Walter Reed National Military Medical Center, BETHESDA, Md.  –   As part of National Stroke Awareness Month, an annual May observance, Walter Reed National Military Medical Center joins stakeholders across the Department of Defense community in championing greater public awareness in recognizing the signs of a stroke and rapidly responding in a medical emergency.

A stroke is a life-changing event – physically and emotionally affecting nearly 800,000 people a year in the United States, according to the National Institutes of Health (NIH). It’s a life-threatening medical emergency limiting blood flow to the brain, potentially impairing a person’s balance, eyesight, facial muscles, and speech.

“Soon, we will publish a new administrative instruction to update and standardize our acute stroke protocol,” as part of an ongoing refinement of best practices consistent with the latest research, explained U.S. Navy Lt. Cmdr. (Dr.) Ryan D. Slabaugh, who works in Walter Reed’s Department of Neurology.

Post Traumatic Stress Disorder (PTSD) Linkage to Strokes

In a 13-year cohort study titled “Posttraumatic Stress Disorder for Stroke in Young and Middle-Age Adults,” researchers linked PTSD to a person's risk of experiencing a stroke. The study indicated that "veterans with PTSD were 61 percent more likely than others to have a mini-stroke and 36 percent more likely than the general population to have a stroke." Researchers primarily focused on participants who were part of the Iraq and Afghanistan wars and who had no previous history of stroke incidents.

Recognizing the Symptoms of a Stroke

According to NIH researchers, recognizing the signs of a stroke and taking immediate action is crucial for improving outcomes. The acronym FAST” is a helpful tool for identifying the signs of a stroke:

F.A.S.T. Warning Signs

Use the letters in F.A.S.T. to Spot a Stroke

• F = Face Drooping – Does one side of the face droop, or is it numb? Ask the person to smile. Is the person's smile uneven?
• A = Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
• S = Speech Difficulty – Is speech slurred?
• T = Time to call 911 – Stroke is an emergency—every minute counts. Call 911 immediately. Note the time when any of the symptoms first appear.

Preventing a Stroke: Healthy Diet and Regular Exercise

“Poor diet (foods high in sugar and fat), lack of physical activity, smoking, and alcohol use,” are contributing factors that may cause a stroke explained Slabaugh.

That’s why neurologists often advise patients to consult with nutritionists to develop a healthy dietary plan to prevent diabetes and hypertension, lessening the likelihood of a stroke.

According to Slabaugh, “a healthy can be achieved in a variety of ways but research has shown that a Mediterranean style diet can potentially reduce cardiovascular disease.”

Mediterranean Diet Guidelines

-- Focus on vegetables, fruits, nuts, seeds, legumes, potatoes, whole grains, herbs, spices, fish, seafood, and extra virgin olive oil

-- Low to moderate consumption poultry, eggs, cheese, yogurt, red wine

-- Limit or avoid red meat, sugar-sweetened beverages, added sugars, processed meat, refined grains, other highly processed foods, beers, and liquors

Physical Activity

“The American Heart Association and the American Stroke Association recommend at least moderate intensity aerobic activity for a minimum of 10 minutes four times a week or vigorous-intensity aerobic activity for a minimum of 20 minutes twice a week,” detailed Slabaugh.

Patient Demographics and Health Equity

“Black and Hispanic communities have about a two-fold increased risk of developing a stroke compared to non-Hispanic whites,” explained Slabaugh. “These inequalities in the community are largely due to a lack of nutritious food and resources for exercise and healthcare education.”

Walter Reed bridges health equity gaps by providing nutritious and affordable food options as well as providing access to fitness centers, all of which improve outcomes for patients, staff and the military community.
In addition, the Defense Health Agency community provides access to medical providers to screen for cardiovascular risk factors, such as hypertension, diabetes, and high cholesterol.

Prospects for Patients Recovering from a Stroke

Slabaugh said acute management is rapidly changing and improving, suggesting that baseline medical records may provide comparative data for providers to make informed decisions about selecting a particular therapeutic strategy.

“We sometimes are able to give a thrombolytic medication to break up the blood clot or our interventional neurovascular specialists can use a catheter-based device to pull out the blood clot,” shared Slabaugh.

Following an acute stroke, Walter Reed has an incredible team of physicians and therapists working extensively with patients to guide them through rehabilitation.

“While we have medications that can thin the blood or reduce blood pressure and cholesterol, one of the most important treatments is still lifestyle modification in the form of diet and exercise to reduce the risk of another stroke,” advised Slabaugh.

Resource Links

To learn more about strokes and preventive best practices, visit these links:

https://www.cdc.gov/stroke/index.html

https://www.ninds.nih.gov/health-information/disorders/stroke

To learn more about Walter Reed’s stroke-related patient care and other neurological specialties, visit this link:

https://walterreed.tricare.mil/Health-Services/Specialty-Care/Neurology