If you’re under 65 and — like most Coloradans — lead a fairly healthy lifestyle, chances are your eyes will glaze over after you read these next five words:
After all, why would you need to worry about stroke?
Because contrary to popular belief, strokes happen to young, healthy people. And in ultra-active Colorado — where accidents from skiing, mountain biking, yoga, horseback riding, and even chiropractic manipulations can inflict trauma on the carotid artery — they are far more common than people think, doctors say.
“We see a lot of 30, 40, and 50 year-olds coming in with stroke, particularly due to trauma,” Dr. Jie Mao, an interventional radiologist with Boulder Community Hospital, recently told me. “Unfortunately, they don’t recognize it, and the stroke goes undiagnosed longer than it should.”
Take Steve Boorstein.
Boorstein was skiing Vail when he was knocked unconscious by a snowboarder. He suffered a concussion, a dislocated shoulder, and cracked ribs. Little did he know, he also sustained a tear in his carotid artery that was slowly throwing off clots into his brain. It would be three months before the disorientation, arm numbness, and throbbing headaches landed him in the emergency room. By then, he’d already had five mini-strokes. He had another massive one on the operating table.
“If I had just known the signs, and paid attention them, I might have been able to head this off,” says Boorstein, 57, who four years later still suffers lingering left-side paralysis, and memory loss.
Boorstein’s book, “Different Strokes: An Intimate Memoir for Stroke Survivors, Families, and Caregivers,” (Skyhorse: 2011), is full of similar cautionary tales: a 33-year-old Boulderite who dissected her carotid artery while scuba diving; a 53-year-old runner who tore his when he tripped over a root; a 19-year-old who had a stroke after a bout with tonsillitis injured her carotid artery.
In fact, according to a recent study in the journal Neurology, 19 percent of strokes occur in people under 55. Another paper, by University of Cincinnati researchers, found that stroke incidence among 20 to 45-year-old Caucasians has more than doubled since 1993.
Better diagnostic tools are partially to credit. And poor diet, smoking, and an increasingly sedentary lifestyle among youth no doubt play a role, doctors say. But strokes also occur in younger people for lesser-known reasons, such as side-effects from prescription drugs (like birth control pills); or an undiagnosed hole in the heart. In the case of trauma, the injured artery bleeds and forms a clot. The clot breaks loose, choking off circulation. And with each minute that passes without blood flow, 2 million brain cells die.
The good news: The death rate from stroke has fallen by a third, due to the advent of a powerful intravenous clot buster called tissue plasminogen activator (tPA), and new mechanical retrieval devices that allow doctors to pluck clots, restoring blood flow. But tPA must be given within 4.5 hours, and endovascular techniques must be given within 8. Even then, the earlier the better. Or, as neurologists often put it: “Time is Brain.”
Eighteen-year-old Parker resident Megan Dougherty was one of the lucky ones.
After her neck smashed up against the neck of her horse during a riding competition two years ago, she grew nauseous and dizzy, and tumbled to the ground. Her mom, a nurse, instantly recognized stroke, and got her the medical attention she needed. Today, she has almost fully recovered.
“We have all grown up thinking that it is just the elderly that have strokes and if people don’t suspect stroke, they don’t act with urgency,” says Megan’s mother Terry Dougherty. “The word needs to get out that young people can have them too.”
Her advice: No matter your age, take a moment to learn the signs:
- F (Face): Ask the person to smile. Does one side of the face droop?
- A (Arms): Ask the person to raise both arms. Does one arm drift downward?
- S (Speech): Ask the person to repeat a simple sentence. Does the speech sound slurred?
- T (Time): If you observe any of these signs, make note of the time, and call 911.
Lisa Marshall is a freelance health and medical science writer in Lyons, Colo. Connect at www.lisaannmarshall.com.
Locally, the Centura Health Stroke Network provides a free, online stroke risk assessment as well as many educational tools that aim to help people to react quickly in the first crucial moments after a stroke occurs.