Stroke: A Speaker’s OutlineStroke: A Speaker’s Outline

Developed by:

The American Stroke Association

Developed by:

The American Stroke Association

Updated 4.19.2011

What Is a Stroke?What Is a Stroke?

A brain injury caused when a blood vessel to the brain becomes blocked our bursts, cutting off blood flow

A brain injury caused when a blood vessel to the brain becomes blocked our bursts, cutting off blood flow

What Is Stroke’s Impact? What Is Stroke’s Impact? Stroke is the third leading cause Stroke is the third leading cause

of death in the United Statesof death in the United States

• About 795,000 Americans suffer a About 795,000 Americans suffer a stroke each year (that’s a stroke stroke each year (that’s a stroke every 40 seconds)every 40 seconds)

• 77% are new strokes and 23% are 77% are new strokes and 23% are recurrent strokesrecurrent strokes

• Stroke kills more than 137,000 Stroke kills more than 137,000 people in a year. ( that’s a death people in a year. ( that’s a death every 4 minutes)every 4 minutes)

Stroke is the third leading cause Stroke is the third leading cause of death in the United Statesof death in the United States

• About 795,000 Americans suffer a About 795,000 Americans suffer a stroke each year (that’s a stroke stroke each year (that’s a stroke every 40 seconds)every 40 seconds)

• 77% are new strokes and 23% are 77% are new strokes and 23% are recurrent strokesrecurrent strokes

• Stroke kills more than 137,000 Stroke kills more than 137,000 people in a year. ( that’s a death people in a year. ( that’s a death every 4 minutes)every 4 minutes)

What Is Stroke’s Impact? (cont’d) What Is Stroke’s Impact? (cont’d)

Stroke is a leading cause of Stroke is a leading cause of serious, long-term disability serious, long-term disability

40% of Stroke deaths occur in 40% of Stroke deaths occur in males, and 60% in females.males, and 60% in females.

Americans paid about $73.7 billion Americans paid about $73.7 billion for stroke-related medical costs in for stroke-related medical costs in 20102010

Stroke is a leading cause of Stroke is a leading cause of serious, long-term disability serious, long-term disability

40% of Stroke deaths occur in 40% of Stroke deaths occur in males, and 60% in females.males, and 60% in females.

Americans paid about $73.7 billion Americans paid about $73.7 billion for stroke-related medical costs in for stroke-related medical costs in 20102010

What Are the Types of Stroke?What Are the Types of Stroke?

Ischemic (Blockage) 87%

Caused by a blockage in the blood vessels to the brain

Hemorrhagic (Bleeding) 13%

Caused by burst or leaking blood vessels in the brain

Ischemic (Blockage) 87%

Caused by a blockage in the blood vessels to the brain

Hemorrhagic (Bleeding) 13%

Caused by burst or leaking blood vessels in the brain

What Causes Ischemic Stroke ?What Causes Ischemic Stroke ?

Fatty deposits line the blood vessel wall

•Thrombus: A blood clot forms at the fatty deposit

•Embolus: A travelingparticle gets stuck in a small vessel

Fatty deposits line the blood vessel wall

•Thrombus: A blood clot forms at the fatty deposit

•Embolus: A travelingparticle gets stuck in a small vessel

Clot-caused Stroke by Age, Sex and RaceClot-caused Stroke by Age, Sex and Race

Annual rate of first cerebral infarction by age, sex and race Annual rate of first cerebral infarction by age, sex and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94).(Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94). Source: Unpublished data from the GC/NKSS; Kissela et al., Stroke. 2004;35:426-31.Source: Unpublished data from the GC/NKSS; Kissela et al., Stroke. 2004;35:426-31.

What Causes Hemorrhagic Strokes?What Causes Hemorrhagic Strokes?

A weakened blood vessel rupturesA weakened blood vessel ruptures

Aneurysms:Aneurysms: Ballooning of a Ballooning of a weakened spot of a weakened spot of a blood vesselblood vessel

Arteriovenous Arteriovenous Malformations (AVMs): Malformations (AVMs): Cluster of abnormal Cluster of abnormal blood vessels blood vessels

A weakened blood vessel rupturesA weakened blood vessel ruptures

Aneurysms:Aneurysms: Ballooning of a Ballooning of a weakened spot of a weakened spot of a blood vesselblood vessel

Arteriovenous Arteriovenous Malformations (AVMs): Malformations (AVMs): Cluster of abnormal Cluster of abnormal blood vessels blood vessels

Hemorrhagic Stroke by Age, Sex and Race

Hemorrhagic Stroke by Age, Sex and Race

Annual rate of first intracerebral hemorrhage by age, sex and race Annual rate of first intracerebral hemorrhage by age, sex and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94).(Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94). Source: Kissela et al., Stroke. 2004;35:426-31.Source: Kissela et al., Stroke. 2004;35:426-31.

