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Episode 32: National Stroke Awareness Month 2021

May is stroke awareness month in the United States of America. In this episode of Brain Injury Insider, host Michael V. Kaplen discusses the causes and classifications of strokes, current treatment options, and calls for stronger regulation of the insurance industry to ensure stroke victims receive the care and support they need.

May is Stroke Awareness Month.

A stroke is an acquired brain injury with devastating physical, cognitive, emotional, and even behavioral consequences.

Strokes have reached epidemic levels in the United States, and here are some frightening statistics from the American Heart Association, and the American Stroke Association.

Approximately eight hundred thousand new strokes take place each year, and approximately one hundred thousand deaths each year are caused by strokes. By the year 2030, one in every twenty five adults will suffer a stroke, which translates into 3.5 million individuals.

But tragically, according to the Centers for Disease Control, only three out of five people in the United States know all major stroke symptoms, and know to call 911 when someone is having a stroke.

When a stroke happens, every minute counts for successful treatment.

The American Heart Association, and the American Stroke Association have developed a saying, "time is brain", to emphasize the need for prompt treatment of strokes to reduce the risk of permanent disability.

Oxygen is the food of the brain and the brain needs oxygen to survive. This oxygen is supplied to the brain through blood vessels, and blood that flows through the brain.

When there is a blockage in the flow of this blood, a clot develops that prevents delivery of oxygen. This blockage and disruption causes rapid death of brain tissue, which results in something known as a stroke.

There is an easy way of remembering stroke signs and symptoms that everyone needs to know about. It's called BEFAST.

B for balance loss, E for eyesight loss, F for face drooping, A for arm weakness, S for speech difficulty, and T for time to call 911.

An individual can have sudden numbness or weakness in the face, arm or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech are all common. And many individuals report sudden trouble seeing in one or both eyes, or sudden trouble walking, or dizziness and loss of balance, or a lack of coordination. Sudden, severe headaches with no known cause are also frequently reported.

It is so important to know and remember that when you suspect someone is having a stroke to call 911 right away. These symptoms, even if transitory, should never be ignored.

And it's recommended that individuals or family members do not drive a possible stroke victim to the hospital, but instead call an ambulance and report the belief that the victim may be suffering from a stroke.

EMS when they arrive can perform vital first steps that will reduce the consequences of the stroke. And many ambulances are now equipped with portable CT scans and stroke busting medications that can rapidly be administered to patients at the scene and before being transported to an emergency department.

There are two major classifications of strokes, the most prevalent being something known as an ischemic stroke, which is caused by a blood clot within a blood vessel in the brain. This accounts for approximately eighty five percent of all strokes.

The second type of stroke is known as a hemorragic stroke, which occurs when a blood vessel in the brain burst or ruptures, and that restricts the flow of blood within the brain. This accounts for approximately 15 percent of strokes.

In all cases, a stroke is a medical emergency requiring prompt diagnosis and timely treatment.

When brain tissue is deprived of oxygen cell death can rapidly take place. Timely intervention will prevent cell death and lead to a better outcome. And the tragic consequences of a stroke can be limited or even reversed if treatment is rapidly instituted.

In our law practice I have been studying strokes and stroke treatment for many years, and have been intrigued by the historic medical controversy involving the stroke busting drug known as TPA, and stroke rescue surgery known as an embolectomy.

Today, there is no longer any controversy, and the recognized gold standard treatment for a stroke is the administration of the clot busting or dissolving medication known as TPA, or tissue plasminogen activator.

This medication if timely administered can dissolve the blood clot, and prevent the devastating consequences of a stroke.

And today, besides medication, a surgical procedure known as a thrombectomy or embolectomy is widely available. This procedure mechanically clears the stroke by pulling it out of the brain, and is an additional means of treating stroke victims. Using this surgical treatment procedure, many patients can receive treatment even up to twenty four hours after a stroke has taken place. This procedure has been nicknamed Mr. Clean.

But tragically, many stroke victims do not receive proper treatment because their stroke was unrecognized by physicians in both the Emergency Department of Hospitals and in private offices. And timely treatment, unfortunately, was not properly instituted.

In some cases, individuals, because of their age or ethnicity, have been improperly identified as being perhaps drug users, and again, did not receive proper treatment.

This is tragic, and our medical profession must think of stroke when an individual arrives in the emergency department with the signs and symptoms that I have described.

In other situations, medical conditions which can lead to a stroke such as high blood pressure, a tear in an artery leading to the brain, or cardiac abnormalities such as atrial fibrillation, go undiagnosed or even untreated.

While not all strokes can be successfully prevented, and in some cases the devastating consequences can't be minimized, rehabilitation is essential to limit the effects of a stroke.

But unfortunately, in today's push for savings, medical providers are being pressured by insurance companies to limit costs, and divert patients away from intensive coordinated rehabilitation programs.

Strong regulation of the insurance industry is critically needed to ensure patients receive the care that they desperately deserve.

So let's all do our part and prevent the needless strokes from happening, and making sure that a suspected stroke is recognized, and that prompt treatment is instituted, and comprehensive rehabilitation is provided.

Audio version

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Brain Injury Insider

michael kaplen
Brain Injury Insider is a weekly video update by The Brain Injury Law Firm ®. We cover the latest news and developments in traumatic brain injury, concussion, and brain injury law.