What You Need to Know About Stroke

Henry H. Woo, MD, Director of the Cerebrovascular Center and a cerebrovascular and endovascular neurosurgeon, and David Fiorella, MD, PhD, a neuroradiologist and neurointerventional radiologist, tell how to recognize the symptoms of stroke--and the importance of getting immediate treatment at the appropriate facility.

What is stroke?

There are two kinds of strokes: ischemic, in which a blockage prevents blood flow to the brain, and hemorrhagic, in which there is bleeding in the brain. Ischemic is the most common, occurring in about 80 percent of cases in Suffolk County. Both kinds can manifest as either acute or chronic. An acute stroke generally signifies the sudden onset of symptoms, indicating that you are indeed having a stroke. A chronic stroke indicates the presence of factors that could eventually cause a stroke, such as a blockage or an unruptured aneurysm. In these cases, if detected in time and treated, stroke can be prevented.

What are the signs of a stroke?

The signs of ischemic stroke include paralysis, particularly on one side of the body, difficulty with speech or vision, overall weakness, or total loss of consciousness. People also may experience more subtle signs, such as numbness and tingling, which may indicate what is commonly called a mini-stroke, or transient ischemic attack (TIA). Although TIAs tend to quickly resolve themselves, they are often a precursor to a major stroke, so it is important to take them seriously and see a doctor if you suspect you had one. The signs of a hemorrhagic stroke are more dramatic and painful: the sudden onset of a headache often described as the worst headache of your life.

When should an individual seek treatment for stroke?

As quickly as possible. With hemorrhagic stroke, the pain is intense so people seek treatment quickly. With ischemic stroke, people tend to wait because they may not be in much pain or they're not sure what is going on. This is a mistake. Like a heart attack, where time equals heart muscle, with a stroke, time equals brain cells. And like heart muscle, brain cells do not grow back. Researchers have found that 1.9 million neurons are lost every minute during a stroke, and that the brain ages 3.6 years for every hour a stroke remains untreated. Seeking help promptly greatly increases the chances for reversing the effects of stroke and your prospects for a full recovery.

If you suspect you're having a stroke, what should you do?

If you experience symptoms of stroke, get immediate help. Call 911 and alert the operator that you have a possible stroke situation. Since speed of treatment is crucial, being at the right place at the right time is key. Ask to be taken to a primary stroke center, where appropriate and efficient protocols are in place, the latest interventions are available 24/7, and your medical team is experienced and highly trained. The Cerebrovascular Center at Stony Brook University Medical Center, designated by the Joint Commission and the New York State Department of Health as a Primary Stroke Center, meets all these criteria, and more. The Center offers specialized and highly trained endovascular teams; the latest equipment including three angiography suites that have capacity to cover all of Suffolk County 24/7; leading edge procedures including every FDA-approved minimally invasive stroke intervention technique; high-tech diagnostics including a new mobile CT scanner; and access to virtually all the major ongoing clinical trials in the United States--in fact, 60 percent of patients treated at Stony Brook's Center enroll in clinical trials.

What else does the Center offer?

Some of the innovative interventions that are available right here in the community include:

For more information about the signs of stroke and the Cerebrovascular Center, call (631) 444-4000.