Stroke

Vidant Health is proud to offer top-notch neurological services across eastern North Carolina, and that includes a strong network of expert stroke care. This is especially important, since stroke is a serious health concern that occurs all too frequently in our communities.

A number of our hospitals have earned special stroke certifications and all are connected by Telestroke, a system that uses video conferencing and diagnostic imaging review to quickly evaluate and treat stroke. At the helm of this growing network is Vidant Medical Center (VMC) in Greenville, where teams are specially trained to treat complex stroke cases, and patients have access to 24/7 surgical care. VMC is home to eastern North Carolina’s only intensive care unit staffed especially for stroke patients, and has received advanced certification as a Comprehensive Stroke Center from The Joint Commission, The American Heart Association and The American Stroke Association.

Both Vidant Edgecombe Hospital and Vidant Duplin Hospital are designated as Primary Stroke Centers. Vidant Roanoke-Chowan Hospital is recognized as an Acute Stroke Ready Hospital. These certifications mean that our hospitals are equipped to treat stroke patients with timely, evidence-based care resulting in improved patient outcomes and more lives saved.

Jennifer's story
Jennifer Holley was just 29 years old, and the mother of a newborn, when she had a stroke. Luckily, her husband recognized the signs and got Jennifer to a Vidant hospital to get the care she needed. Jennifer's story explains what Vidant Medical Center's Comprehensive Stroke designation means for eastern North Carolina.

A stroke is a medical emergency. Always call 9-1-1 first.

What is a stroke?

A stroke is a medical emergency that occurs when blood flow to the brain is stopped or disrupted. If blood supply is stopped even for a short time, brain cells can begin to die and brain function is quickly lost.

A stroke can happen to anyone at anytime and may affect your ability to:

  • Move
  • Speak
  • Eat
  • Think and remember
  • Control your bowel and bladder
  • Control your emotions
  • Control other vital body functions

Types of stroke

  • Ischemic stroke. This is the most common type of stroke. It occurs when a major blood vessel in the brain is blocked - often by a blood clot or by a buildup of fatty deposit and cholesterol. Learn more.
  • Hemorrhagic stroke. This occurs when a blood vessel in your brain bursts, causing brain cells to die. Learn more.
  • Transient ischemic attack. Sometimes called a mini-stroke, this condition causes symptoms similar to those of a stroke, but does not result in permanent brain damage. Learn more.

Who is at risk for a stroke?

Anyone can have a stroke at any age. But your chance of having a stroke increases if you have certain risk factors.

Here are some stroke risk factors that can be changed, treated or medically managed:

  • High blood pressure. Blood pressure of 140/90 or higher can damage blood vessels (arteries) that supply blood to the brain.
  • Heart disease. Heart disease is the second most important risk factor for stroke, and the major cause of death among stroke survivors. Heart disease and stroke have many of the same risk factors.
  • Diabetes. People with diabetes are at greater risk for a stroke than someone without the condition.
  • Smoking. Smoking almost doubles your risk for an ischemic stroke.
  • Birth control pills (oral contraceptives)
  • History of Transient Ischemic Attacks (TIAs). These episodes have the same symptoms as stroke, but the symptoms don’t last. If you have had one or more TIAs, you are almost 10 times more likely to have a stroke than someone of the same age and sex who has not had a TIA.
  • High red blood cell count. A significant increase in the number of red blood cells thickens the blood and makes clots more likely. This raises the risk for stroke.
  • High blood cholesterol and lipids. High cholesterol levels can contribute to thickening or hardening of the arteries (atherosclerosis) caused by a buildup of plaque - deposits of fatty substances, cholesterol, and calcium. Plaque buildup on the inside of the artery walls can decrease the amount of blood flow to the brain, and this can result in a stroke.
  • Lack of exercise
  • Obesity
  • Excessive alcohol use. More than 2 drinks per day raises your blood pressure. Binge drinking can lead to stroke.
  • Illegal drugs. IV (intravenous) drug abuse carries a high risk of stroke from blood clots (cerebral embolisms). Cocaine and other drugs have been closely linked to strokes, heart attacks, and many other cardiovascular problems.
  • Abnormal heart rhythm. Some types of heart disease can raise your risk for stroke. Having an irregular heartbeat (atrial fibrillation) is the most powerful and treatable heart risk factor of stroke.
  • Cardiac structural abnormalities. Damaged heart valves (valvular heart disease) can cause long-term (chronic) heart damage. Over time, this can raise your risk for stroke.