What Parts of theBrain Can Stroke Affect?

What Parts of theBrain Can Stroke Affect?

What Are the Effects of Stroke?What Are the Effects of Stroke?

Right Brain Right Brain

What Are the Effects of Stroke?What Are the Effects of Stroke?

Left Brain Left Brain

Stroke Warning SignsStroke Warning Signs Sudden weakness or numbness of the

face, arm or leg, especially on one sideof the body

Sudden confusion, trouble speaking or understanding

Sudden trouble seeing in one or both eyes

Sudden trouble walking, dizziness, loss of balance or coordination

Sudden, severe headaches with no known cause

Sudden weakness or numbness of the face, arm or leg, especially on one sideof the body

Sudden confusion, trouble speaking or understanding

Sudden trouble seeing in one or both eyes

Sudden trouble walking, dizziness, loss of balance or coordination

Sudden, severe headaches with no known cause

Learn to recognize a stroke.

Time lost is brain lost.

Learn to recognize a stroke.

Time lost is brain lost. If you notice one or more of

the stroke warning signs,GET HELP IMMEDIATELY!

Stroke is an emergency – CALL 9-1-1.

If you notice one or more of the stroke warning signs,GET HELP IMMEDIATELY!

Stroke is an emergency – CALL 9-1-1.

Transient Ischemic Attacks (TIAs)Transient Ischemic Attacks (TIAs)

TIAs are “warning strokes” that can happen before a major stroke

They occur when blood flow through a brain artery is briefly blocked or reduced

TIAs are “warning strokes” that can happen before a major stroke

They occur when blood flow through a brain artery is briefly blocked or reduced

TIA symptoms are temporary but similar to those of a full-fledged stroke

A person who has a TIA is 9.5 times more likely to have a stroke

A TIA is a medical emergency

TIA symptoms are temporary but similar to those of a full-fledged stroke

A person who has a TIA is 9.5 times more likely to have a stroke

A TIA is a medical emergency

Transient Ischemic Attacks (TIAs)Transient Ischemic Attacks (TIAs)

Stroke Risk Factors That Cannot Be TreatedStroke Risk Factors That Cannot Be Treated Age

Heredity (family history) and race

Sex (gender)

Prior stroke, TIA or heart attack

Age

Heredity (family history) and race

Sex (gender)

Prior stroke, TIA or heart attack

Stroke Prevalence by Age & Sex

Stroke Prevalence by Age & Sex

Prevalence of stroke by age and sexPrevalence of stroke by age and sex (NHANES: 1999-2004). (NHANES: 1999-2004). Source: NCHS and NHLBI.Source: NCHS and NHLBI.

0.5 1.2

6.5

0.5

2.3

6.2

12.414.8

0

2

4

6

8

10

12

14

16

20-39 40-59 60-79 80+

Perc

ent o

f Pop

ulat

ion

Men Women

Stroke Risk FactorsThat Can Be TreatedStroke Risk FactorsThat Can Be Treated High blood pressure

Tobacco use

Diabetes

Carotid or other artery disease

Atrial fibrillation

Other heart disease

High blood pressure

Tobacco use

Diabetes

Carotid or other artery disease

Atrial fibrillation

Other heart disease

Stroke Risk FactorsThat Can Be Treated (cont’d)Stroke Risk FactorsThat Can Be Treated (cont’d) Sickle Cell Disease (Sickle

Cell Anemia)

High blood cholesterol

Poor diet

Physical inactivity

Obesity

Stroke Risk by Levelsof Risk Factors

Stroke Risk by Levelsof Risk Factors

AA BB CC DD EE FFSystolic BP*Systolic BP* 95-10595-105 130-148130-148 130-148130-148 130-148130-148 130-148130-148130-148130-148DiabetesDiabetes NoNo NoNo YesYes YesYes YesYesYesYesCigarettesCigarettes NoNo NoNo NoNo YesYes YesYesYesYesPrior Atrial Prior Atrial Fib.Fib. NoNo NoNo NoNo NoNo Yes Yes YesYesPrior CVDPrior CVD NoNo NoNo NoNo NoNo NoNoYesYes

Estimated 10-year stroke risk in 55-year-old adults according to levels of Estimated 10-year stroke risk in 55-year-old adults according to levels of various risk factors various risk factors (FHS). (FHS). Source: Wolf et al., Stroke.1991;22:312-318.Source: Wolf et al., Stroke.1991;22:312-318.

