According to the Montreal Neurological Institute-Hospital, a stroke occurs every 10 minutes. About 14,000 Canadians die from one each year, making it the third leading cause of death among Canadians¹.
What exactly is a stroke?
A stroke (cerebrovascular accident, or CVA) is a sudden neurological deficit of vascular origin caused by an infarction or a hemorrhage in the brain. The blood flow heading to the brain is thereby interrupted. The term “accident” is used to emphasize the sudden nature of the symptoms.
Blood flow in the brain is essential, because the brain needs a constant supply of oxygen and nutrients to function properly. Interrupting this supply can cause the death of certain cells². This interruption can therefore lead to permanent damage or death.³.
The heart attack, for its part, is caused by the blockage of the coronary arteries, which prevents enough oxygen from reaching the heart⁴. Despite popular belief, stroke and heart attack are therefore two very different conditions, because they do not affect the same organs.
The three types of stroke
The term ischemia refers to an interruption of blood circulation in an organ⁵. A stroke is therefore considered ischemic when it is caused by a blood clot that blocks a blood vessel in the brain. This is, moreover, the most common type of stroke⁶.
The term hemorrhage refers to blood leaking out of the blood vessels⁷. A stroke is therefore described as hemorrhagic when it is caused by the rupture of an artery in the brain⁶.
Strictly speaking, the mini-stroke is not a stroke. It is instead a transient ischemic attack (TIA). A TIA is an alteration of brain function due to a temporary interruption of the blood supply to the brain that generally lasts less than an hour⁸.
The causes and symptoms of TIAs and ischemic strokes are identical. However, unlike a stroke, a TIA does not appear to cause permanent brain damage. Indeed, the symptoms of a TIA disappear completely and quickly, and the number of brain cells that die from it is very minimal.
A TIA can be a warning sign of an imminent ischemic stroke. Recognizing a TIA, identifying its cause and treating it can help prevent a stroke⁸.
The symptoms of a stroke
F ace – Is it drooping? Is there a distortion of the mouth?
A rms – Can the victim raise both arms at the same time?
S peech – Does the victim have trouble speaking or pronouncing words?
T ime, extreme urgency – Call emergency prehospital services quickly (9-1-1)⁹.
Although the FAST signs are the most common, they are not the only ones. One may also experience: intense and sudden headaches, numbness localized on only one side of the body, vision problems or dizziness causing balance complications⁹.
• Stop all activity, loosen clothing and place the victim in a comfortable position.
• Cover them with a warm blanket or a foil blanket.
• Alert 9-1-1 immediately.
• Reassess vital signs regularly.
Upon arrival at the hospital, the medical team has three objectives:
1. Stabilize your condition.
2. Make a diagnosis (which type of stroke)
3. Implement the treatment according to the type of stroke¹⁰.
In the case of an ischemic stroke
Victims who get to the hospital within three hours of the onset of the first symptoms can receive a type of medication called a thrombolytic, which breaks up clots. Those who receive this medication have a better chance of achieving a full recovery. They are also less likely to need long-term care.
If the victim gets to the hospital after three hours, the professionals can administer other medications, such as anticoagulants, or perform surgery to remove the clot³.
In the case of a hemorrhagic stroke
There are several treatments to stop the hemorrhage and save brain tissue, such as taking medication.
Endovascular procedures can help repair a weak point or a rupture in a blood vessel.
If the bleeding is caused by a ruptured aneurysm, a metal clip can be put in place to stop the loss of blood³. In this case, it will therefore be a surgical treatment.
According to the Fondation des maladies du cœur, the after-effects of a stroke can range from mild to severe and vary from one person to another.
The severity of the after-effects
The severity depends on factors such as:
• The type of stroke (ischemic or hemorrhagic);
• The regions and hemisphere of the brain in which the stroke occurred (left or right);
• The extent of the damaged region of the brain;
• The body functions that this region controls;
• The duration of the interruption of blood flow in the affected part of the brain⁶.
The origin of the risks
Being aware of your own risks
Knowing your risk factors is essential, because it allows you to make certain lifestyle choices that will help reduce them.
Some of these risk factors are unfortunately uncontrollable. However, knowing them allows you to be aware of your own risk, to be more attentive to your health and to watch for warning signs.
