James Grotta, MD, FAAN, explains stroke warning signs and why it’s necessary to seek immediate medical care—even during the COVID-19 pandemic
James Grotta, MD, FAAN, Director of Stroke Research at the Clinical Institute for Research and Innovation at Memorial Hermann Hospital, hosted a Facebook Live with the American Brain Foundation to discuss stroke and COVID-19. “The presence of this pandemic has affected the way we manage stroke as physicians, as nurses, as healthcare providers, and also affects the way patients at risk for stroke are dealing with their disease,” Dr. Grotta explains. Watch his video to learn more about what stroke is, how to identify warning signs as they occur and the most effective ways to prevent stroke.
Stroke Care During the COVID-19 Pandemic
Dr. Grotta reminds us that while hospitals have stopped elective procedures in order to ensure that space, staff and equipment are available to treat COVID-19 patients, stroke treatment is not elective. “We can’t ignore stroke or heart disease, or any other common conditions, just because COVID-19 is going on,” he says. In the US, at least 140,000 people die from stroke every year. Not seeking treatment can be fatal or cause long-term neurological deficits.
Despite this, the COVID-19 pandemic has reduced the number of people calling 911 and seeking life-saving stroke treatment. “People may not want to go to the hospital because of COVID-19 risk and they might think the numbness may go away,” he explains. However, due to the nature of strokes, patients should seek treatment as soon as possible. He goes on, “If you call 911, you’re going to get treated faster and better than if you go to the hospital on your own.”
Dr. Grotta assures patients that hospitals have the ability to treat stroke patients safely. Though the emergency room is busier than before, hospitals “in most parts of the country are able to sequester and deal with COVID-19 patients, and allow stroke patients to be managed separately” with some added protections to maintain safety and cleanliness. His institution uses a mobile stroke unit, specifically deployed to treat stroke patients quickly on the scene.
He also adds that some patients who experience strokes do turn out to have COVID-19—as this virus affects more than just breathing. “It can also affect the nervous system and cause blood clotting in the vessels, which may predispose you to have a stroke,” he says.
What Is Stroke?
Stroke is a brain disease that comes on suddenly—either as the result of a blood clot or a hemorrhage. The first type occurs when “the blood vessel in the brain supplying blood to the brain blocks off suddenly,” Dr. Grotta explains. These clots result in the death of the surrounding brain tissue. “The blood clot needs to be dissolved and opened as soon as possible,” he says.
“Another type of stroke is caused by bleeding, as in brain hemorrhages,” says Dr. Grotta. In this case, the bleeding must be stopped quickly to avoid long-term damage or death.
Stroke Warning Signs
It’s important to know the signs and act immediately to get patients the treatment they need. The following acronym helps people identify the signs of stroke in themselves, loved ones and anyone close by.
BE-FAST
- Balance – Sudden dizziness or loss of balance and coordination
- Eyes – Difficulty seeing
- Face – One side of their face is drooping
- Arm – Can’t lift their arm or are experiencing weakness or numbness in the arm or leg
- Speech – They have slurred speech or are unable to talk
- Time – React right away and call 911
Other symptoms of stroke can include severe headache, vertigo and visual loss that come on abruptly.
Dr. Grotta explains that because patients tend to minimize their symptoms, it is up to others close by to recognize them and ensure they get emergency care as soon as possible. Strokes damage the brain, which means the patient may be unable to react due to their symptoms. If you see stroke symptoms, don’t delay calling 911.
“We now have treatments that can be effective even 12-24 hours later. There is still an option for treatment. A subset of those patients still have salvageable tissue that can be recovered,” he says. He urges those who observe stroke symptoms to react as soon as possible. Even if the stroke occurred during the night or while they were out, it’s still important to seek urgent emergency care as soon as the symptoms are discovered.
Stroke Prevention
There are effective ways to prevent stroke—either through medication or lifestyle changes like starting a healthier diet and exercise routine. While lifestyle changes can be difficult, Dr. Grotta offers hope: “We changed our lifestyle overnight to a stay-at-home lifestyle. If we can make this big lifestyle change overnight, we can make changes that are healthy for us such as lifestyle and diet.”
When it comes to medication, Grotta tells patients to schedule and keep telehealth appointments with their healthcare providers or stroke specialists and to not let their prescriptions lapse. “Don’t let your blood pressure or anticoagulant medication prescription run out. Blood pressure is the single most important risk factor for stroke. Don’t run out of your medications,” he cautions.
While COVID-19 is going to change the way strokes are managed in the hospital and by prehospital providers, Dr. Grotta assures patients that at most places in the country, there is plenty of capability to care for both COVID-19 and stroke.
The American Brain Foundation was founded to bring researchers and donors together in the fight against brain disease. We believe that when we cure one disease, we will cure many. Learn more about stroke and other brain diseases or help us in our mission by giving today.