What You Need To Know About Strokes - Capital Health

Experts at Capital Health warn anyone experiencing even one of the signs or symptoms of stroke to call 911 and get to the hospital immediately. Numbness or weakness of the face, arm or leg, confusion, and trouble speaking or understanding speech are just some of the signs of a stroke. With stay-at-home orders and social distancing guidelines in place during the COVID-19pandemic, healthcare experts have expressed concern about people hesitating to call 911 and delaying necessary treatment, particularly for time-sensitive emergencies like stroke.

"Treatment for stroke cannot be delayed," said Dr. Dustin Rochestie, director of Stroke, Neurology, and Neurocritical Care at Capital Health and a board certified neuro intensivist. "Every minute is critical because there is a short window in which we can achieve the best results. Hospitals have taken significant measures to protect people, so concerns regardingCOVID-19should never prevent someone from seeking lifesaving treatments."

If you, or someone else, are experiencing any of the following signs or symptoms of stroke, call 911 immediately.

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of 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 headache with no known cause.


The most common type of stroke is an ischemic stroke. Ischemic strokes are caused by a blockage in a blood vessel which restricts blood flow to the brain. This accounts for about 87 percent of cases according to the American Stroke Association. Hemorrhagic strokes, the second type, occur when a blood vessel bursts, causing bleeding in the brain. Both are time-sensitive emergencies.

When an ischemic stroke occurs, the blood supply doesn't reach parts of the brain, which prevents oxygen from getting to brain tissue, according to Dr. Daniel Landau, a fellowship trained and board certified vascular neurologist and neuro hospitalist at Capital Health.

"Brain cells die when oxygen doesn't reach the brain," said Dr. Landau. "It's critical to get help immediately so that we can try to restore blood flow as quickly as possible and get oxygen back to the affected area of the brain."

A person having an acute ischemic stroke may be treated for up to 4.5hours after stroke onset using the clot busting drug tPA.

In patients who have a blood clot in larger vessels of brain, the stroke team at Capital Health may perform a mechanical thrombectomy, another minimally invasive approach. Physicians who are specially trained in performing these interventions access the artery in the wrist or groin and use devices they navigate carefully to the site of the clot in the brain.

"For a number of reasons tPA may not be an option, or it may not eliminate the clot," said Dr. Pratit Patel, a board certified and fellowship trained endovascular neurologist who can manage both the medical and surgical treatment of stroke. "Mechanical thrombectomies allows us to get right to the clot so we can try to gently remove it so it no longer blocks the flow of blood."

The risk of having a stroke gets higher with age, and women have a higher lifetime risk, according to Landau, noting that the African American community has the highest risk. Your risk also increases if you have family history of stroke or if you've had a prior transient ischemic attack (TIA), stroke or heart attack.

While there are some things that contribute to your stroke risk that you cannot change, Dr. Landau notes there are things you can do to take control and reduce your risk of having a stroke. Knowing your blood pressure, blood sugar and cholesterol numbers and controlling them with diet, exercise,and medication when needed, are important steps in preventing a stroke.

Also important is treating or controlling heart disease, atrial fibrillation, arterial diseases and other heart conditions.

Maintaining a healthy weight, exercising and eating a healthy diet are all important, not just for stroke, but for other diseases as well. "Staying physically active and being mindful of your diet can really make a difference in your overall health and longevity," said Landau.

If you smoke, get help quitting, because smoking also contributes to stroke.

"Like heart disease, there are steps you can take to lower your risk factors for stroke," said Dr. Rochestie. "Some risk factors are harder to control than others, but it's worth it for the sake of your health."
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