Signs/Symptoms Risk Factors Prevention Definition Statistics Printable Stroke Facts Brochure (pdf file)
	Please read the following information so that you can learn to protect yourself, and your loved ones, from the devastating effects of stroke. And please contact the Stroke Association of Southern California at (310) 575-1699 if you have any questions or concerns, or if you would like any additional information.

What are the warning signs?

• Sudden numbness, weakness or paralysis of the face, arm or leg on one side of the body.
• Sudden loss of speech or trouble talking or understanding speech.
• Sudden dimness or loss of vision, particularly in only one eye.
• Unexplained dizziness, unsteadiness or sudden falls, especially in conjunction with any of the previous symptoms.
• Sudden severe headache with no apparent cause, often described as "the worst headache I have ever had."
• A mini stroke, or transient ischemic attack (TIA), is also a warning sign of a larger stroke. A TIA has the same warning signs as a stroke. But with a TIA, the symptoms usually go away rapidly, often within five to ten minutes. In some cases however, the symptoms last for up to 24 hours. If you are having a TIA your doctor will evaluate the underlying causes and begin appropriate preventive measures.

 TAKE ACTION IMMEDIATELY

STROKE IS A 911 EMERGENCY!!

• If you experience any of the above symptoms, or observe them in someone else, call 911 as soon as possible! Even if these symptoms don’t cause pain or they go away quickly — call 911 immediately.
  
• Several new medical advancements are now available at some hospitals to minimize the damage from a stroke (i.e. t-PA — a clot dissolving drug). But these drugs are only effective if taken within 3 hours of onset of the stroke.
  
  

	LEARN THE RISK FACTORS
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There are various risk factors associated with stroke. While some cannot be altered, many can be controlled with medical treatment and/or lifestyle changes. If you are at risk for stroke, it is important to consult with your doctor.

• Age — Risk for stroke increases with age, but nearly 30% of stroke victims are under the age of 65. For people over 55, the incidence of stroke more than doubles in each successive decade.
  

  For young adults (under 45 years of age) primary risk factors also include use of oral contraceptives, pregnancy, migraine, as well as traditional vascular risk factors including hypertension, diabetes mellitus, cocaine use and cigarette smoking.¹¹
  
  

• Gender — The incidence of stroke is about 30% higher for men. Still, stroke kills more than twice as many American women every year as breast cancer.
• Race — African Americans have a 60% higher incidence of stroke than Caucasians.
• Heredity — Individuals with a family history of stroke are at greater risk.
• Diabetes — People with diabetes, especially those who have high blood pressure, are at increased risk.
• High blood pressure — The higher the blood pressure, the higher the risk of stroke. High blood pressure is the number one risk factor for stroke!
• Heart disease — People with heart disease have more than twice the risk of stroke than people with no heart problems.
• Transient Ischemic Attack (TIAs or mini-strokes) - are a strong predictor of stroke. A TIA can be treated in order to prevent a stroke.
• High cholesterol and triglyceride levels — It is important to follow a low-fat, low cholesterol diet.
• Cigarette smoking — Smoking damages the arteries and thickens the blood, making stroke inducing clots more likely to form.
• Excessive alcohol intake (three drinks or more per day)— Alcohol increases your blood pressure and weakens your heart, therefore increasing your risk of stroke.
• Obesity — Excess weight increases your chances of having other risk factors for stroke such as high blood pressure, diabetes and heart disease.
• Physical activity — Inactivity increases risk of high blood pressure, obesity and/or heart disease, thereby increasing risk of stroke.

	PROTECT YOURSELF
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Regular medical check-ups are the best protection against stroke. With the help of a comprehensive medical history and examination, your doctor can help assess your risk of stroke, suggest life-style changes, and/or prescribe medications necessary to help prevent stroke.

Following are just a few life-style changes that can help protect you from stroke:

Treat hypertension

Lose excess weight

• Being overweight is known to be a risk factor in hypertension and diabetes, which are risk factors for stroke. A regular exercise plan, in combination with a high fiber, low fat, low sodium diet will help you to burn calories and lose weight.
  

Start exercising

Lower cholesterol levels

Limit alcohol intake

Put that cigarette out!

	WHAT IS STROKE?
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A stroke is a sudden and often severe attack caused by an interruption of blood supply to part of the brain. Simply stated, a stroke is an injury to the brain caused by a blockage or rupture of a blood vessel.

The brain is composed of billions of nerve cells which are dependent on a continuous supply of oxygen. When a person has a stroke, this continuous supply is cut off and brain cells suffer damage. Unlike other parts of the body that can withstand loss of blood flow for a prolonged period of time, the brain cell, so deprived, dies.

There are two major types of stroke: ischemic (the most common) and hemorrhagic (the most fatal).

1) Ischemic is a blockage caused by one of the following:

• Thrombosis -- when a clot forms within a blood vessel of the brain/neck;
• Embolism -- when a clot from another part of the body (such as the heart) moves "upstream" and closes off a blood vessel;
• Stenosis -- when there is a severe narrowing of an artery in or leading to the brain.
  
  

2) Hemorrhagic is bleeding in the brain caused by one of the following:

• Subarachnoid — when a blood vessel inside the skull ruptures, causing a bleed between the brain and skull;
• Cerebral — when a defective artery in the brain bursts.

After a stroke, some area of the brain has been injured and is no longer capable of functioning as it did before the stroke. The extent and location of the injury to the brain determines which brain functions are affected. Some losses of function are visible (i.e. paralysis), while others are not (i.e. word recall, memory). It is the combination of visible and invisible injuries that makes stroke so mysterious and difficult for family members, the public, and even the stroke survivor to understand.

