Q: What is a stroke?

A: A stroke occurs when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain. When either of these things happens, brain cells begin to die and brain damage occurs.

Q: Are there different kinds of strokes?

A: Yes, strokes can be ischemic (a blocked artery or blood vessel); hemorrhagic (a ruptured blood vessel); or a transient ischemic attack (TIA or mini stroke).

Q: What are the symptoms of a stroke?

A: Symptoms of an ischemic stroke or TIA may include facial droop; numbness or weakness of extremities; slurred speech, blurred vision; and dizziness. Symptoms of a hemorrhagic stroke may include severe headache with no known cause; loss of consciousness; vomiting or severe nausea; and sudden weakness or numbness of face, arm or leg.

Q: What are the effects of a stroke?

A: The effects of stroke depend on where in the brain the stroke occurred and how much brain tissue was affected. If the stroke is on the right side of the body, there might be paralysis on the left side of the body, vision problems or memory loss. If the stroke is on the left side of the body, there might be paralysis on the right side of the body, speech/language problems and memory loss.

Q: What is the treatment?

A. The only FDA approved treatment for an acute ischemic stroke is tissue plasminogen activator (tPA). tPA works by dissolving the clot and improving blood flow to the part of the brain being deprived of blood flow if administered within three hours and up to four and a half hours for eligible patients.

Another treatment is an endovascular procedure in which specially trained interventional radiologists attempt removing the blood clot by sending a catheter to the site of the blocked blood vessel. Sometimes tPA can be administered directly to the blood clot.

Q: Can tPA be used for all ischemic strokes?

A: No, tPA cannot be used for all ischemic strokes. tPA should only be administered three hours after the stroke symptom onset. tPA is contraindicated if the patient has an intracranial hemorrhage; active bleeding; recent (within three months) intracranial or intraspinal surgery; history of intracranial hemorrhage; un- controlled hypertension at time of treatment; current use of oral anticoagulants; administration of heparin within 48 hours of onset of stroke; or a platelet count under 100,000/mm3.

Q: What are the risk factors for stroke? What can be done to reduce risk?

A: Some risk factors of stroke are uncontrolled high blood pressure, high cholesterol, family history, heart disease and history of stroke or TIA in the past. Controlling risk factors such as blood pressure and cholesterol and having an active healthy lifestyle can decrease the risk of stroke.

Q: Can a stroke victim return to independent living?

A: While some patients are unable to care for themselves, many patients are able to return to independent living. This depends on the severity of the stroke and what long-term effects the patient has suffered. St. Luke's offers a variety of inpatient and outpatient rehabilitation services for stroke patients including occupational, speech and physical therapies, as well as counseling to help patients adjust to lives after stroke and provide the best quality of life as possible.

For more information on stroke care, treatment and rehabilitation at St. Luke's, call St. Luke's InfoLink at 1-866-STLUKES.

Robert J. Coni, D.O. is the chief of neurology and medical director for the Acute Rehabilitation Center for St. Luke's University Health Network.