Debunking 10 Myths About Stroke: Separating Fact from Fiction

This feature on Medical Myths examines 10 commonly misunderstood concepts surrounding strokes, and with insights from a medical professional, debunks their falsehoods.

Busting 10 Stroke Myths

Design by Andrew Nguyen.

According to the Centers for Disease Control and Prevention (CDC), over 795,000 people in the United States have a stroke every year, with around 610,000 experiencing their first stroke. In 2019, stroke was the second leading cause of mortality globally, accounting for 11% of deaths.

There are three main types of stroke: ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA). Ischemic stroke, which occurs when blood flow to the brain is blocked, is the most common type, accounting for 87% of cases. Hemorrhagic stroke is caused by a rupture in an artery in the brain, while TIA, often referred to as a “ministroke,” is a temporary blockage of blood flow to the brain.

Despite its prevalence, stroke is often misunderstood. To help dispel myths and improve our understanding, we reached out to Dr. Rafael Alexander Ortiz, chief of Neuro-Endovascular Surgery and Interventional Neuro-Radiology at Lenox Hill Hospital. Let’s dive into the misconceptions surrounding stroke and separate fact from fiction.

1. Stroke is a problem of the heart

Although stroke risk is linked to cardiovascular risk factors, strokes happen in the brain, not the heart. Dr. Ortiz clarifies, “A stroke is a problem of the brain, caused by the blockage or rupture of arteries or veins in the brain, and not the heart.” It’s important to differentiate stroke from a heart attack, which is caused by a blockage in blood flow to the heart.

2. Stroke is not preventable

While some believe that stroke is unavoidable, many risk factors can be modified through lifestyle changes. According to Dr. Ortiz, common risk factors for stroke include hypertension, smoking, high cholesterol, obesity, diabetes, head or neck trauma, and cardiac arrhythmias. Regular exercise and a healthy diet can help reduce these risk factors.

Unhealthy lifestyle factors like alcohol consumption and stress can also contribute to stroke risk. Working on reducing or eliminating these factors can further decrease the chances of experiencing a stroke.

3. Stroke does not run in families

Certain genetic factors can indirectly increase the risk of stroke. Single-gene disorders such as sickle cell disease can directly increase the risk. Additionally, families sharing lifestyles and environments may have unhealthy lifestyle factors that contribute to stroke risk, especially when coupled with genetic risk factors.

4. Stroke symptoms are hard to recognize

Recognizing stroke symptoms is crucial for timely intervention. The most common symptoms of stroke can be remembered using the acronym “F.A.S.T.”:

  • F: Face dropping
  • A: Arm weakness
  • S: Speech difficulty
  • T: Time to call 911

Other symptoms include numbness or weakness on one side of the body, confusion, difficulty speaking or understanding speech, vision problems, difficulty walking, balance issues, severe headaches without a known cause.

5. Stroke cannot be treated

Contrary to popular belief, strokes can be treated, especially when emergency treatment is sought promptly. Dr. Ortiz explains that injection of a clot-busting drug, minimally invasive mechanical thrombectomy, or surgery can reverse stroke symptoms. The earlier treatment is received, the better the outcome. It is crucial to call 911 at the onset of stroke symptoms to ensure prompt transport to the nearest hospital.

Research also suggests that those who arrive within 3 hours of experiencing symptoms have better outcomes compared to those who arrive later.

6. Stroke occurs only in the elderly

While age is a significant risk factor for stroke, it can occur at any age. In 2009, 34% of stroke hospitalizations were under the age of 65. Young adults and adolescents may experience approximately 15% of all ischemic strokes. Risk factors such as hypertension, diabetes, obesity, lipid disorders, and tobacco use are common among this age group.

7. All strokes have symptoms

Not all strokes present symptoms, and silent strokes may be more common than those with symptoms. A study found that out of over 11 million strokes, 770,000 presented symptoms, while close to 11 million were silent. Silent strokes can be identified through MRI scans, showing scarred tissue from blockages or ruptured blood vessels. Although symptom-free, they should still be treated similarly to strokes with symptoms, as they increase the risk of future symptomatic strokes, cognitive decline, and dementia.

8. A ministroke is not so risky

The term “ministroke” is sometimes used incorrectly to suggest low-risk small strokes. However, a ministroke, also known as a transient ischemic attack (TIA), is a premonition that a large stroke can occur. Dr. Ortiz emphasizes that any symptom of acute stroke, transient or persistent, requires emergency workup and management to prevent a potentially devastating large stroke.

9. Stroke always causes paralysis

While stroke is a leading cause of long-term disability, not all stroke survivors experience paralysis or weakness. The impacts of stroke vary based on factors such as the extent and area of brain tissue affected. Damage to the left brain can lead to paralysis on the right side of the body, speech and language problems, slow behavior, and memory loss. Damage to the right brain may cause paralysis on the left side of the body, vision problems, quick behavior, and memory loss.

10. Stroke recovery happens fast

Stroke recovery is a long and ongoing process. According to the American Stroke Association, recovery outcomes vary among stroke survivors. While 10% may make a nearly complete recovery, another 10% may require long-term care. Additionally, 25% may recover with minor impairments, while 40% may experience moderate to severe impairments.

Research suggests a critical time window between 2-3 months after stroke onset, during which intensive motor rehabilitation is more likely to lead to recovery. Some spontaneous recovery may also occur during this period. Beyond this window and the 6-month mark, improvements are possible, albeit slower.

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Q&A

Q: Can strokes be caused by stress alone?

A: While stress can contribute to stroke risk, it is typically not the sole cause. Stress can lead to unhealthy behaviors like smoking, poor diet, and lack of exercise, which are established risk factors for stroke. However, managing stress levels through relaxation techniques and self-care can be beneficial for overall health.

Q: Are all strokes treated with clot-busting drugs?

A: No, the type of treatment depends on the type and severity of the stroke. Clot-busting drugs are commonly used for ischemic strokes caused by blood clots. However, hemorrhagic strokes, which involve bleeding in the brain, require different treatment approaches. It is essential to consult a healthcare professional for proper diagnosis and treatment.

Q: Can stroke risk be reduced through dietary changes alone?

A: While dietary changes can certainly contribute to reducing stroke risk, they are most effective when combined with other lifestyle modifications. A heart-healthy diet that includes fruits, vegetables, whole grains, lean proteins, and healthy fats can help reduce the risk of hypertension, high cholesterol, obesity, and diabetes, all of which are significant risk factors for stroke.

For more information on strokes and their prevention, you can refer to these reputable sources:

  1. American Stroke Association
  2. National Institute of Neurological Disorders and Stroke

Now that you’re armed with accurate information about strokes, help spread awareness by sharing this article on social media. Together, we can debunk myths and promote better understanding of stroke prevention and treatment.

Disclaimer: This article is for informational purposes only and should not replace medical advice. Consult a healthcare professional for personalized guidance and treatment.