1. Recognize symptoms, act quickly when
stroke occurs
By Donna Adinolfe Correspondent |Updated May1,2012
Time is not on your side when you or a loved one is having a stroke, and knowing the signs can
help you determine whether a stroke is occurring. If so, get to the hospital immediately.
Most of the classic signs of stroke come on suddenly, and there is about a three-hour window to
receive tPA, a medication that can prevent permanent damage caused by a stroke.
Sudden weakness in the arm, leg or face are signs that stroke may occur, said Dr. James A.Ware
Jr., medical director of the stroke program at Capital Health. Whichever part of the brain is
affected during a stroke controls what the symptoms are, he added.
Stroke occurs when the brain is deprived of oxygen, usually from a blood clot.
Sudden onset of garbled speech or speech that doesn't make any sense, are also classic signs of
stroke, said Ware.
Vision also can be affected by a stroke. Patients can experience double vision or sudden loss of
vision. Dizziness and difficulty walking also can occur.
A hemorrhagic stroke occurs when a blood vessel bursts causing bleeding to the
brain. Victims experience an extremely painful headache, which can be accompanied by nausea,
neck stiffness and sleepiness.
If symptoms occur it is important to get to the hospital immediately, Ware said.
"The key is these symptoms occur suddenly," he said. "You can rise from your bed and fall to the
floor. Your toothbrush may drop and you can't pick it up. If you ignore the symptoms, time is
lost to reverse the stroke. The first three hours are critical."
tPA has been used since 1996 and it improves functional outcome in stroke patients. Those who
are administered the drug are more likely to be functioning in 90 days, according to Dr. Mitchell
Rubin, director of neurology for the Capital Health Institute for Neurosciences.
"Call 9-1-1," Ware said. "Don't drive yourself. EMTs are trained to treat strokes and if you drive
yourself you may not get treated as quickly (as those who arrive by ambulance)."
Other signs of stroke that are more subtle, but still require immediate treatment, are sudden
clumsiness on one side of the body, inability to read, or loss of feeling in an arm or leg, Ware
said.

2. In addition, those who have suffered a transient ischemic attack or "mini stroke" are at greater
risk of a future stroke, he said adding that high blood pressure, diabetes, age, smoking, obesity,
atrial fibrillation and high cholesterol all contribute to the risk of stroke.
Knowing your blood pressure, blood sugar and cholesterol numbers and controlling them with
medication, diet and exercise are important steps in preventing a stroke.
Blood pressure should be 120/80 or lower, Ware said.
Men are at a higher risk and the risk gets higher with age, Ware said, adding that the African
American community has the highest risk of stroke.
Smoking can contribute to both hemorrhagic stroke and ischemic stroke. Ischemic stroke is the
most common type of stroke. It is caused by a blockage in the blood vessel that restricts blood
flow to the brain.
Women who have just one alcoholic drink per day and men who have just two per day are at a
greater risk, he said.
"The best way to treat a stroke is to prevent a stroke," Ware said. "Have a healthy, active
lifestyle."
He recommended eating a low-fat diet with fish, grains, fruit and fiber.
Although stroke risk increases with age, children are not immune to stroke.
More younger people are suffering from stroke, according to Ware.
At Capital Health, all emergency room physicians are certified in the correct use and
interpretation of the National Institute of Health Stroke Scale. This certification means they've
been tested and proven to be proficient using the stroke scale for acute stroke assessment.
Capital Health Regional Medical Center is a New Jersey state designated Comprehensive Stroke
Center. This designation gives the hospital a leadership role in providing the most-advanced
treatment of stroke patients while achieving the best possible outcomes.
Capital Health is also home to the Stroke and Cerebrovascular Center of NJ and some of the
country's most experienced dual-trained neurosurgeons, who are available 24 hours a day, seven
days a week to treat the most complex stroke and cerebrovascular disorders.
With a rooftop helipad, a dedicated neuroendovascular suite and operating room, as well as a
dedicated neurosurgical ICU and the country's first and only neuro dedicated emergency
department, the hospital has made a significant investment in the treatment of neurologically
focused disorders.