Saturday, June 20, 2015

The FAST Campaign Is Not Working

Rebecca Dutton
Home After a Stroke
June 25, 2013

The American Stroke Association (ASA) and the National Stroke Association (NSA) try to get people who are having a stroke to the emergency room quickly with their FAST campaign. FAST stands for face (sagging on one side), arm (weakness in one arm), speech (impaired), and time lost is brain lost. However, these are warning signs for strokes that affect the front of the brain. The ASA estimates that 25% of strokes cut off the blood supply to the back of the brain where vision, balance, and coordination are controlled. One type of a stroke that affects the back of the brain is a lacunar stroke. A lacunar stroke is caused by small blood vessels in the brainstem that get clogged by cholesterol. The brainstem includes the bridge to the cerebellum that controls balance and coordination. A second type of stroke that affects the back of the brain is a brainstem cavernous angioma. An angioma is a cluster of abnormally dilated blood vessels that begin to bleed. A third type of stroke that affects the back of the brain is stenosis of the vertebral artery. This artery runs up the inside of the neck vertebrae and provides blood for the brainstem. When stenosis narrows the vertebral artery people are more vulnerable to having a stroke when a chiropractor bends their neck. Think of a kink in a garden hose that stops the water from flowing.

The scary part about poor vision, balance, and coordination is that medical personnel ignore them as signs of a stroke. I went immediately to the emergency room with a sudden onset of impaired balance but a neurologist wasn't called for several hours. I had a second sudden onset of poor balance two years later. A neurologist said this was probably caused by an ear infection. He agreed that I had another lacunar stroke when I told him I lost the ability to distinguish between hot and cold in my hemiplegic leg and acquired double vision that was confirmed by an optometrist.

Both stroke associations need to promote the Five Sudden, Severe Symptoms outlined by Dr. Lynden, director of the stroke program at Cedars-Sinai Medical Center in Los Angeles. The five symptoms are: 1) sudden trouble seeing on one side, 2) sudden severe dizziness, loss of balance, difficulty walking, or incoordination, 3) sudden severe headache with no known cause, 4) sudden numbness or weakness of the face, arm, or leg on one side of the body, and 5) sudden confusion, trouble speaking, or trouble understanding. What makes these warning signs of a stroke is that they are sudden or severe or both. The ASA and NSA need to step up and serve the entire stroke community.

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