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Preventing brain damage depends on recognizing, reacting to stroke signs

Warning signs of a stroke are easy to spot, says Dr. Oscar Sanchez.

"If the patient has difficulty speaking, a sudden weakness of arms or legs or face, difficulty pronouncing words, difficulty seeing, sudden severe headache or difficulty in ability to coordinate or walk, then call 911," said the neurologist and medical director of Rogue Valley Medical Center's primary stroke center.

The quicker a stroke victim receives professional help, the less brain damage there will be, he stressed.

Recent studies indicate that some people may be genetically predisposed to certain types of strokes, he said.

"But right now the most important thing is to control the risk factors," he said.

Those risks include cardiac rhythm problems, high blood pressure, cholesterol, inappropriate diet and diabetes, he said.

Nearly 800,000 people are expected to die from strokes in the United States this year, according to the Centers for Disease Control and Prevention in Atlanta.

The most common — nearly 90 percent — is an ischemic stroke that occurs when blood clots block the blood vessels to the brain.

Both RVMC and Providence Medford Medical Center's primary stroke centers have established protocols to minimize the deadly effects of a stroke.

Interventions range from clot-busting drugs to surgery to remove blockages.

"Primary stroke center-certified hospitals have better outcomes than non-certified hospitals," said Charity Barrueta, a registered nurse and program coordinator for RVMC's stroke center.

A new system at RVMC scheduled to be in place on Monday will allow emergency staff to contact stroke specialists at the Oregon Health & Science University in Portland within five to seven minutes of a stroke patient's arrival, she said.

"We're linking with OHSU through our telemedicine services," Barrueta said. "If an acute stroke patient comes into the emergency department, our ER physician will immediately call OHSU and discuss the case."

If necessary, a telemedicine robot will be activated to observe the patient, she noted.

"This is a mechanism for the OHSU stroke neurologist to visualize the patient through a very fancy robot and do an assessment with the ER physician," she said. "It is like they are physically there in the room."

A similar system was recently installed in the Carl Brophy Stroke Program at Providence. The "telestroke" service offers instant video-conference access to neurologists at the Providence Brain Institute in Portland, according to a spokeswoman.

The percentage of strokes is generally higher among the older population because of increased risk factors brought about by age, Sanchez said.

"Not everybody has the same severe weakness and fatigue that can develop," he said. "But the older we are, the less reserve we have."

A stroke in our senior years does not mean we cannot bounce back, he said.

"Our brain can learn until the day we die," he said. "It depends obviously on what area was affected by the stroke. Some of the things we learn are compensatory. And some are learning new activities involving other areas of the brain that could do the same or similar function to help us compensate."

Unfortunately, while the medical community is making headway in helping stroke victims recover, there will likely be a higher percentage of strokes in the future, he said.

"There is going to be a major explosion of strokes," he predicted. "Children have different habits than we did as kids. There is a real epidemic because of the high blood pressure and diabetes in children."

In two decades, there could be a 30 percent increase in strokes because of health problems among today's children, he said, citing recent medical research.

"It is really a worrisome proposition," he said.

Reach reporter Paul Fattig at 541-776-4496 or email him at pfattig@mailtribune.com.