WEBVTT 00:00:06.956 --> 00:00:12.525 Every two seconds, someone somewhere in the world experiences a stroke. 00:00:12.525 --> 00:00:17.878 And one out of every six people will have one at some point in their lives. 00:00:17.878 --> 00:00:20.868 Strokes deprive brain cells of oxygen 00:00:20.868 --> 00:00:23.879 and are one of the most common causes of death, 00:00:23.879 --> 00:00:27.095 and a leading cause of preventable disability. 00:00:27.095 --> 00:00:31.449 When someone experiences a stroke, quick medical care is critical, 00:00:31.449 --> 00:00:35.019 and can often help avoid permanent brain damage. 00:00:35.019 --> 00:00:37.678 But what causes strokes in the first place? 00:00:37.678 --> 00:00:40.379 And what can doctors do to treat them? 00:00:40.379 --> 00:00:44.520 The brain makes up just 2% of your body’s mass 00:00:44.520 --> 00:00:48.958 but consumes more than 20% of the oxygen in your blood. 00:00:48.958 --> 00:00:52.751 That oxygen is carried to the brain through a system of arteries. 00:00:52.751 --> 00:00:55.638 Carotid arteries supply the front of the brain, 00:00:55.638 --> 00:00:58.688 and vertebral arteries supply the back. 00:00:58.688 --> 00:01:00.719 These are connected to each other, 00:01:00.719 --> 00:01:03.369 and divide into smaller and smaller vessels 00:01:03.369 --> 00:01:07.180 that get billions of neurons the oxygen they need. 00:01:07.180 --> 00:01:13.349 If the blood flow is interrupted, oxygen delivery stops, and brain cells die 00:01:13.349 --> 00:01:15.490 There are two ways this can happen. 00:01:15.490 --> 00:01:20.641 Hemorrhagic strokes are when a perforated vessel allows blood to leak out. 00:01:20.641 --> 00:01:23.530 But the more common type is the ischemic stroke, 00:01:23.530 --> 00:01:28.628 when a clot blocks a vessel and brings blood flow to a halt. 00:01:28.628 --> 00:01:30.690 Where do these clots come from? 00:01:30.690 --> 00:01:33.591 On rare occasions, a sudden change in heart rhythm 00:01:33.591 --> 00:01:37.900 prevents the upper chambers of the heart from contracting normally. 00:01:37.900 --> 00:01:39.809 This slows down blood flow, 00:01:39.809 --> 00:01:45.442 allowing platelets, clotting factors, and fibrin to stick together. 00:01:45.442 --> 00:01:47.161 The clot can be carried up 00:01:47.161 --> 00:01:50.611 towards the arteries and blood vessels supplying the brain 00:01:50.611 --> 00:01:53.682 until it gets to one it can’t squeeze through. 00:01:53.682 --> 00:01:56.297 This is called an embolism, 00:01:56.297 --> 00:02:00.665 and it cuts off the oxygen supply to all the cells downstream. 00:02:00.665 --> 00:02:05.862 The brain doesn't have pain receptors, so you can't feel the blockage itself. 00:02:05.862 --> 00:02:08.672 But oxygen deprivation slows brain function 00:02:08.672 --> 00:02:11.802 and can have sudden, noticeable effects. 00:02:11.802 --> 00:02:15.593 For example, if the affected area is responsible for speech, 00:02:15.593 --> 00:02:18.514 an individual’s words may be slurred. 00:02:18.514 --> 00:02:21.972 If the stroke affects a part of the brain that controls muscle movement, 00:02:21.972 --> 00:02:26.553 it can cause weakness, often just on one side of the body. 00:02:26.553 --> 00:02:30.435 When this happens, the body will immediately try to compensate 00:02:30.435 --> 00:02:33.405 by diverting blood flow to the affected area, 00:02:33.405 --> 00:02:35.625 but this isn’t a perfect solution. 00:02:35.625 --> 00:02:39.824 Eventually, the oxygen-deprived cells will start to die, 00:02:39.824 --> 00:02:43.748 leading to brain damage that may be severe or permanent. 00:02:43.748 --> 00:02:48.390 That’s why it’s important to get medical care as fast as possible. 00:02:48.390 --> 00:02:51.370 The first line of treatment is an intravenous medication 00:02:51.370 --> 00:02:54.205 called Tissue Plasminogen Activator, 00:02:54.205 --> 00:02:55.884 which can break up the blood clot 00:02:55.884 --> 00:02:59.855 and allow blood to flow again in the compromised artery. 00:02:59.855 --> 00:03:02.015 If it’s delivered within a few hours, 00:03:02.015 --> 00:03:05.415 this medication greatly increases the chance of surviving the stroke 00:03:05.415 --> 00:03:08.156 and avoiding permanent consequences. 00:03:08.156 --> 00:03:11.646 If Tissue Plasminogen Activator cannot be given 00:03:11.646 --> 00:03:13.976 because the patient is on certain medications, 00:03:13.976 --> 00:03:15.595 has history of major bleeding, 00:03:15.595 --> 00:03:18.336 or the clot is particularly large, 00:03:18.336 --> 00:03:23.155 doctors can perform a procedure called an endovascular thrombectomy. 00:03:23.155 --> 00:03:28.694 Using a fluorescent dye that illuminates the blood vessels under a strong x-ray, 00:03:28.694 --> 00:03:33.146 the physician inserts a long, thin, flexible tube called a catheter 00:03:33.146 --> 00:03:35.375 into an artery in the leg, 00:03:35.375 --> 00:03:38.508 and maneuvers it all the way to the blockage. 00:03:38.508 --> 00:03:41.377 A retriever is passed through this catheter. 00:03:41.377 --> 00:03:45.707 It expands and anchors into the clot when it’s just passed it. 00:03:45.707 --> 00:03:50.737 The catheter then pulls the clot out when it’s removed. 00:03:50.737 --> 00:03:53.679 These treatments need to be delivered as soon as possible 00:03:53.679 --> 00:03:55.338 to preserve brain function, 00:03:55.338 --> 00:03:59.588 which means figuring out fast if someone is having a stroke. 00:03:59.588 --> 00:04:01.017 So how can you tell? 00:04:01.017 --> 00:04:03.869 Here are three quick things to try. 00:04:03.869 --> 00:04:06.558 1: Ask the person to smile; 00:04:06.558 --> 00:04:11.118 A crooked mouth or facial drooping can indicate muscle weakness. 00:04:11.118 --> 00:04:13.879 2: Ask them to raise their arms; 00:04:13.879 --> 00:04:19.829 If one drifts downward, that arm weakness is also a sign of a stroke. 00:04:19.829 --> 00:04:23.919 3: Ask them to repeat a simple word or phrase; 00:04:23.919 --> 00:04:26.788 if their speech sounds slurred or strange, 00:04:26.788 --> 00:04:31.489 it could mean that the language area of their brain is oxygen-deprived. 00:04:31.489 --> 00:04:37.281 This is sometimes called the FAST test, and the T stands for time. 00:04:37.281 --> 00:04:42.290 If you see any of those signs, call emergency services right away. 00:04:42.290 --> 00:04:44.331 Lives may depend on it.