1 00:00:06,956 --> 00:00:12,525 Every two seconds, someone somewhere in the world experiences a stroke. 2 00:00:12,525 --> 00:00:17,878 And one out of every six people will have one at some point in their lives. 3 00:00:17,878 --> 00:00:20,868 Strokes deprive brain cells of oxygen 4 00:00:20,868 --> 00:00:23,589 and are one of the most common causes of death 5 00:00:23,589 --> 00:00:26,785 and a leading cause of preventable disability. 6 00:00:26,785 --> 00:00:31,449 When someone experiences a stroke, quick medical care is critical, 7 00:00:31,449 --> 00:00:34,729 and can often help avoid permanent brain damage. 8 00:00:34,729 --> 00:00:37,588 But what causes strokes in the first place? 9 00:00:37,588 --> 00:00:40,849 And what can doctors do to treat them? 10 00:00:40,849 --> 00:00:44,520 The brain makes up just 2% of your body’s mass 11 00:00:44,520 --> 00:00:48,958 but consumes more than 20% of the oxygen in your blood. 12 00:00:48,958 --> 00:00:52,751 That oxygen is carried to the brain through a system of arteries. 13 00:00:52,751 --> 00:00:55,638 Carotid arteries supply the front of the brain, 14 00:00:55,638 --> 00:00:58,688 and vertebral arteries supply the back. 15 00:00:58,688 --> 00:01:00,719 These are connected to each other, 16 00:01:00,719 --> 00:01:03,369 and divide into smaller and smaller vessels 17 00:01:03,369 --> 00:01:07,380 that get billions of neurons the oxygen they need. 18 00:01:07,380 --> 00:01:13,349 If the blood flow is interrupted, oxygen delivery stops and brain cells die. 19 00:01:13,349 --> 00:01:15,490 There are two ways this can happen. 20 00:01:15,490 --> 00:01:20,641 Hemorrhagic strokes are when a perforated vessel allows blood to leak out. 21 00:01:20,641 --> 00:01:23,530 But the more common type is the ischemic stroke, 22 00:01:23,530 --> 00:01:28,518 when a clot blocks a vessel and brings blood flow to a halt. 23 00:01:28,518 --> 00:01:30,690 Where do these clots come from? 24 00:01:30,690 --> 00:01:33,591 On rare occasions, a sudden change in heart rhythm 25 00:01:33,591 --> 00:01:37,900 prevents the upper chambers of the heart from contracting normally. 26 00:01:37,900 --> 00:01:39,809 This slows down blood flow, 27 00:01:39,809 --> 00:01:45,382 allowing platelets, clotting factors, and fibrin to stick together. 28 00:01:45,382 --> 00:01:46,731 The clot can be carried up 29 00:01:46,731 --> 00:01:50,611 towards the arteries and blood vessels supplying the brain 30 00:01:50,611 --> 00:01:54,092 until it gets to one it can’t squeeze through. 31 00:01:54,092 --> 00:01:56,297 This is called an embolism 32 00:01:56,297 --> 00:02:00,665 and it cuts off the oxygen supply to all the cells downstream. 33 00:02:00,665 --> 00:02:05,862 The brain doesn't have pain receptors, so you can't feel the blockage itself. 34 00:02:05,862 --> 00:02:08,672 But oxygen deprivation slows brain function 35 00:02:08,672 --> 00:02:11,802 and can have sudden, noticeable effects. 36 00:02:11,802 --> 00:02:15,593 For example, if the affected area is responsible for speech, 37 00:02:15,593 --> 00:02:18,514 an individual’s words may be slurred. 38 00:02:18,514 --> 00:02:21,972 If the stroke affects a part of the brain that controls muscle movement, 39 00:02:21,972 --> 00:02:26,553 it can cause weakness, often just on one side of the body. 40 00:02:26,553 --> 00:02:30,435 When this happens, the body will immediately try to compensate 41 00:02:30,435 --> 00:02:33,405 by diverting blood flow to the affected area, 42 00:02:33,405 --> 00:02:35,885 but this isn’t a perfect solution. 43 00:02:35,885 --> 00:02:39,824 Eventually, the oxygen-deprived cells will start to die, 44 00:02:39,824 --> 00:02:43,748 leading to brain damage that may be severe or permanent. 45 00:02:43,748 --> 00:02:48,390 That’s why it’s important to get medical care as fast as possible. 46 00:02:48,390 --> 00:02:51,370 The first line of treatment is an intravenous medication 47 00:02:51,370 --> 00:02:54,205 called Tissue Plasminogen Activator, 48 00:02:54,205 --> 00:02:55,884 which can break up the blood clot 49 00:02:55,884 --> 00:02:59,855 and allow blood to flow again in the compromised artery. 50 00:02:59,855 --> 00:03:02,015 If it’s delivered within a few hours, 51 00:03:02,015 --> 00:03:05,415 this medication greatly increases the chance of surviving the stroke 52 00:03:05,415 --> 00:03:08,496 and avoiding permanent consequences. 53 00:03:08,496 --> 00:03:11,646 If Tissue Plasminogen Activator cannot be given 54 00:03:11,646 --> 00:03:13,976 because the patient is on certain medications, 55 00:03:13,976 --> 00:03:15,595 has history of major bleeding, 56 00:03:15,595 --> 00:03:18,336 or the clot is particularly large, 57 00:03:18,336 --> 00:03:23,605 doctors can perform a procedure called an endovascular thrombectomy. 58 00:03:23,605 --> 00:03:28,694 Using a fluorescent dye that illuminates the blood vessels under a strong x-ray, 59 00:03:28,694 --> 00:03:33,146 the physician inserts a long, thin, flexible tube called a catheter 60 00:03:33,146 --> 00:03:35,375 into an artery in the leg 61 00:03:35,375 --> 00:03:38,508 and maneuvers it all the way to the blockage. 62 00:03:38,508 --> 00:03:41,377 A retriever is passed through this catheter. 63 00:03:41,377 --> 00:03:45,867 It expands and anchors into the clot when it’s just past it. 64 00:03:45,867 --> 00:03:50,737 The catheter then pulls the clot out when it’s removed. 65 00:03:50,737 --> 00:03:53,679 These treatments need to be delivered as soon as possible 66 00:03:53,679 --> 00:03:55,338 to preserve brain function, 67 00:03:55,338 --> 00:03:59,588 which means figuring out fast if someone is having a stroke. 68 00:03:59,588 --> 00:04:01,017 So how can you tell? 69 00:04:01,017 --> 00:04:03,869 Here are three quick things to try: 70 00:04:03,869 --> 00:04:06,558 1. Ask the person to smile. 71 00:04:06,558 --> 00:04:11,118 A crooked mouth or facial drooping can indicate muscle weakness. 72 00:04:11,118 --> 00:04:13,879 2. Ask them to raise their arms. 73 00:04:13,879 --> 00:04:19,829 If one drifts downward, that arm weakness is also a sign of a stroke. 74 00:04:19,829 --> 00:04:23,919 3. Ask them to repeat a simple word or phrase. 75 00:04:23,919 --> 00:04:26,788 If their speech sounds slurred or strange, 76 00:04:26,788 --> 00:04:31,489 it could mean that the language area of their brain is oxygen-deprived. 77 00:04:31,489 --> 00:04:37,281 This is sometimes called the FAST test, and the T stands for time. 78 00:04:37,281 --> 00:04:42,290 If you see any of those signs, call emergency services right away. 79 00:04:42,290 --> 00:04:44,331 Lives may depend on it.