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Ask the Doctor


Jim Wessely, MD, Co-Medical Director, St. Luke's Emergency Department

Q: What is a stroke, who is at risk and what should I do if I think I'm having one?

A: A stroke is a problem with blood flow to part of the brain which can cause brain damage. Risk factors for stroke are high blood pressure, high cholesterol, obesity, sedentary lifestyle, smoking, diabetes, heart disease (especially an irregular heart beat - i.e., atrial fibrillation), use of drugs and a family history of stroke. There are some rare genetic defects (Marfan's syndrome) that also predispose a person to having a stroke.

Symptoms may include sudden change in vision, speech, swallowing, balance or coordination. A person also may have sensations or numbness - usually only one side of the body, paralysis (local weakness on one side of the body) and loss of memory - usually regarding recent events. Occasionally, it may occur with a sudden inability to write, read or understand language.

You should call 9-1-1 immediately if you think you are having a stroke. There is a drug, called tPA, that was very successful with "busting clots" in patients having heart attacks. Most strokes are caused by a blood clot that interrupts the blood flow to part of the brain. Unfortunately, this "clot busting" has not been as successful with strokes as it is with heart attacks and only helps a small percentage of patients. However, the patients that it may help are those who get the drug very early after their onset of the stroke, usually within three hours. So, it is still important to get to the emergency room as quickly as possible.

To reduce your risk of stroke, one should exercise regularly, maintain a normal weight, keep blood pressure under control, aim for normal cholesterol, treat diabetes, stop smoking, stop using illicit drugs, take blood-thinning medicine (if prescribed), ask your doctor if you should take a daily aspirin and, most importantly, have regular visits with your doctor and follow their advice.

St. Luke's is #1 rated for cardiac services and neurosciences in the state of Missouri*. St. Luke's is proud to have earned The Joint Commission's Gold Seal of Approval for certification as a Primary Stroke Center.

*HealthGrades, 2012