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May 3, 2022

May is National Stroke Awareness Month

Per the Centers for Disease Control and Prevention (Stroke Facts | cdc.gov, 2021):

Every 40 seconds, someone in America has a stroke/cerebrovascular accident (CVA).
Every four minutes, someone in America dies of a stroke/CVA.
Over 795,000 Americans have had a stroke/CVA each year.
Stroke/CVA is a leading cause of serious long-term disability in America.
Risk of having a first stroke/CVA is almost twice as high for the black Americans as compared to the white Americans.
Black Americans have the highest rate of death due to stroke/CVA.

Stroke is the fifth leading cause of death in America (Million Hearts® Risks for Heart Disease and Stroke, 2019). However, four in five strokes can be prevented (Women and Stroke | cdc.gov, 2021). May is National Stroke Awareness Month. It provides an excellent opportunity to educate the community about warning signs and symptoms of CVA (cerebrovascular accident) and TIA (transient ischemic attack), ways to modify risk factors, and the importance of early treatment.

Signs and Symptoms
Prompt treatment following a stroke (within 3 hours of developing symptoms) is crucial to reduce the amount of possible brain damage that may occur. Patients may suddenly exhibit numbness, weakness, confusion, difficulty with speech, balance issues, dizziness, coordination issues, visual difficulties, and severe headache when a CVA occurs. The acronym B.E. F.A.S.T. (“Be Fast”) can be used to educate the community on the signs and symptoms of a CVA.

B- Balance (Does the person exhibit difficulty with balance or coordination? Does the person complain of dizziness?)
E- Eyes (Does the person report a sudden loss of vision in one or both eyes? Does the person report a sudden onset of blurry vision and/or double vision?)
F- Face (Ask the person to smile and look for uneven or one-sided facial drooping.)
A-Arm (Does the person report numbness and/or weakness? Ask the person to raise both arms and look for one-sided arm drifting.)
S- Speech (Ask the person to say a simple phrase and note for slurring or unusual speech, sudden confusion, and/or difficulty saying words or being understood when speaking. Does the person have difficulty speaking?)
T- Time (Call 9-1-1 if any of the above signs are present. Note the time when the signs/symptoms first occurred.)

Signs and symptoms of a TIA are similar to those found during a CVA. Complications from stroke/CVA include, but are not limited to paralysis, speech and swallowing difficulties, pain, numbness, behavioral changes, memory loss, and cognitive issues.

Risk factors
Risk factors include age, race/ethnicity, sex, personal medical history, family medical history, taking certain medications (such as hormonal therapy), overweight/obesity, lack of physical activity, poor diet, excessive alcohol use, and smoking.

Screening and Diagnosis
If a CVA is suspected, upon arrival to the emergency room, the medical team will perform testing to determine the type of CVA that may have occurred as well as rule out other causes for the symptoms. Since a TIA can lead to a future CVA, immediate medical evaluation is also crucial if a TIA is suspected. Testing may include physical examination, imaging, and blood work.

Treatment
The treatment depends on the type of stroke that occurred. Treatment modalities include medications and/or surgery. Following a CVA, the patient usually completes stroke rehabilitation. The goal is to allow the patient to reach his/her highest level of functioning post stroke.

Prevention
You can assist patients with preventing cerebrovascular disease and CVA.

Encourage your patients to schedule annual wellness visits and health screenings.
Talk to your patients about cerebrovascular health including risk factors for CVA and TIA.
Educate your patients on healthy habits such as exercising, eating a well-balanced diet (including foods that are low in salt, fat, and cholesterol), lowering stress levels, controlling weight (or losing weight if needed), and getting enough sleep.
Encourage your patients to quit smoking. Instruct your patients on the effects of smoking and the link between smoking and risk for CVA. Medicare covers counseling to prevent tobacco use for those patients that qualify. Discuss this Medicare covered benefit with your patients and encourage them to enroll.
Encourage your patients to refrain from or to limit use of alcohol.
Monitor your patients’ blood pressure levels. Manage and treat accordingly. Educate your patients about the relationship between elevated blood pressure and cerebrovascular disease.
If your patients are diabetic, monitor their blood glucose levels. Manage and treat accordingly. Educate your patients about the relationship between elevated blood glucose levels and cerebrovascular disease.
If your patients are prescribed preventive medications (such as anti-platelet drugs and anticoagulants) or currently on cardiovascular or diabetic medications, review the importance of regularly taking medications. Address any questions they may have regarding the medications prescribed, including safety precautions while taking these medications.
Medicare covers Cardiovascular Disease Screening Tests as well as Intensive Behavioral Therapy (IBT) for Cardiovascular Disease and Intensive Behavioral Therapy (IBT) for Obesity for those patients that qualify. Discuss this Medicare covered benefits with your patients and encourage them to enroll if applicable.

To learn more about Medicare-covered services, visit CMS Preventive Services

For More Information

CMS.gov and Medicare.gov Resources

Other Resources

References

Behaviors That Increase Risk for Stroke | cdc.gov. (2020, January 31). www.cdc.gov. https://www.cdc.gov/stroke/behavior.htm
Family History and Other Characteristics That Increase Risk for Stroke | cdc.gov. (2021, March 17). www.cdc.gov. https://www.cdc.gov/stroke/family_history.htm
Know the Signs of Stroke - BE FAST | Duke Health. (2021, September 23). Duke Health. https://www.dukehealth.org/blog/know-signs-of-stroke-be-fast
Million Hearts® Risks for Heart Disease and Stroke. (2019, October 10). Centers for Disease Control and Prevention. https://millionhearts.hhs.gov/learn-prevent/risks.html
Stroke - Diagnosis and treatment - Mayo Clinic. (2021, February 9). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/drc-20350119
Stroke Facts | cdc.gov. (2021, May 25). www.cdc.gov. https://www.cdc.gov/stroke/facts.htm
Stroke Signs and Symptoms | cdc.gov. (2021, August 28). www.cdc.gov. https://www.cdc.gov/stroke/signs_symptoms.htm
When It Comes To A Stroke. (n.d.). Strokeawareness.com. https://www.strokeawareness.com/content/dam/gene/strokeawareness/patient/pdfs/patient-handout.pdf
Women and Stroke | cdc.gov. (2021, May 6). www.cdc.gov. https://www.cdc.gov/stroke/women.htm

License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

AMA Disclaimer of Warranties and Liabilities.

CMS Disclaimer

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

May is National Stroke Awareness Month

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