Mississippi has one of the highest stroke mortality rates in the country, a ranking stroke care professionals at the University of Mississippi Medical Center would like to reduce.
"Every stroke victim is someone's loved one," said Dr. Sean Duke, assistant professor of neurology. "While Mississippi does lead the nation in stroke mortality, there is untapped potential for improvement through awareness and lifestyle change.
Duke, a Caledonia native who earned his MD at the UMMC School of Medicine, returned to Mississippi to start his neurology practice. "I'm from Mississippi, and it was important for me to come back and help build up the stroke system in the state," he said.
A stroke happens when the flow of blood to the brain is blocked (an ischemic stroke) or if there is sudden bleeding in the brain (a hemorrhagic stroke). In America, about 87% of strokes are ischemic. All strokes are medical emergencies that can result in death or permanent injury.
About one of every six Americans will have a stroke in their lifetime, "and that's probably higher in Mississippi," he said.
UMMC is one of three Comprehensive Stroke Centers in the state. Accredited by The Joint Commission, the center has rapid response protocols that are in place around the clock to quickly treat stroke patients based on guidelines that have been shown to give patients the best possible outcomes.
Healthy heart, healthy brain
Americans are having strokes at younger ages. American Heart Association research shows that 10% to 15% of strokes happen to those between 18 and 45.
"We're seeing younger and younger stroke patients," Duke said. "That drop in age is a reflection of our health, higher rates of metabolic syndrome and less activity."
Metabolic syndrome is a collection of different conditions that, together, contribute to higher rates of stroke and cardiovascular disease. These include high blood pressure and high LDL, or bad cholesterol, levels.
"If you have heart disease, you probably have 'brain' disease as well," Duke said. "Generally, the things that can contribute to heart disease can also make strokes more likely."
Know the symptoms
Stroke symptoms develop suddenly and can range from mild weakness to paralysis or numbness on one side of the face or body, slurred speech, a severe headache, vision problems or trouble speaking.
The acronym BE FAST can be a reminder of symptoms to watch for: B is for "balance," E is for "eyes - changes in vision," F is for "face drooping," A is for "arm weakness," S is for "speech difficulty," and T is for "time to call 911."
"If you suddenly experience any of those signs, call 911 immediately," Duke said.
Rapid response to a stroke can allow stroke specialists to assess the patient's condition and offer treatments that can reverse the stroke such as clot-busting medications or a thrombectomy, a procedure in which the clot is removed manually with a wire. After the first couple of hours however, treatment options are more limited.
Get care quickly
"Patients should be aware of any new sudden changes, call 911 and get checked out," Duke said. "The tragedy is that we have elaborate stroke support systems to help identify patients and get them care quickly, but not all stroke patients arrive fast enough to take advantage of the benefits of care. We average less than 30 minutes to treatment for stroke patients. But that only works when patients or their families seek help quickly."
With timely treatment, the effects of a stroke are more likely to be reversed. The longer a patient waits for care, the more risks rise and potential benefits of treatment decrease.
"Time is brain," Duke said.
Emergency response personnel contact the UMMC stroke response team to alert them that they're bringing a stroke patient to the Medical Center. The team then moves quickly to be in place when the patient arrives at the Emergency Department. The same group of about 20 medical professionals responds to patients already in the hospital who experience strokes.
All patients suspected of having strokes are quickly sent to CT imaging, where a stroke diagnosis can be assessed.
Some patients may decide to go to bed instead of getting help. "If you are experiencing a brain bleed, that's the absolute worst thing you can do."
Seek recovery care
Lifestyle changes should follow a stroke, Duke said. Recovery can include occupational and physical therapy, speech therapy and medications. Heart-healthy changes can make recurring strokes less likely.
"Recovery depends on a patient's mindset and determination to overcome as well as family support and access to care," Duke said.
Depression can often follow a stroke, he said, "and that can lead to worse outcomes."
Injuries from strokes can lead to other problems, Duke said, noting that they may be more likely to get pneumonia and can be more likely to fall. Making the home environment safer can prevent injuries.
Making future strokes less likely is essential, since one of the risk factors for strokes is having suffered a prior stroke. Quitting smoking and getting blood pressure down are at the top of the list for preventing first and subsequent strokes.
For more information, visit https://www.umc.edu/Healthcare/Stroke/Home.html.