Some risk factors for stroke can’t be changed, treated or medically managed:

  • Older age. For each decade of life after age 55, your chance of having a stroke more than doubles.
  • Race. African Americans have a much higher risk for death and disability from a stroke, partly because this population has a greater incidence of high blood pressure.
  • Gender. Stroke occurs more often in men, but more women than men die from stroke.
  • History of prior stroke. You are at higher risk for having a second stroke after you have already had a stroke.
  • Heredity or genetics. The chance of stroke is greater in people with a family history of stroke.

Other risk factors include:

  • Where you live. Strokes are more common among people living in the southeastern U.S. than in other areas. This may be because of regional differences in lifestyle, race, smoking habits, and diet.
  • Temperature, season, and climate. Stroke deaths occur more often during extreme temperatures.
  • Social and economic factors. There is some evidence that strokes are more common among low-income people.

What are the symptoms of a stroke?

A stroke is an emergency situation. Always call 9-1-1- first.

It’s important to know the signs of a stroke and get help quickly. Treatment is most effective when started right away.

Stroke symptoms may happen suddenly. Each person’s symptoms may vary. Symptoms may include:

  • Weakness or numbness of the face, arm, or leg - usually on one side of the body
  • Having trouble speaking or understanding
  • Problems with vision, such as dimness or loss of vision in one or both eyes
  • Dizziness or problems with balance or coordination
  • Problems with movement or walking
  • Fainting (loss of consciousness) or seizure
  • Severe headaches with no known cause, especially if they happen suddenly

Other less common symptoms of stroke may include:

  • Sudden nausea or vomiting not caused by a viral illness
  • Brief loss or change of consciousness, such as fainting, confusion, seizures, or coma
  • Transient Ischemic Attack (TIA)

A TIA can cause many of the same symptoms as a stroke. But TIA symptoms are passing. They can last for a few minutes or up to 24 hours. Call 9-1-1 immediately if you think someone is having a TIA. It may be a warning sign that a stroke is about to occur.

BE FAST is an easy way to remember the signs of a stroke. When you see these signs, you will know that you need to call 911 fast. FAST stands for:

B - Balance. The person may experience a sudden loss of balance or coordination.

E - Eyes. You may notice sudden blurred or double vision or sudden, persistent vision trouble.

F - Face drooping. One side of the face is drooping or numb. When the person smiles, the smile is uneven.

Arm weakness.  One arm is weak or numb. When the person lifts both arms at the same time, one arm may drift downward.

S - Speech difficulty. You may see slurred speech or difficulty speaking. The person can't repeat a simple sentence correctly when asked.

T - Time to call 911. If someone shows any of these symptoms, call 911 right away. Call even if the symptom goes away. Make note of the time the symptoms first appeared.

How is a stroke diagnosed?

Your health care provider will take a complete health history and do a physical exam. Tests may include:

  • CT scan of the brain. An imaging test that uses X-rays to take clear, detailed images of the brain. A brain CT scan can show bleeding in the brain or damage to brain cells caused by a stroke. It is used to find abnormalities and help find the location or type of stroke.
  • MRI. This test uses a combination of large magnets, radiofrequencies, and a computer to make detailed images of organs and structures in the body. An MRI uses magnetic fields to find small changes in brain tissue that help to find and diagnose stroke.
  • CTA (computed tomographic angiography). An X-ray image of the blood vessels. A CT angiogram uses CT technology to get images of blood vessels.
  • MRA (magnetic resonance angiography). This test uses MRI technology to check blood flow through the arteries.  
  • Doppler sonography (carotid ultrasound). A test that uses sound waves to create pictures of the inside of your carotid arteries. This test can show if plaque has narrowed or blocked your carotid arteries.

The following heart tests may also be used to help diagnose heart problems that may have led to a stroke:

  • Electrocardiogram (ECG). This test records your heart’s electrical activity. It shows any irregular heart rhythms that may have caused a stroke.
  • Echocardiography. This test uses sound waves to create a picture of your heart. This test shows the size and shape of your heart. It can check if the heart valves are working properly. It can also see if there are blood clots inside your heart.
  • Transesophageal Echocardiogram. This test uses sound waves to make pictures of your heart’s muscle and chambers, valves and outer lining (pericardium), as well as the blood vessels that connect to your heart.

Treatments

There is no cure for stroke once it has occurred. But advanced medical and surgical treatments are available. These can help reduce your risk for another stroke.

