Dear Doctor: I was a huge Luke Perry fan in high school, and like so many others, I was shocked that he had a stroke at just 52 years old. Isn't that awfully young? How do you know if you're having a stroke?
Dear Reader: While it's true that the majority of strokes occur in people 65 and older, they can happen in people of any age. This includes not only young and middle-aged adults, but also children and even infants in utero.
Stroke is the fifth-leading cause of death in the United States. Risk factors include high blood pressure, high cholesterol, smoking, obesity and diabetes. Of the 795,000 people each year who have a stroke, 140,000 do not survive. A significant percentage of those who do survive are left with a range of disabilities that affect speech, movement and cognition. One of the challenges for younger stroke victims is misdiagnosis. Symptoms can be mistaken for conditions like migraine, seizure and inner ear disorders.
A stroke occurs when the blood supply to the brain is interrupted, which happens in two ways. The most common type of stroke, known as an ischemic stroke, occurs when blood is unable to travel through a blood vessel and reach the brain. This can be due to a clot that arises in or travels to the brain and blocks the vessel, or to narrowing of the blood vessel itself. In a hemorrhagic stroke, the second major type of stroke, the blood vessel tears or ruptures. In both types of stroke, the result is the same -- the oxygen and nutrients carried by the blood can't reach the brain cells. In a very short period of time, the brain cells begin to die.
A third type of stroke is known as a transient ischemic attack, or TIA. This is when stroke symptoms appear for a brief period of time but then go away. These so-called "mini strokes" can sometimes be precursors to a major stroke, so it's important to take TIAs seriously and seek medical treatment immediately.
Signs of stroke include sudden weakness or numbness in a limb or in the face, often on just one side of the body. Sudden dizziness, confusion, garbled speech, loss of balance or coordination, or problems with eyesight in one or both eyes can also signal a stroke. So can the advent of a sudden headache, often quite severe, sometimes accompanied by tingling sensations in the face or body.
A useful memory prompt for stroke symptoms is the word FAST. The letters represent three major indicators of stroke. F is for face drooping, A is for arm weakness and S is for speech. The final letter, T, stands for "time to call 911." That's particularly important because swift treatment can be the difference between life and death. It can also affect the level of disability that the stroke causes in a survivor. Studies show that receiving emergency medical care within three hours of the first symptoms of stroke results in less disability three months later as compared to those for whom medical care was delayed. So no matter someone's age, when symptoms suggest a stroke, seek immediate medical help.
Eve Glazier, M.D., MBA, and Elizabeth Ko, M.D.