Studies give a clearer picture of preventing stroke and stroke recovery

April 04, 2016
Dr. Daniel Lackland, left, talks with Dr. Tanya Turan and Dr. Robert Adams.
Dr. Daniel Lackland, left, talks with Dr. Tanya Turan and Dr. Robert Adams. Photo by Brennan Wesley

A 40-year-old woman walks in the door of her house after work and suddenly feels weak and has a hard time seeing.

A 35-year-old man is at a restaurant with his father when the older man comes down with a severe headache and can’t keep his balance.

Neither the 40-year-old woman nor the 35-year-old man recognizes what would be obvious if they knew the warning signs of stroke. A recent study found that an astonishing 75 percent of people under 45 have no idea what a stroke looks like. When you’re dealing with a problem where time is of the essence – the more time that passes after a stroke, the greater the damage – the consequences can be severe. (The F.A.S.T. checklist spells out the warning signs.) 

The good news is, there is a growing body of information about stroke prevention and treatment that is helping patients at the Medical University of South Carolina and across the country.

Daniel Lackland, who holds a doctorate of public health degree, directs MUSC’s Stroke Research and Education Center. “We’ve never been in as a good a position as we are now,” Lackland said.

Here’s what researchers recently revealed.

  • Obese women who take oral contraceptives are almost 30 times more likely than other women to develop cerebral venous thrombosis, which can lead to a stroke. A report on the study in JAMA Neurology included an editorial by Chirantan Banerjee, M.D., of MUSC. In it, Banarjee wrote that better counseling of obese women, including consideration of non-hormonal contraceptive options, "would be prudent."
  • Consuming more than two drinks a day raises stroke risk. A study in the journalStroke found that it can cause a person to have a stroke five years earlier than he or she would have otherwise. The report also said people who drink heavily in their 50s and 60s tend to have strokes earlier in life than light drinkers or non-drinkers.
  • People who have had a stroke are more likely to take their medications if they get them through the mail than if they pick them up in person at a pharmacy. The chairman of MUSC’s Department of Neurology, Bruce Ovbiagele, M.D., worked with colleagues to look at prescription data from Kaiser Permanente. Their conclusion: Prescription medication delivery reminds people to take their drugs and makes it much easier to get the medication. Their findings will be published later this year.

Lackland said the studies come at an exciting time for people in the field of stroke prevention and treatment.

On the prevention front, he said research has led to better approaches. “We have new therapies including aggressive blood pressure control, cholesterol and diabetes. These have all been able to help us keep the stroke from occurring.”

When it comes to treatment, he said, there have been multiple improvements as well. For one thing, it’s gotten easier to quickly give people who suffer ischemic strokes the clot-busting treatment tPA, or tissue plasminogen activator, considered the gold standard.

“Thanks to telestroke, a significant number of people are getting tPA. It’s almost like they never had a stroke.” Telestroke is an MUSC program that uses technology to connect neurologists at Medical University Hospital with doctors in smaller community hospitals to help them quickly and safely treat stroke patients.

“It gives people access to some of the best stroke neurologists in the country,” Lackland said.

Another change: Therapy for stroke patients is getting better and better, he said. “People are recovering from some of their paralysis they used to have with a variety of opportunities, including robotics, that help them get better and become more functional.”

While all of that is encouraging, Lackland said it’s up to everyone to know what to look for, whether you’re 25 or 75. Stroke kills about 130,000 people in this country each year. While most stroke patients are over 65, about 1 in 1,000 people age 45 and under suffer a stroke as well.

F.A.S.T. Checklist

Face drooping: Does one side of the face droop, or is it numb?

Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one drift downward?

Speech trouble: Is speech slurred or hard to understand? Ask the person to repeat a simple sentence and note if it's repeated the right way.

Time to call 9-1-1: Get help if any of these symptoms affect you or someone else - even if the symptoms go away.