No two stroke survivors suffer exactly the same injuries or disabilities. Some may recover to such a degree that a normal life can be resumed, some may have residual deficits although they can still perform many skills, while others suffer injuries that are extensive and permanent.

	STROKE STATISTICS
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• Stroke is the #1 cause of serious, long-term adult disability in the United States.¹
  
  
• Stroke is the third leading cause of death after heart disease and cancer. It kills nearly 160,000 people each year.¹
  
  
• Every 45 seconds someone in the U.S. will experience a stroke. This means that every year more than 750,000 Americans have a new or recurrent stroke.²
  
  
• Over the course of a lifetime, four out of every five American families will be touched by stroke.³
  
  
• 4,000,000 Americans are living with the effects of stroke. About 1/3 have mild impairments, another third are moderately impaired and the remainder are severely impaired.³
  
  
• Nearly 30% of those who suffer a stroke are under the age of 65.⁷ Each year, stroke affects 120,000 women and 105,000 men under 45 years of age.¹⁰
  
  
• For people over 55, the incidence of stroke more than doubles in each successive decade.⁷
  
  
• The incidence of stroke is higher for males than for females, especially in the under 65 age group. But while women account for 43% of the strokes that occur each year, they account for 62% of stroke deaths.¹
  
  
• Each year, stroke kills more than twice as many American women as breast cancer.¹
  
  
• Among women over age 45, stroke is more common than heart attack.¹
  
  
• Women over age 30 who smoke and take high-estrogen oral contraceptives have a stroke risk 22 times higher than average.¹²
  
  
• Stroke incidence among African Americans is almost double that of white Americans.¹
  
  
• African-Americans not only have a higher incidence of strokes than Caucasians and Hispanics, but they also suffer more extensive physical impairments that last longer than those of other racial groups in the U.S. Not only are African-Americans twice as likely as Caucasians to have a stroke, they are also twice as likely to die from a stroke.¹³
  
  
• People with diabetes, especially those who have high blood pressure, are at increased risk for stroke. Women with diabetes are at greater risk than men.¹⁴
  
  
• Hypertension is a major contributing factor for up to 70% of strokes.¹⁵
  
  
• Among adults age 50 and over, a recent survey showed that 97% could not identify a single stroke symptom. Only 1% could name stroke as a leading cause of death.¹⁶
  
  
• Approximately one third of younger individuals with stroke and three quarters of older individuals with stroke have persisting impairments and disabilities.⁴
  
  
• It has been estimated that one in three stroke survivors need help caring for themselves, one in five need help walking and seven out of ten cannot return to their previous jobs.⁵ 51% are unable to return to any type of work after stroke.⁶
  
  
• Approximately 1/3 of all stroke survivors will have another stroke within five years.⁷ About 14% will have another within one year.⁸
  
  
• Stroke costs the U.S. $30 billion dollars annually in medical expenses and lost productivity.⁹
  
  

REFERENCES

1. Hoyert DL, Kochanek KD, Murphy SL. Deaths: Final Data for 1997. National Vital Statistics Reports; Vol. 47 no. 19. Hyattsville, Maryland: National Center for Health Statistics. 1999.
2. Williams GR, Jiang JG, Matchar DB, Samsa GP. Incidence and Occurrence of Total (First-Ever and Recurrent) Stroke. Stroke. 1999;30:2523-2528.
3. American Heart Association. 1999 Heart and Stroke Statistical Update. Dallas, Texas: American Heart Association. 1998.
4. Malmagren R, Bamford J, Warlow C, et al. Projecting the number of patients with first-ever strokes and patients newly handicapped by stroke in England and Wales. BMJ. 1989;298:656-660.
5. Kannel WB, Wolf PA, Verter J, et al. Epidemiologic assessment of the role of blood pressure in stroke risk: the Framingham Study. JAMA. 1970;214:301-310.
6. Black-Schaffer RM, Osber JS. Return to work after stroke: development of a predictive model. Arch Phys Med Rehab. 1990;71:285-290.
7. National Institutes of Health, National Institute of Neurological Disorders and Stroke. Stroke: Hope Through Research. www.ninds.nih.gov, May 1999.
8. Broderick J, Brott T, Kothari R, et al. The Greater Cincinnati/Northern Kentucky Stroke Study: Preliminary first-ever and total incidence rates of strokes among blacks. Stroke. 1998;29:415-421.
9. Matchar DB, Duncan PW. Cost of Stroke. Stroke Clin Updates. 1994;5:9-12.
10. Cardiovascular Disease Surveillance, Stroke, 1980-1989. Atlanta, GA: Centers for Disease Control; 1994:69.
11. Collins JG. National Center for Heath Statistics, 1988: prevalence of selected chronic conditions, United States, 1983-1985. In. Advance Data from Vital and Health Statistics. Hyattsville, MD: Public Health Service; 1989:155.
12. Petitti DB, Winger J. Use of oral contraceptives and cigarette smoking and risk of subarachnoid hemorrhage. Lancet. 1978;2(8083):234-5.
13. Horner, R. Racial Variations on Ischemic Stroke-Related Physical and Functional Impairments. Stroke. 1991;22:1497-1501.
14. Gorelick PB, Sacco RL, Smith DB, et al. Prevention of first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA. 1999;281:1112-1120.
15. Dunbabin DW, Sandercock PAG. Preventing stroke by the modification of risk factors. Stroke. 1990;21(suppl IV): 36-39.
16. Gallup/National Stroke Association Survey of Stroke Awareness in America. 1996.
17. National Stroke Association, Stroke/Brain Attack Briefing. 1999.