HJAR Nov/Dec 2019

46 NOV / DEC 2019 I  HEALTHCARE JOURNAL OF ARKANSAS COLUMN NEUROLOGY As a society, we often find it easier to focus on the dangers of heart attack, but I often describe stroke as a brain attack. A clot or bleeding blood vessel in the brain triggers the stroke and begins to starve the brain of oxy- gen. Without that oxygen, brain cells will be- gin to die within minutes, and once they die, they cannot be replaced. When it comes to treatment and brain health following a stroke, we have to begin by understanding that time = brain. To ensure the best possible outcome for patients, they require care within three hours of the first sign of stroke. After that, brain cells begin to die by the minute, mak- ing treatment less effective. We know that everyminute matters, and quick response not only saves lives, but also helps minimize or prevent common functional deficits associ- ated with stroke. Our community needs to work together to ensure that patients receive the care they need in a timely manner. That means imme- diately recognizing the symptoms or signs of stroke. Numbness or weakness of the face, arm, or leg, especially on one side of the body, is a common symptom. Confusion, trouble speaking or understanding, problems seeing in one or both eyes, and trouble walking are all common symptoms as well. Some patients may even describe having the worst head- ache in their life strike them like a clap of thunder. When a physician or family mem- ber recognizes those signs, they need to get the patient to the nearest emergency room immediately. Expanding Our Understanding of Stroke And Treatment Despite the prevalence of stroke, brain tumors, aneurysms, and other neurologi- cal conditions, many misconceptions about neurosurgery and treatment remain. Many patients still believe that treatment always means a surgeon will need to crack open their skull to operate, and that is simply not true. In skilled and experienced hands, even the most delicate brain surgeries today are extremely safe. Surgeons have pioneered advancements in certain procedures that were once consid- ered unsafe or even impossible, making them entirely safe and possible for patients today. In some cases, we can even conduct bypass surgery on a blood vessel in the brain to di- rect blood to a region impacted by a stroke, just as a cardiac surgeon would conduct a bypass surgery on the heart. Training and improvements in Stroke: THE BRAIN ATTACK The mortality rate for stroke in Arkansas sits among the worst in the nation. That alone should come as a sobering realization, but what makes it worse is the fact that as a community, we have the resources, facilities, technology, knowledge, and most importantly, the will to save lives before, and even after someone suffers a stroke.