Less Well-Documented Stroke Risk FactorsLess Well-Documented Stroke Risk Factors

Geographical location

Socioeconomic factors

Excessive alcohol intake

Certain kinds of drug abuse

Geographical location

Socioeconomic factors

Excessive alcohol intake

Certain kinds of drug abuse

How Can You ReduceYour Risk of Stroke?How Can You ReduceYour Risk of Stroke?

Control high blood pressure Don’t smoke Consume less sodium Lower cholesterol Lose excess weight Be physically active

Control high blood pressure Don’t smoke Consume less sodium Lower cholesterol Lose excess weight Be physically active

Other Actions That Will Probably Reduce Stroke Risk

Other Actions That Will Probably Reduce Stroke Risk Limit alcohol intake Don’t use illicit drugs Women who smoke or have a

history of blood clots should not take oral contraceptives

Look for signs of sleep-disordered breathing

Limit alcohol intake Don’t use illicit drugs Women who smoke or have a

history of blood clots should not take oral contraceptives

Look for signs of sleep-disordered breathing

How Are Strokes Treated?How Are Strokes Treated? Ischemic StrokeIschemic Stroke

• Acute treatmentAcute treatment Clot-buster, e.g., t-PAClot-buster, e.g., t-PA Interventional proceduresInterventional procedures

• Preventive treatmentPreventive treatment Anticoagulants (warfarin)Anticoagulants (warfarin) Antiplatelet agents (aspirin) Antiplatelet agents (aspirin) Carotid endarterectomyCarotid endarterectomy Angioplasty/stentsAngioplasty/stents

Hemorrhagic StrokeHemorrhagic Stroke• Surgery Surgery • Endovascular procedures, e.g., “coils”Endovascular procedures, e.g., “coils”

Ischemic StrokeIschemic Stroke• Acute treatmentAcute treatment

Clot-buster, e.g., t-PAClot-buster, e.g., t-PA Interventional proceduresInterventional procedures

• Preventive treatmentPreventive treatment Anticoagulants (warfarin)Anticoagulants (warfarin) Antiplatelet agents (aspirin) Antiplatelet agents (aspirin) Carotid endarterectomyCarotid endarterectomy Angioplasty/stentsAngioplasty/stents

Hemorrhagic StrokeHemorrhagic Stroke• Surgery Surgery • Endovascular procedures, e.g., “coils”Endovascular procedures, e.g., “coils”

RehabilitationRehabilitation If you have a stroke, start a

rehabilitation program as soonas you can

Rehabilitation may focus on:

• Self-care

• Mobility     

• Communication

• Cognitive skills

• Social skills

If you have a stroke, start a rehabilitation program as soonas you can

Rehabilitation may focus on:

• Self-care

• Mobility     

• Communication

• Cognitive skills

• Social skills

Types of Rehabilitation ProgramsTypes of Rehabilitation Programs Acute care and rehabilitation

hospitals Long-term nursing care facilities    At home, through home health

agencies          Outpatient facilities

Acute care and rehabilitation hospitals

Long-term nursing care facilities    At home, through home health

agencies          Outpatient facilities

Rehabilitation SpecialistsRehabilitation Specialists Physicians

Rehabilitation nurses

Physical therapists

Speech/language therapists

Physicians

Rehabilitation nurses

Physical therapists

Speech/language therapists

Rehabilitation Specialists (cont’d)Rehabilitation Specialists (cont’d) Audiologists Audiologists

Occupational therapists Occupational therapists

PhysiatristsPhysiatrists

Psychologists / Psychologists / psychiatristspsychiatrists

Audiologists Audiologists

Occupational therapists Occupational therapists

PhysiatristsPhysiatrists

Psychologists / Psychologists / psychiatristspsychiatrists

Are you a stroke survivor,

caregiver, family member or healthcare provider

who needs information about

stroke?

Are you a stroke survivor,

caregiver, family member or healthcare provider

who needs information about

stroke?

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To Learn More About Stroke…To Learn More About Stroke…

CALL 1-888-4-STROKE (1-888-478-

7653)

Or visit us online at StrokeAssociation.org

CALL 1-888-4-STROKE (1-888-478-

7653)

Or visit us online at StrokeAssociation.org