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Stroke

Johns Hopkins has two Joint Commission on Accreditation of Healthcare Organizations (JCAHO) certified Primary Stroke Centers — one at our main campus in downtown Baltimore and one at the Johns Hopkins Bayview Medical Center.

Symptoms of a Stroke

  • Sudden onset of numbness or weakness
  • Sudden onset of confusion or difficulty speaking
  • Sudden onset of vision loss
  • Sudden onset of dizziness or imbalance
  • Sudden onset of severe headache

If you should experience any of these symptoms, please call 911 immediately!

Types of Stroke

  • Hemorrhagic Stroke — A hemorrhagic stroke is caused by the rupture of a blood vessel with bleeding into the tissue of the brain.
     
  • Ischemic stroke — Ischemic stroke is by far the most common type of stroke, accounting for approximately 80-90% of all strokes. Ischemic stroke refers to a situation in which a region of the brain is deprived of blood flow, usually due to either a blood clot or blockage of the artery by atherosclerosis (e.g. cholesterol deposits in the artery). Risk factors for ischemic stroke include increasing age, high blood pressure, heart disease, diabetes, smoking and elevated cholesterol. At each age, stroke is more common in men than women, and it is more common among African-Americans than white Americans. However, because women live longer than men, more women than men die of stroke each year. Treatment involves reducing risk factors and identifying the source of the blockage. Once the specific cause of an ischemic stroke is found, the best treatment can be determined.
     
  • Transient Ischemic Attack — A transient ischemic attack (TIA) is similar to an ischemic stroke in that it is caused by a blocked artery, but the symptoms clear up completely, usually in under an hour. Most TIAs last only five or ten minutes long. Because they are brief and not painful, TIAs are often ignored by patients. However, a TIA may precede a stroke by days or weeks and represent a warning sign. Patients with TIA?s should undergo a comprehensive evaluation quickly, because sometimes an underlying problem is discovered which can be treated, averting a stroke. Of 1,707 TIA patients evaluated in the emergency department of a large health care plan, 180 patients or ten percent developed stroke within 90 days. (American Heart Association Heart Disease and Stroke Statistics — 2004 Update)

Stroke in Young Adults:

Up to 10% of strokes may occur in relatively young individuals (under 45 years of age) and represent a challenge in terms of diagnosis and treatment. Patients typically undergo a detailed evaluation including brain imaging, vascular studies, cardiac evaluations and hematologic assessment using the most advanced diagnostic techniques. The cerebrovascular team at Johns Hopkins has expertise in the diagnosis and management of a variety of uncommon conditions which may occur in young adults, such as arterial dissection, vasculitis, cerebral vein thrombosis and moya-moya syndrome. We often include pediatric neurologists in the evaluation of children with stroke as well.

Stroke Prevention:

  • Stop smoking!
  • Get regular exercise (20 minutes a day three-to-four times per week). Going for a stroll counts.
  • Eat fish two-to-three times a week
  • Lose weight to help control blood pressure
  • Have your doctor check blood pressure, cholesterol and blood sugars
  • If you have high blood pressure, high cholesterol or diabetes, work with your doctor to control it.

For more information, contact the Johns Hopkins Cerebrovascular Center at 410-955-2228.

 

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