Medical staff at Upstate University Hospital are seeing changes in the diagnoses of strokes and the ways they’re treating them. Registered Nurse and Stroke Program Manager Josh Onyan said he’s seen patients as young as 4-years-old, and treated a clot in a 13-year-old.
He suggested the most important thing people can know about strokes is how to spot them. Onyan noted the acronym FAST helps: Face drooping, Arm numbness, Slurred speech, and T for Time to get help.
“You don't have to have all those symptoms. And … they don't have to be major symptoms, but just something that suddenly happens to you and you no longer have that neurological ability to either speak, move your arm, or your face is drooping,” said Onyan, who recommended people call 911 with any concerns about those symptoms to get EMS to the patient quickly. “They let us know and then our team can be at the door waiting for you and we'll take you right to CAT scan because, time is treatment, time is brain.”
The most prevalent risk factors for stroke are high cholesterol and high blood pressure – both also linked to increased risk for heart attack. Onyan emphasized both can be controlled through lifestyle choices and changes.
“Risk factors for both heart attack and stroke, diabetes being one of them, the high sugar in your blood from diabetes just causes like an inflammatory response across your whole body, affecting your kidneys, your eyes, your heart and your head. High blood pressure is probably the biggest risk factor that we can be aware of and control. We call it the silent killer. Many people have high blood pressure and aren't even aware that they're having it”, Onyan added.
Treatment of stroke has advanced in recent years. Onyan says it’s only in the past 30 years that they can reduce the blood clots that cause a stroke without surgery through “an IV clot-busting medication called alteplase for breaking up a clot for stroke. We have recently got evidence and guideline changes to use a new medication called tenecteplase, which is the same class of medication. It breaks up a blood clot when given IV.”
He added advancements in CT scans and MRI software, using AI, can offer more information about how a clot has affected the brain, “and give us a better picture of actually how much brain tissue has died based on how much time has passed.”
The key time element here is 4.5 hours; Onyan explained that’s the window from the onset of stroke symptoms in which they have the best chance of treatment to minimize any brain damage or long-term effects.
Latest advice on recognizing stroke symptoms: BE FAST
- B - Balance Loss: Sudden dizziness, loss of balance, or coordination problems.
- E - Eye Changes: Sudden blurred, double, or lost vision, particularly in one eye.
- F - Face Drooping: One side of the face droops or is numb; uneven smile.
- A - Arm Weakness: Sudden numbness or weakness in one arm or leg; if you raise both, one drifts down.
- S - Speech Difficulty: Slurred speech, trouble speaking, or difficulty understanding.
- T - Time to Call 911: Time is critical. Even if symptoms disappear, call for emergency help right away.
State Health Department data show New York hospitals treat between 33,000 and 35,000 patients with strokes each year.