Your healthcare provider will create a care plan for you based on:

  • Your age, overall health, and past health
  • Type of stroke
  • Severity of your stroke
  • Specific location in the brain where your stroke occurred
  • Cause of your stroke
  • Your ability to handle certain medicines, treatments or therapies
  • Your opinion or preference

Treatment is most effective when started right away. Emergency treatment after a stroke may include:

  • Clot-busting medicines (thrombolytics or fibrinolytics). These medicines dissolve the blood clots that cause an ischemic stroke. They can help reduce the damage to brain cells caused by the stroke. To be most effective, they must be given within 3 hours of a stroke occurring.
  • Mechanical Thrombectomy. This procedure can help in certain situations when the patient has a blockage in one of the large arteries in the brain. It involves inserting a catheter with a "stent retriever" into the artery to remove the clot that is causing stroke symptoms. This treatment can reduce long-term disability caused by the stroke.
  • Medicines and therapy to reduce or control brain swelling. Special types of IV (intravenous) fluids are often used to help reduce or control brain swelling. They are used especially after a hemorrhagic stroke.
  • Neuroprotective medicines. These medicines help protect the brain from damage and lack of oxygen (ischemia).
  • Life support measures. These treatments include using a machine to help you breathe (a ventilator), having IV fluids, getting proper nutrition, and controlling your blood pressure.
  • Craniotomy. This is a type of brain surgery that is done to remove blood clots, relieve pressure, or repair bleeding in the brain.

What are the complications of having a stroke?

Recovery from stroke and the specific ability affected depends on the size and location of the stroke. A small stroke may cause problems such as weakness in your arm or leg. Larger strokes may cause parts of your body to not be able to move (be paralyzed). Larger strokes can also cause loss of speech or even death.

Support services are available to help with physical and emotional needs after a stroke.

What can I do to prevent a stroke?

Know your risk for stroke. Many stroke risk factors can be changed, treated or medically modified. Some things you can do to control your risk factors are listed below.

Lifestyle changes

A healthy lifestyle can help reduce your risk for stroke. That includes the following:

  • Stop smoking.
  • Make healthy food choices. Eat the recommended amounts of fruits, vegetables and whole grains. Choose foods that are low in saturated fat, trans fat, cholesterol, salt (sodium) and added sugars.
  • Stay at a healthy weight.
  • Be physically active.
  • Limit alcohol use.
Medicines

Take your medicines as instructed by your health care provider. The following medicines can help prevent stroke:

  • Blood-thinning medicines (anticoagulants) help prevent blood clots from forming. If you take a blood thinner, you may need regular blood tests.
  • Antiplatelets, such as aspirin, are prescribed for many stroke patients. They make blood clots less likely to form. Aspirin is available over the counter.
  • Blood-pressure medicines help lower high blood pressure. You may need to take more than one blood-pressure medicine.
  • Cholesterol-lowering drugs make plaque less likely to build up in your artery walls, which can reduce the risk for stroke.
  • Heart medicines can treat certain heart problems that increase your risk of stroke.
  • Diabetes medicines adjust blood sugar levels. This can prevent problems that lead to stroke.
Surgery

Several types of surgery may be done to help prevent or treat a stroke. These include:

  • Carotid endarterectomy. Carotid endarterectomy is surgery to remove plaque and clots from the carotid arteries located in the neck. These arteries supply the brain with blood from the heart. Endarterectomy may help stop a stroke from occurring.
  • Carotid stenting. A large metal coil (stent) is placed in the carotid artery much like a stent is placed in a coronary artery.
  • Surgery to repair aneurysms and AVMs (arteriovenous malformations). An aneurysm is a weakened, ballooned area on an artery wall. It is at risk for bursting (rupturing) and bleeding into the brain. An AVM is a tangle of arteries and veins. It interferes with blood circulation and puts you at risk for bleeding.
  • PFO (patent foramen ovale) closure. The foramen ovale is an opening that occurs in the wall between the 2 upper chambers of the heart. This opening usually closes right after birth. If the flap does not close, any clots or air bubbles can pass into the brain circulation. This can cause a stroke or TIA (transient ischemic attack). However, experts are still debating whether the PFO should be closed.
Get the most from a visit to your health care provider:
  • Before your visit, write down questions you want answered.

  • At the visit, write down the names of new medicines, treatments, or tests and any new instructions your provider gives you.

  • Know how you can contact your provider after office hours. This is important if you become ill and you have questions or need advice.

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Treatments for Stroke

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Symptoms and Screenings for Stroke

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Causes and Preventions for Stroke

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Education and Resources for Stroke

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Support groups for Stroke

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Learn More about Stroke

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