Philip J. Goscienski, M.D.
July 2008
Stroke is the third leading cause of death in the United States yet remarkably few people know how to recognize it, fewer still take steps that can prevent it and even physicians are sometimes unaware of how this devastating disease has changed over the past century. Each of these issues will be the topic of a future column but for the moment we need to consider the importance of what is usually considered a mild, transient stroke.
The term mild is misleading. There is no such thing as a mild stroke; only the symptoms are mild. The process that sets it in motion is serious. If the symptoms pass quickly it is known as a transient ischemic attack or TIA, sometimes referred to as a mini-stroke.
Stroke would have been a rare event in the Stone Age. We obviously have no direct evidence of that but among the globe's hunter-gatherers, people who still live as Stone Agers did tens of thousands of years ago, stroke is very rare. When it does happen the outcome is swiftly fatal because it's the result of a burst blood vessel in the brain. This hemorrhagic variety of stroke results from plain bad luck, a weakness in the wall of a blood vessel that gives way when blood pressure rises. In the Stone Age it might have happened during the intense excitement of a hunt or a battle.
As recently as a hundred years ago almost all strokes were due to burst blood vessels within the brain. Only about 10 or 15 percent of strokes are of the hemorrhagic type today.
It's lifestyle, not bad luck that leads to today's kind of stroke, the ischemic type. The sugar-laden, fat-filled, high salt diet that results in clogged arteries and damaged hearts sets the stage for this new kind of stroke. When a blood clot forms in an artery that supplies part of the brain or arrives there from somewhere else the supply of oxygen is partially or completely interrupted. Brain cells don't tolerate a lack of oxygen for more than a few seconds; they start to die in minutes. When a large portion of the brain is cut off from its oxygen supply the damage can be severe, even fatal.
If the clot dissolves quickly or it doesn't completely close off the flow of blood the symptoms go away within minutes or hours. Even so you should never ignore numbness on one side of the body, inability to speak clearly, unsteady gait, sudden clumsiness or sudden blurred or dim vision.
A TIA or ministroke is a medical emergency even if the symptoms go away completely. A major life-shattering stroke will occur in 5 to 10 percent of victims within one week but with immediate treatment the risk goes down by about 80 percent.
Strokes occur in middle and old age but the damage begins in childhood. It's no exaggeration to say that more than 90 percent of strokes of both types are avoidable with a proper exercise and diet. After all, that's how Stone-Agers, except for those unlucky ones, avoided them.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.