• Adopting an unhealthy diet
• Lack of exercise
• A lifestyle conducive to stress
• The consumption of alcohol and recreational drugs
The uncontrollable causes
Age: The risk increases as you get older.
Sex: Due to their distinct cardiovascular physiology and the many hormonal changes experienced over the course of their lives, certain risks are specific to women. For example, the risk increases after menopause.
History: family and medical.
Indigenous origins: Unfortunately, “First Nations, Inuit and Métis people more frequently suffer from high blood pressure and diabetes¹¹.”
African and South Asian origins: Just like people of Indigenous origin, the risk of high blood pressure and diabetes is higher for people of African and South Asian origin.
Pregnancy factors
Because of stress, weight gain and hormonal changes, a pregnancy can indirectly cause problems that increase the risk of stroke, such as:
• High blood pressure
• Gestational diabetes
No one is safe from a stroke. However, certain actions can be taken to reduce the risks. Taking care of your body and mind by adopting healthy habits can make all the difference!
Written by Laurie Lévesque • formerly Writer
Edited by Émilie Bédard • Communications Manager
Illustrated, laid out and edited by Roxanne Duchesneau • Graphic Designer
¹ Hayward, S. 2017. Juin, mois de la sensibilisation à l'AVC. Le Neuro. https://www.mcgill.ca/neuro/fr/channels/news/juin-mois-de-la-sensibilisation-lavc-268466 [Last accessed on 10/06/2022]
² Johns Hopkins Medicine. n.d. Health: Stroke. https://www.mcgill.ca/neuro/fr/channels/news/juin-mois-de-la-sensibilisation-lavc-268466 [Last accessed on 10/06/2022]
³ Centers for Disease Control and Prevention. 2022. About Stroke. https://www.cdc.gov/stroke/about/?CDC_AAref_Val=https://www.cdc.gov/stroke/about.htm [Last accessed on 10/06/2022]
⁴ Brunet. n.d. Les maladies cardiovasculaires et l'AVC https://www.cdc.gov/stroke/about/?CDC_AAref_Val=https://www.cdc.gov/stroke/about.htm [Last accessed on 10/06/2022]
⁵ Office québécoise de la langue française (OQLF). 1999. Ischémie [Grand dictionnaire terminologique]. Gouvernement du Québec. https://vitrinelinguistique.oqlf.gouv.qc.ca/fiche-gdt/fiche/8374325/ischemie [Last accessed on 10/06/2022]
⁶ Fondation des maladies du cœur et de l'AVC. n.d. (a). Les types d'AVC. https://www.coeuretavc.ca/avc/questce-quun-avc/les-types-d-avc [Last accessed on 10/06/2022]
⁷ Office québécoise de la langue française (OQLF). 2019. Hémorragie [Grand dictionnaire terminologique]. Gouvernement du Québec. https://gdt.oqlf.gouv.qc.ca/ficheOqlf.aspx?Id_Fiche=17028499&terme=h%u00e9morragie [Last accessed on 10/06/2022]
⁸ Chong, J. 2020. « Accidents ischémiques transitoires (AIT) ». Le manuel Merk. https://www.merckmanuals.com/fr-ca/accueil/troubles-du-cerveau-de-la-moelle-%C3%A9pini%C3%A8re-et-des-nerfs/accident-vasculaire-c%C3%A9r%C3%A9bral/accidents-isch%C3%A9miques-transitoires-ait [Last accessed on 10/06/2022]
⁹ Fondation des maladies du coeur et de l'AVC. 2021. Existe-t-il d'autres signes de l'AVC que VITE ?. https://www.coeuretavc.ca/avc/signes-de-l-avc/existe-t-il-d-autres-signes-de-l-avc-que-vite [Last accessed on 10/06/2022]
¹⁰ Fondation des maladies du cœur et de l'AVC. n.d. (c). Traitements. https://www.coeuretavc.ca/avc/traitements [Last accessed on 10/06/2022]
¹¹ Fondation des maladies du cœur et de l'AVC. n.d. (b). Risque et prévention. https://www.coeuretavc.ca/avc/risk-and-prevention [Last accessed on 10/06/2022]