Stroke Center

Hospitals & Locations > Bethesda North Hospital

Video: Hemal Shah MD explains stroke risk and prevention.

At the Bethesda North Advanced Primary Stroke Center, we treat nearly 400 strokes each year. We're also certified by The Joint Commission (TJC), meaning that we meet national standards of care, and provide the safe, high-quality treatments and services you and your loved ones deserve. 

Our multidisciplinary team:

  • Meets national standards in “door to needle” time (the time you enter the emergency department to the time you are given tissue plasminogen activator medicine).
  • Offers education to both patients and their family members on the signs and symptoms of a stroke, ways to control blood pressure and ways to minimize stroke risk factors. This also includes an in-depth stroke risk assessment.
  • Focuses on secondary prevention, which is critical in preventing recurrent strokes.

A Stroke: What Is It?

A stroke, also called a “brain attack,” happens when blood flow to a part of the brain stops. When blood flow is stopped the brain tissue does not get enough blood and oxygen to survive. Brain cells can die, causing permanent damage.

Stroke Risk Factors

While some risk factors, like age, gender, family history and race, cannot be changed, other risk factors can be changed with medical treatment or lifestyle modification.

Risk factors that can be changed with medical treatment:

  • High blood pressure - High blood pressure has no symptoms, so regular blood pressure checks are important. The condition can be easily and successfully controlled with medication. (Keeping blood pressure at 120/80 or less could prevent about 50% of strokes each year.)
  • High blood cholesterol levels - Studies have shown that lowering cholesterol levels by changing your lifestyle and taking medication can reduce the risk of stroke by as much as 30%. Keeping cholesterol low can reduce the risk of blood clots and plaque buildup within the walls of arteries in the brain.
  • TIAs, or "mini-strokes" - A surprising number of people ignore the symptoms of TIAs, which are warning signs that a stroke may be imminent. In fact, 50% of people who have had a TIA suffer a stroke within one year. It is very important to seek medical attention for these symptoms because if you have had a TIA, there are definite steps you can take to help prevent a major stroke. Doctors prescribe blood thinners such as aspirin, warfarin (Coumadin), or other drugs to prevent blood clots if you have had a TIA.
  • Cardiovascular disease - Certain disorders of the heart or blood vessels, such as atherosclerosis (plaque buildup in artery walls) and atrial fibrillation (an abnormal heart rhythm), can produce blood clots that may break loose and travel to the brain. These conditions are also treated with blood thinners to reduce risk of stroke.
  • Diabetes - People with diabetes are more at risk. It is important to note that type 2 diabetes (often called adult onset) is highly influenced by certain lifestyle factors, particularly diet and excess weight.
  • Blood clotting disorders - People who form blood clots more easily, called hypercoagulable conditions, are at greater risk for stroke. Hypercoagulable states are also treated with blood thinners such as warfarin (Coumadin) in order to try to prevent stroke and other complications.
  • Sleep apnea - People with sleep apnea have 3 - 6 times the risk of stroke compared to people who do not have this disorder. This condition, defined as cessation of breathing many times throughout the night, is generally treatable by losing weight and using a special device called a CPAP machine.

Risk factors that can change through lifestyle modifications:

  • Cigarette smoking - Cigarette smoking has been linked to heart attacks, strokes, artery disease in the legs, and lung cancer. Nicotine raises blood pressure, carbon monoxide reduces the amount of oxygen the blood can carry to the brain, and cigarette smoke makes the blood thicker and more likely to clot. It is never too late to give up smoking.
  • Smoking and birth control pills - Research shows that smoking and taking birth control pills significantly increases a woman's risk for stroke. Together, they can cause blood clots to form. Women who take birth control pills should not smoke.
  • Drinking large amounts of alcohol - Frequent intoxication can make a person more likely to experience bleeding in the brain. Also, alcohol in large amounts can raise blood pressure.
  • Obesity - Being overweight increases your risk of having a stroke, along with other health problems.
  • Lack of exercise - Moderate exercise can help keep blood pressure and cholesterol levels within normal ranges.
  • Poor diet - A diet high in fat and sugar can cause conditions within the body -- such as obesity, type 2 diabetes, and high cholesterol -- that contribute to a greater risk of stroke.
  • Stress - Ongoing stress can raise blood pressure. Plus, not dealing well with stress can contribute to unhealthy habits such as smoking and overeating. Finding healthy ways to handle stress is important.

Signs of a Stroke

In order to determine if a loved one is experiencing a stroke, follow the FAST method:

  • Face - Ask the person to smile. Does one side of the face droop?
  • Arms - Ask the person to raise both arms. Does one arm drift downward?
  • Speech - Ask the person to repeat a simple phrase. Does the speech sound slurred or strange?
  • Time - If you observe any of these signs, it's time to call 911.

Other symptoms may include:

  • A headache that starts suddenly (it may be severe), wakes you up from your sleep, or gets worse when you change positions, or when you bend, strain or cough
  • Change in alertness (including sleepiness, unconsciousness, and coma)
  • Changes in hearing
  • Changes in taste
  • Changes that affect touch and the ability to feel pain, pressure, or different temperatures
  • Clumsiness
  • Confusion or loss of memory
  • Difficulty swallowing
  • Difficulty writing or reading
  • Dizziness or abnormal feeling of movement (vertigo)
  • Lack of control over the bladder or bowels
  • Loss of balance
  • Loss of coordination
  • Muscle weakness in the face, arm, or leg (on just one side)
  • Numbness or tingling on one side of the body
  • Personality, mood, or emotional changes
  • Problems with eyesight, including decreased vision, double vision, or total loss of vision
  • Trouble speaking or understanding others who are speaking
  • Trouble walking

source: A.D.A.M. Health Library

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