IU researchers focus on reducing risks of stroke

Transient Ischemic Attack.

Most IU students have never even heard the phrase, but it could one day save their lives.

“Basically, it’s a mini-stroke,” researcher Marieke Van Puymbroeck said. “It’s often a warning sign for stroke.”

According to a 2000 study, up to 20 percent of individuals with a first-time TIA have a stroke within 90 days and as many as 60 percent are estimated to suffer a stroke within five years.

Van Puymbroeck is working with other IU researchers to develop more effective cardiac rehabilitation procedures following a TIA to help prevent future strokes, including monitored aerobic exercise, resistance training and health education. Her preliminary findings have been promising, she said.

TIAs have many of the same symptoms as a stroke — blurred vision, loss of the ability to speak or move one side of the body — but all symptoms fade within 24 hours and leave no permanent damage.

“It’s a stroke that doesn’t leave any definite sign it was there, so it comes and goes very quickly,” said Susan Savastuk, coordinator of the stroke program at Bloomington Hospital.

In contrast, a stroke can leave severe permanent damage.

“A stroke is like a heart attack that happens in the brain,” Van Puymbroeck said. “A stroke causes tissue death in a certain area.”

Depending on the location of the tissue death, a stroke can leave the victim with partial paralysis, inability to communicate or understand new information, inability to swallow due to tongue or throat muscle weakness or other effects.

“Most people will totally recover if they seek treatment immediately,” Savastuck said, estimating that 15 percent die from the stroke within a few days of onset, while some live but are bedridden.

According to the Centers for Disease Control and Prevention, about 85 percent of strokes are caused by blood clots or plaque blocking blood flow to the brain. The rest result from a blood vessel bursting in the brain; blood accumulates in the brain, putting pressure on the surrounding blood tissue.

For the blood clot patients, Savastuk said there is only one FDA-approved drug, Activase, that has proven effective as an emergency cure.

“I’ve seen people actually reverse every symptom of stroke within an hour,” she said, as long as the drug is delivered within three hours of stroke’s onset.

The three-hour deadline is why Savastuk said it is incredibly important for victims to call 911 immediately. It takes about an hour to do the assessment once a patient arrives at the hospital, she said.

A medical professional must confirm it was a stroke, then the patient undergoes a CAT scan to determine whether the cause is blood clot or internal bleeding then is asked several questions about whether the patient can take Activase. The drug could seriously harm the patient under certain situations, such as internal bleeding, if the patient is on blood thinners or has recently had surgery.

“We’re very cautious about who we give it to,” Savastuk said.

With the warning of a TIA, people can reduce many of their risk factors for a full-blown stroke, Van Puymbroeck said, which include high cholesterol, obesity, physical inactivity, smoking and taking oral contraception. There is also a noted correlation between stroke and diabetes.

A youth problem too

Many young people don’t even consider a stroke a possibility, but recent almuna Sarah Mordis can attest that a stroke can happen to anyone.

Now 22, Mordis woke up just days after her high school graduation to find the left side of her body — her face, arm and leg — completely paralyzed.

The teen then spent seven hours in her local emergency room as doctors tried to figure out what had happened — because of her age, they didn’t consider a stroke.

“They had no idea. They couldn’t correlate the symptoms,” Mordis said. “They had no idea that a healthy 18-year-old girl could have anything like that.”

With physical and speech therapy, Mordis was able to start her freshman year on time but needed the help of a cane and Disability Services for Students.

She is on a lifetime regimen of aspirin as a blood thinner and still shows slight signs of drop foot, or difficulty lifting the front part of her foot, when she’s tired.

“Fine motor was really a challenge for me and still is kind of difficult,” she said, explaining that her right hand still does most of the typing.

Despite these concerns, Mordis said she is thankful because it could have been worse — she could have suffered communication or cognitive damage instead.

“I was really lucky,” she said.