfortunately, for some patients who later find out that they have had a stroke, they don’t believe that these symptoms qualify as an emergency [since they are not stroke-specific] and as such often decide to wait and see if they progress into anything,” Dr Nicholson-Spence told All Woman.

She said that a stroke, which is the interruption of blood supply to the brain, is generally caused by an abrupt blockage of arteries leading to the brain (ischaemic stroke), or it may a occur following bleeding into the brain tissues when a blood vessel burst (haemorrhagic stroke). It may be preempted by other symptoms which are often ignored because they are so subtle. These include dizziness, a sudden change in vision usually in one eye, where there is a blackout or partial vision loss in a quadrant or the corner of the eye, a severe headache (migraine), loss of balance or coordination, slurred speech, droopy eyelid or lip, and confusion or trouble understanding.

Other uncommon signs of stroke, which people tend to miss, include a possible loss of the ability to taste, you might not be able to keep your tongue straight, and you might lose the ability to swallow —so you may realise that you are starting to choke on food and that you are coughing whenever you try to drink liquid.

“It is important for people to learn the early signs of a stroke. An inability to recognise these stroke symptoms may lead to dangerous delays in receiving medical care. Early intervention can reduce the scope of damage to the brain, major disabilities, or even death since treatment is time sensitive. For example, if you have a clot stroke called an ischaemic stroke, you have a three-hour window or up to four and a half hours max in which to give the clot-bursting drugs. However, this only available for persons who are in a facility that offers it, which in Jamaica is the University Hospital of the West Indies because it has to be done at a type A facility,” Dr Nicholson-Spence said.

Naturally, she said that this time window would pose a challenge so of course this can pose a problem for many people who are farther away from these institutions and as such are unable to access the facility within this short window of time. Further to this, Dr Nicholson-Spence said that it is only applicable to people with strokes over a certain score — which means it has to be a major stroke, for example, when one side of your body is not moving or something else that is dramatic.

“If the stroke results in a major bleed and the blood is organised, then there may be a way for surgeons to evacuate the blood. Most persons do not end up being surgical candidates in that category. Thankfully, only 20 per cent of strokes are the bleeding variety; the remaining 80 per cent have clots. They are usually treated with Aspirin, which is the number one drug for the treatment and prevention of strokes,” Dr Nicholson-Spence advised.

She said that while a stroke sometimes occurs without a known trigger, some risk factors may increase your chances of a stroke. As such, she said that it is important to manage risk factors where possible.

“Anyone can get a stoke, including babies; however it most commonly affects older people and a greater number of women. The lead risk factor is hypertension, which affects one in three Jamaicans. However, diabetics, people with kidney disease, high cholesterol, smokers, and people with severe heart disease such as congenital and rheumatic heart disease are at an increased risk of a stroke,” Dr Nicholson-Spence outlined.

Some not-so-common risk factors for a stroke, according to Dr Nicholson-Spence, include people with the sickle cell disease, migraines, autoimmune disease such as Lupus, and people with structural abnormalities where the vessels in the brain are not formed properly — called arteriovenous malformation.