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Getting Wise about Stroke

  • Considerations for your 30s, 40s, 50s and Beyond

  • Be honest with yourself. Who do you see when you picture a stroke victim?

    Chances are you don’t imagine someone blond, edgy and vital. But maybe you should. Bad girl actress Sharon Stone seemed the antithesis of any sort of victim – much less a candidate for a stroke -- when she suffered a hemorrhagic stroke at 43. Most people were stunned to learn that the actress’ severe headache was in fact a sign of a hemorrhagic stroke.

    The reality is, stroke isn’t just for old folks. A third of women who suffer strokes are younger than 65. Young, middle-aged and beyond, twice as many women die of stroke than breast cancer each year. And like heart attacks, women are much more likely to die when a stroke happens.

    The good news is that up to 80 percent of strokes are preventable. And for those who do have strokes, early and prompt treatment can dramatically lessen chances of disability and death.

    “Stroke is a preventable and treatable disease, and we can have much better outcomes with acute and early treatments,” says neurologist Nobl Barazangi, M.D., Ph.D., a specialist in Neurocritical Care and Vascular Neurology at California Pacific Medical CenterOpens new window.

  • Understanding Stroke

  • Stroke is like a heart attack in the brain, where a blood clot or hemorrhage inhibits proper blood flow. Without this oxygenated blood, brain tissues are damaged, the result of which can be disability and death. Catch the problem early, and the prognosis is remarkably positive. Catch it late, and the odds for a good outcome diminish.

    “We have very effective treatments for acute ischemic stroke symptoms that can make a huge difference in a patient’s recovery,” says Dr. Barazangi referring to helpful imaging and interventional procedures, as well as tPA (tissue Plasminogen Activator), a clot-busting agent that can dramatically improve outcomes.

    Barazangi encourages women to get care immediately for a suspected stroke, even if they think it’s no use. “People used to think that tPA had to be given within three hours of a stroke, but we’re seeing benefit even up to 4.5 hours. And even when we can’t use tPA, there are many new emerging interventional and other therapies that may help.”

    The key, of course, is getting help. And sometimes that’s more complicated than it might seem.

  • Is it a Stroke?

  • People wait and see. Will the dizziness pass? Will the headache go away with a little aspirin? Maybe a little sleep will help the blurred vision . . .

    Denial, even cautious observation, takes time – time that a person doesn’t have when a stroke is happening. The signs and symptoms of stroke can sometimes be subtle, especially in women. Stroke symptoms can also overlap with the symptoms of more common conditions like migraines, anxiety and even inner-ear infections. Still, the expert advice is always to err on the side of safety.

    “Generally, anyone experiencing a symptom they’ve never had before, especially if it’s severe, should seek medical attention immediately,” says Dr. Barazangi. “If you can’t get a hold of a doctor within 5 or 10 minutes, go to the ER.”

  • What is Your Risk?

  • Women with a thorough understanding of their risk for stroke are much more likely to spot a stroke when it happens. Women should look not only at individual risk factors but at how those risks combine to increase the likelihood of stroke. Risks also evolve with age. Here are a few considerations for each life stage:

  • 30s and 40s

  • Are you highly coagulable? Not exactly party talk but probably something you should know. That is, is your blood more likely to clot than the average person’s? Things that might affect blood coagulation include birth control pills, hormonal changes during pregnancy, smoking and simple genetics. You could also be at greater risk for stroke if you suffer from migraines or have a family history of vascular malformations and aneurysm. Talk to your doctor about all possible risk factors and stay on top of basic screenings for blood pressure, cholesterol and blood sugar.

  • 50s to early 60s

  • The menopause years are an important time to pay close attention to previous risk factors, as well as waist size, blood pressure, blood sugar and cholesterol. (Women with a waist size greater than 34 inches have four times the risk of stroke than those with slimmer midsections, according to a University of Heidelberg study.) If you are considering hormone replacement therapies, talk with your doctor about your risk factors and the possibility of short-term HRT therapies. Today’s stroke experts advise against long term hormone therapies, especially in women with known stroke risk factors. Now is also the time to talk with your doctor about aspirin as a preventive therapy.

  • 65 and Beyond

  • According to the National Stroke Association, stroke risk doubles every age over 55. Still, older women can protect themselves by exercising regularly and staying in close touch with their doctors about risk factors, current medications and any new symptoms. Older women and their loved ones should also be aware that seniors, women in particular, are at increased risk for depression should a stroke occur.