Strokes: Myths vs. Facts

About half of American adults have at least one risk factor for stroke, including high blood pressure, diabetes, high cholesterol and being overweight. But most are not fully aware of the differences between stroke risks and heart disease, and they may take stroke symptoms and warning signs for granted.

For the first time last year, stroke dropped from fourth to the fifth-leading cause of death in the United States, according to the U.S. Centers for Disease Control and Prevention. And there has been progress in stroke treatment and early intervention. But it still accounts for about 130,000 deaths a year, behind heart disease, cancer, chronic lower respiratory diseases and accidents.

“Strokes are not as common as heart attacks, for example, but they are a main source of people losing work because they can have long-term disabilities that can continue for years,” says Paul Damski, M.D., a neurologist affiliated with Baptist Health Neuroscience Center. “Fortunately, it’s a decreasing cause of death.”

Every year, more than 795,000 people in the U. S. have a stroke, the CDC says. In some cases, survivors are left with paralysis on one side of the body, speech or vision problems or memory loss — and long-term rehabilitation is required.

Physicians who treat stroke victims often have to educate patients and family members about strokes because there are longstanding myths or misconceptions about this condition. And that can often lead to victims and their loved ones not recognizing symptoms or warning signs. Delays in treating strokes can lead to death or severe debilitations.

An ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain. It accounts for about 87 percent of all stroke cases and can potentially be treated with tPA, the clot-busting drug. Far fewer strokes are hemorrhagic, caused when a weakened blood vessel ruptures.

Myths vs. Facts

Here are the most common myths or misconceptions about stroke, with accompanying facts:

1. MYTH: Strokes only happen to the elderly.

FACT: While older people may tend to have a higher rate of risk factors, such as high blood pressure and diabetes, age is not necessarily a factor. Even young adults can have a stroke, says Dr. Damski. Adults in middle age, in their 40s and 50s, may be more susceptible, for example, if they are smokers and have other underlying risk factors.

“Even women at the time of pregnancy, when pressure can change and blood thickens, can have a stroke,” he says. The increased stroke risk among younger people has been tied to the obesity epidemic and accompanying high blood pressure.

2. MYTH: Strokes cannot be treated.

FACT: Strokes can be treated, but a fast response time is vital. Emergency room physicians and consulting neurologists use the standard of three to 4.5 hours. After that amount of time, it’s likely too risky to administer the clot-busting drug, tPA, which means a greater possibility of permanent disability or death from a stroke. Physicians who deal with stroke victims stress the acronym ‘FAST,’ a process that may minimize the amount of damage to brain cells.

3. MYTH: Strokes are not preventable.

FACT: The underlying risk factors can be managed, thus significantly reducing the potential of having a stroke.

“There is no way of completely eliminating the risk, but you can substantially improve your chances,” says Dr. Damski.

Risk factors for stroke include: high blood pressure, diabetes, high cholesterol, smoking and too much alcohol.  Physical inactivity and unhealthy eating can significantly contribute to these risk factors — so lifestyle changes, including exercising and a healthy diet, can diminish your risk of a stroke.

4. MYTH: A stroke takes place in the heart.

FACT: A stroke takes place in the brain. But there is much confusion between strokes and heart attacks. In South Florida, a mix of cultures and languages can heighten confusion. In the local community, “many think a stroke is a heart condition, but it is clearly a brain problem that is sometimes caused by heart problems,” says Dr. Damski. A reason for the confusion: The risk factors for stroke are practically the same as those for overall heart disease.

5. MYTH: A common warning sign of a stroke is pain.

FACT: A stroke will produce pain in less than one-third of victims.

“Unlike heart attacks and the associated chest pain, strokes are often painless,” Dr. Damski says.

The most common symptoms of stroke include a sudden onset of numbness or weakness on one side, double vision, confusion, lack of coordination and trouble speaking. When pain is involved, it usually comes as a sudden and severe headache.