Jun. 25--The symptoms

Physicians recommend that you act quickly if you are at risk for and start showing signs of a stroke. Because strokes involve the brain, the damage from a stroke can be devastating and generally varies widely.

Strokes generally result either from a clot or hemorrhage in an artery to the brain.

The following are factors that contribute to a higher risk of having a stroke: Age (55 and older), high blood pressure, smoking, diabetes, heart disease, sickle cell disease, poor diet, high cholesterol, physical inactivity, alcohol or drug abuse.

The following are warning signs of a possible oncoming stroke:

--Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.

--Sudden confusion, trouble speaking or understanding.

--Sudden trouble seeing in one or both eyes.

--Sudden trouble walking, dizziness, loss of balance or coordination.

--Sudden, severe headache with no known cause.

- www.strokeassociation.org

Strokes are the fourth-leading cause of death in Mississippi behind heart disease, cancer and accidents. However, their prevalence in the state was one of the factors that led the Commonwealth Fund -- a nonprofit, health care advocacy group -- to rank Mississippi at the bottom of the states where people are likely to live the longest in a recent study.

Many medical professionals consider Mississippi to be the heart of the "stroke belt" that runs through much of the Deep South. (Many also consider Mississippi to be the heart of the "hypertension belt," "diabetes belt" and "morbid obesity belt," all of which can lead to a stroke.)

The good news for South Mississippians is that nearly every hospital in the area has the only drug designed to treat strokes in stock- tissue plasminogen activator, or TPA. The clot-busting drug only works in the case of ischemic, or clotting, strokes.

Many of the area's medical professionals said the problem in South Mississippi is not the availability of treatment, but the timing.

"We're fairly aggressive on the Coast in giving that (TPA) medication," said Dr. Tom Seglio, chief physician in Biloxi Regional Medical Center's emergency department. "The problems come, of course, because people don't come in early enough."

Studies have shown there is a 3-hour window between the onset of symptoms and the point at which doctors can no longer alleviate the short- and long-term effects from a stroke.

Most hospitals can perform the necessary exams and screenings that are required before TPA can be given in about 45 minutes to an hour. That means that patients have two hours once symptoms begin to get to a hospital.

The problem for many patients is recognizing the difference between ordinary aches and pains and signs of an oncoming stroke, medical experts said. The problem is worse in black and Latino communities, where studies have shown they are up to twice as likely to suffer a stroke as Caucasians.

"Lack of education and information is a big part of it," said Lindsey Larson, director of communications for the American Stroke Association. "Strokes can be so subtle they dismiss the symptoms, try to sleep it off or whatever. They'll think, 'Oh, that was just a bad headache,' so they never go to the hospital and then a few days after have a full-fledged stroke."

While nearly every Coast hospital is capable of dealing with some strokes, only two said last week they were working on getting certification for their stroke treatment programs, Gulfport Memorial Hospital and Singing River Hospital in Jackson County.

Dr. Lee Voulters, stroke program director at Memorial, said he and others are also trying to establish a statewide stroke treatment network similar to the trauma region network already in place for emergency care.

"Our goal is to develop a stroke system which will offer the best care possible," Voulters said.

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Copyright (c) 2007, The Sun Herald, Biloxi, Miss.

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