A stroke occurs every 40 seconds in the United States. Every 3.5 minutes, someone in the country dies due to a stroke.  Stroke is the third leading cause of death worldwide and a major cause of severe adult disability in developed countries. When it comes to stroke, every second counts! Nearly 2 million brain cells die each minute a stroke remains untreated, so knowing the signs of a stroke and obtaining medical treatment fast can often make the difference between a full recovery and permanent health issues.

A stroke occurs when the blood supply to a part of the brain is disrupted, leading to damage or death of brain cells. This can happen due to a blockage in a blood vessel (ischemic stroke) or bleeding in the brain (hemorrhagic stroke).

Three Main Stroke Types

Ischemic strokes happen when blood flow is blocked through an artery that delivers blood to the brain. According to the Centers for Disease Control and Prevention, these strokes account for the vast majority of all strokes.

Transient ischemic attacks, sometimes called "mini-strokes," are different from ischemic strokes because these strokes block blood flow from the brain for a short period — often as short as five minutes. Like ischemic strokes, these strokes are also usually caused by blood clots.  Although short-lived, transient ischemic attacks warn of future strokes and are medical emergencies. According to the CDC, more than a third of people who experience these do not receive treatment and have a major stroke within a year.

A hemorrhagic stroke is another type of stroke that occurs when an artery in the brain leaks blood or ruptures. The leaked blood puts pressure on brain cells and damages them. High blood pressure and aneurysms can cause these strokes, the CDC says.

Stroke Symptoms

The signs and symptoms of a stroke include sudden weakness or numbness of the face, arm, or leg, especially on one side of the body; confusion or trouble speaking or understanding speech; trouble seeing in one or both eyes; difficulty walking, dizziness, or loss of balance or coordination; and a severe headache with no known cause.

As an easy way to remember the symptom of stroke, the acronym FAST was originated in February 2009 by the Department of Health in England when it launched the Face, Arm, Speech, and Time (FAST) mass media campaign, to raise public awareness of stroke symptoms and the need for emergency response.  Since then, it has been broadly used by the National Stroke Association, which in 2019 folded its activities into the American Stroke Association, a division of the American Heart Association, and other organizations to educate the public on detecting symptoms of a stroke. 

If you aren’t sure whether you’re seeing or experiencing a stroke, remember to act F.A.S.T:

• F – FACE: Is there numbness or drooping in the face? Ask them to smile. Is it uneven?

• A – ARMS: Is one arm weak or numb? Ask them to raise both arms. Does one pull downward?

• S – SPEECH: Is speech slurred or strange? Ask them to repeat a simple phrase.

• T – TIME: If you see any of these signs, call 9-1-1 immediately.

The American Stroke Association encourages anyone who spots these sudden and severe symptoms to call 911 immediately. In some cases, a clot-busting drug can be given to dissolve the blood clot causing the stroke, but this needs to be done within a few hours of the onset of symptoms. Other treatments include surgery to remove the clot or repair the bleeding blood vessel, rehabilitation, and medications to manage the risk factors for stroke.

Risk Factors for Strokes

The risk factors for stroke include high blood pressure, smoking, and diabetes, which can also damage the heart and increase the risk of heart disease. Additionally, a stroke can cause complications that affect the heart, such as an irregular heartbeat or changes in blood pressure. Those with a heart condition may also be more susceptible to a stroke. This is because many heart conditions can increase the risk of blood clots forming in the heart. When these blood clots break loose, they can travel to the brain and cause a stroke. Some examples of heart conditions that increase the risk of stroke include atrial fibrillation, an irregular heartbeat that can cause blood clots to form in the heart, and heart valve disease, which can also cause blood clots to form.

While strokes are more commonly associated with older adults, there has been an increase in strokes in young people in recent years. Stroke rates in adults younger than 49 are increasing, according to the American Stroke Association.  Some of the factors contributing to this increase mirror the risk factors for all ages and may include:

• Obesity and unhealthy lifestyle habits: The rise in obesity rates, particularly in young people, has been linked to increased risk factors for stroke, such as high blood pressure, high cholesterol, and diabetes. Unhealthy lifestyle habits, such as a lack of physical activity and poor diet, can also contribute to these risk factors.

• Diabetes: From 1990 through 2019, the incidence of type 2 diabetes among people aged 15 to 39 years jumped 56%, according to JAMA. If you have diabetes, your chances of having a stroke are 2 times higher than in people who don't have diabetes.

• Smoking: Smoking contributes to plaque buildup in your arteries, increases the risk of blood clots, reduces the oxygen in your blood, and makes your heart work harder.  Smokers are two times more likely to have a heart attack or stroke.

• Substance abuse: The use of drugs, particularly opioids, and cocaine, has been linked to an increased risk of stroke in young people.

• Lack of regular doctor visits:  Younger adults may be less inclined to visit their primary care physician for regular check-ups, labs, and blood pressure checks. These annual visits are key to catching issues before they progress.

It’s important for young people to be aware of their risk factors for stroke and to take steps to reduce their risk. This includes maintaining a healthy weight, being physically active, avoiding substance abuse, managing chronic health conditions, and talking to a healthcare provider about the risks and benefits of certain medications. 

The good news for young adults is that if no other health conditions are present that might interfere with stroke recovery, younger people tend to recover better from stroke damage than older people. Recovery in young people may also continue for a longer time period. Doctors believe improved recovery may be connected to the younger brain’s natural ability to use undamaged brain circuits to take over the functions of damaged circuits. In older patients, that brain plasticity may be reduced, but recovery does continue.

Overall to prevent stroke, follow the American Heart Association/American Stroke Association’s Life’s Simple 7 Tips:

• Manage blood pressure

• Control cholesterol

• Reduce blood sugar

• Get active

• Eat better

• Lose weight

• Stop smoking