Stroke (Cerebrovascular Accident), Ischemic, Discharge Information

What is a stroke?

A stroke is damage to part of the brain when its blood supply is suddenly slowed or stopped. A stroke may also be called a cerebral vascular accident, or CVA. The part of the brain that does not get enough blood dies and can no longer function.

An ischemic stroke is the most common kind. This type of stroke happens when there is a blockage in a blood vessel in the brain. The blockage may be caused by a blood clot that forms in a blood vessel of the brain or neck or a clot that travels from another part of the body to the brain or neck, such as a blood clot caused by an irregular heart rhythm called atrial fibrillation. An ischemic stroke may also be caused by a severe narrowing of an artery in the brain, or of an artery leading to the brain, such as an artery in the neck.

Any of the following factors can increase the risk of a stroke:

• High blood pressure
• Diabetes or borderline high blood sugar level
• High LDL cholesterol level, low HDL cholesterol level or high triglyceride level
• Cigarette smoking
• Being overweight, especially excess weight around the waist
• Family history of stroke
• Heart valve or heart muscle disease called endocarditis
• Heart disease or coronary artery disease
• Heart rhythm problems such as atrial fibrillation
• Sleep apnea
• Sickle cell anemia
• Patent foramen ovale (a heart birth defect)

Symptoms of a stroke include:

• Sudden numbness or weakness of the face, arm or leg, usually on one side of your body
• Sudden trouble walking or loss of balance
• Sudden trouble speaking or thinking clearly
• Sudden dizziness or severe headache
• Sudden trouble seeing in one or both eyes
• Nausea and vomiting

How can I take care of myself when I go home?

How long it takes to get better depends on the cause of your stroke, your treatment, how well you recover, your overall health, and any complications you may have. Talk to your healthcare provider about the cause of your stroke. Follow your provider’s advice on how to avoid having another stroke.

Management

• Your provider will give you a list of your medicines when you leave the hospital.
  • Know your medicines. Know what they look like, how much you should take each time, how often you should take them, and why you take each one.
  • Take your medicines exactly as your provider tells you to.
  • Carry a list of your medicines in your wallet or purse. Include any nonprescription medicines and supplements on the list.
  • Talk to your provider before you use any other medicines, including nonprescription medicines.
• Your provider may prescribe medicine to:
  • Prevent blood clots
  • Help the heart to beat normally
  • Control cholesterol levels
  • Reduce straining with a bowel movement
  • Treat other conditions that may have been a risk factor for your stroke, such as high blood pressure
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.
• You may need to continue your stroke rehabilitation program after you leave the hospital to help you adjust to some of the functions you may have lost due to the stroke. This may be done in an intensive rehabilitation center or at home. Most rehabilitation programs include:
  • Physical therapy to help you regain muscle strength and teach you ways to move safely.
  • Occupational therapy to help you relearn ways to do the tasks that you previously did.
  • Speech therapy to help you if you have problems with swallowing, speaking, or understanding words.
• Therapy may include skin care and training to help you control your bladder and bowels.
• You may need help with daily activities.
• Follow the treatment plan your healthcare provider prescribes.
• Don't smoke. Smoking can worsen poor blood circulation.
• If you have diabetes, check and control your blood glucose (sugar).
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Learn ways to manage stress. Exercise according to your healthcare provider's instructions.
• Eat a healthy diet and try to keep a healthy weight. You will probably need to make changes in some of the foods you eat. Ask your provider about the benefits of talking to a dietician to learn what you need in a healthy diet.
• Ask your healthcare provider if there are any foods or medicines you should avoid. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.

Appointments

• Follow your provider’s instructions for follow-up appointments.
• Keep appointments for any testing you may need.

Talk with your provider about any questions or concerns you have.

Call emergency medical services or 911:

The acronym FAST describes stroke symptoms and needed action. The symptoms come on FAST and may include:

• Face/Head:
  • Weakness, numbness, drooping, tingling of face (may just be on one side)
  • Trouble seeing (one or both eyes)
  • Severe headache
  • Trouble thinking
  • Trouble swallowing
  • Feeling dizzy may also be noted with the above symptoms
• Arm/Leg:
  • Weakness, numbness, or tingling in your arm, or leg (usually on just one side of your body)
  • Trouble walking, moving your arm or leg
• Speech: Trouble talking or understanding speech
• Time: Call 911 for emergency help right away if you have symptoms of a stroke.

You should also call emergency medical services or 911 if you have new or worsening:

• Loss of bowel or bladder control
• Seizures or convulsions

If you have any of these symptoms, do not drive yourself.

Call your healthcare provider if you have new or worsening:

• Loss of balance or coordination
• Confusion
• Personality changes
• Dizziness or lightheadedness
• Headache that will not go away after treatment