What is a stroke?

Arteries are blood vessels that carry blood from your heart to the rest of your body. Most strokes happen when an artery that carries blood to the brain becomes blocked. When this happens, part of the brain doesn't get enough blood and can become damaged. You may lose control of a function that is controlled by that part of the brain. For example, you could lose the use of an arm or leg, or the ability to speak. The damage can be temporary or permanent, partial or complete. Doctors have found that if you get treatment right away after symptoms start, there is a better chance of getting the blood moving to your brain, and less chance of damage.

How do I know if I'm having a stroke?

If you have any of the following symptoms, call for emergency help immediately. The sooner you get help, the more doctors can do to prevent further or permanent damage.

• Sudden weakness or numbness of the face, arm or leg on one side of the body
• Sudden dimness or loss of vision, particularly in one eye
• Loss of speech, trouble talking or understanding what others are saying
• Sudden severe headache with no known cause
• Unexplained dizziness, unstable walking or falling, especially along with any of the other symptoms

Another warning sign of a stroke is called a transient ischemic attack (TIA). A TIA is a "mini-stroke" that can cause the symptoms listed above and may only last a few minutes, but should not be ignored. People who have a TIA are at greater risk of having a stroke later. Call your doctor immediately if you think you are having a TIA.

What are the risk factors for stroke?

Risk factors for stroke include the following:

• Atherosclerosis (hardening of the arteries)
• Uncontrolled diabetes
• High blood pressure
• High cholesterol level
• Smoking
• Previous transient ischemic attack (TIA)
• Heart disease
• Carotid artery disease (disease of the artery that carries blood to your brain)

After I have had a stroke, am I more likely to have another one?

Yes. People who have had a stroke are at increased risk of having another stroke, especially during the first year after the first stroke.

What is stroke rehabilitation?

Stroke rehabilitation is a very important part of recovery for many people who have had a stroke. It helps build your strength, coordination, endurance and confidence. In stroke rehabilitation, you may work on how to move, talk, think and care for yourself. The goal of stroke rehabilitation is to help you learn how to do things that you did before the stroke.

Your doctor will be able to determine whether you need stroke rehabilitation and, if so, what kind of rehabilitation would help you. Most people who have had a stroke do get better. How fast and how much you improve depends on how severe your stroke was. Rehabilitation can begin right after the stroke is over and your condition is stable. Some improvements occur by themselves as the brain is healing.

What can friends and relatives do to help their loved one recover from a stroke?

If you are a friend or relative of someone who has had a stroke, you should encourage and support him or her. Visit your loved one in the hospital or rehabilitation center. If he or she has trouble talking, ask the speech therapist how you can help. You can relax with your friend or family member by playing cards, watching television, listening to the radio or playing a board game together.

Some places offer classes for stroke survivors and their families. Ask if you can go to some rehabilitation sessions. This is a good way to learn how rehabilitation works and how to help your loved one get better.

Encourage and help your friend or family member practice the skills learned in rehabilitation. Make sure that the rehabilitation staff know about activities that fit your loved one's needs and interests. Find out what he or she can do alone, what he or she can do with help, and what he or she can't do at all. Avoid doing things for your friend or family member that he or she is able to do alone. Confidence will grow with each task he or she does without help.

Ask your loved one's doctor and the rehabilitation staff to meet with you and your family so that everyone can ask questions and find out how your loved one is doing. In addition, take care of yourself by eating well, getting enough rest and taking time to do things that you enjoy.

Encourage and help your family member practice the skills learned in rehabilitation. Make sure that the rehabilitation staff suggest activities that fit your loved one's needs and interests. Find out what he or she can do alone, what he or she can do with help, and what he or she can't do at all. Avoid doing things for your family member that he or she is able to do alone. Confidence will grow with each task he or she does without help.

Ask your loved one's doctor and the rehabilitation staff to meet with you and your family so that everyone can ask questions and find out how your loved one is doing. In addition, take care of yourself by eating well, getting enough rest and taking time to do things that you enjoy.

What are some of the effects of a stroke?

The following are the most common effects of stroke:

• Weakness or paralysis on one side of the body
• Problems with speech and language
• Poor balance or clumsy movement
• Not knowing what happens on one side of the body
• Trouble swallowing
• Problems with bladder or bowel control
• Problems with memory, thinking or problem solving
• Poor vision and/or changes in vision
• Numbness
• Problems getting around and caring for yourself

What about depression after a stroke?

Emotional changes may occur from stroke because of brain injury and loss of function. After a stroke, your moods may change more quickly than before, or you may become depressed. You may suddenly start crying or laughing for no reason.

Soon after the stroke, you may find it difficult to control your emotions. Usually this gets better over time. It is understandable if you feel depressed, sad or frustrated. These feelings are a part of getting used to the changes brought on by the stroke. Emotional reactions and depression are common after a stroke, but they can be treated. Talk to your doctor about feeling depressed and sad.

What about driving a car again after a stroke?

Driving gives a feeling of independence, and you may want to drive after your stroke. However, a stroke can affect your mobility, vision, thinking and communication skills. Your reaction time may also be slowed. Think carefully about how these changes may affect your own safety and the safety of others. Your doctor can help you decide when and if it is safe for you to drive after the stroke.

Call your state department of motor vehicles and ask about the rules for people who have had a stroke. You may receive a driver assessment, classroom instruction and suggestions for modifying your vehicle. Driver training programs are often available through rehabilitation centers.

If you can't drive, try to take comfort in the fact that you have made the responsible choice for your safety and the safety of others. There are other ways for you to get around, including public transportation, specialized vans, taxis and rides from friends and family. Find out about community resources, such as senior citizen groups and local volunteer agencies.

What can I do to reduce my risk of stroke?

Your risk of having a stroke (or another stroke) is higher if you are older, if you smoke cigarettes or if you drink a lot of alcohol. The risk is also increased if you have high blood pressure, high cholesterol, diabetes or are obese. Your risk is also increased if you have heart failure or a transient ischemic attack (sometimes called a TIA or a mini-stroke).

Ways to reduce your risk of having another stroke:

• Have regular check-ups. Your doctor can work with you to improve your health.
• If you are a smoker, stop smoking.
• Reduce the amount of alcohol you drink.
• Control your blood pressure.
• Control your cholesterol levels
• If you have diabetes, control your blood sugar level.
• Enjoy regular physical activity.

Ask your doctor for advice on making these lifestyle changes, and ask friends and family for support. Regular checkups are important to find problems that can increase your risk of having a stroke. Talk to your doctor about whether taking aspirin in low doses would help reduce your risk of stroke or TIA. Aspirin can help keep your blood from forming clots that can eventually block the arteries.

• Am I at risk for stroke?
• What lifestyle changes can I make at home to reduce my risk of stroke?
• What symptoms should I look out for?
•  How serious was my stroke?
• What will stroke rehabilitation entail?
• How long will it take me to recover from my stroke?
• Am I at risk of having another stroke? Am I at risk for other health problems?
• Will medicine help reduce my risk of having another stroke?
• What lifestyle changes can I make at home to reduce my risk of another stroke?