In the News: Senator Tim Johnson's Stroke
This week South Dakota Senator Tim Johnson underwent surgery to repair a bleeding arteriovenous malformation, also known as AVM, after displaying symptoms of a stroke. It was reported that Senator Johnson was in the midst of a telephone conference with news reporters when he began having difficulty speaking.
Senator Johnson's illness is rooted in a congenital (from birth) defect in the brain which causes arteries and veins to grow abnormally large and become tangled. AVM is believed to affect about 300,000 Americans, according to the National Institute of Neurological Disorders and Stroke. This institute's Web site reports that only about 12% of people (36,000 individuals) with this condition experience symptoms. Researchers believe that each year between 2 and 4 percent of all AVMs hemorrhage, like Senator Johnson's did.
AVMs can cause a wide range of specific neurological symptoms that vary from person to person, depending upon the location of the malformation. These symptoms may include muscle weakness or paralysis, loss of coordination, difficulty carrying out tasks that require planning, dizziness, visual disturbances, problems using or understanding language, abnormal sensations (such as numbness, tingling, or spontaneous pain), memory deficits, mental confusion, hallucinations, or dementia.
It was noted that during his phone call with reporters the Senator began having difficulty with his speech, including having problems finding the words he wanted to say and slurring his speech. Senator Johnson was displaying the signs that he was in the early stages of a stroke, in his case caused by hemorrhage from his AVM.
There are two types of stroke: ischemic and hemorrhagic. Ischemic strokes occur when the blood flow to the brain is stopped by a blood clot or by low blood pressure throughout the body. If you are talking to a medical professional, they may refer to the formation these blood clots in one of two ways, either thrombosis or embolism. A thrombosis is a clot that forms in an artery or vein and stays in the place where it forms. An embolism is a clot that forms in one place in the body (often in the heart) and then travels somewhere else (usually the brain), and becomes trapped in an artery.
There are other sources of emboli besides blood clots, such as broken off bits of arterial plaque, fatty emboli which can occur after surgery or broken bones, amniotic emboli after childbirth, and bacterial emboli from an infection in the heart called endocarditis. The most common emboli is a clot that forms in the heart of a person in atrial fibrillation and travels to the brain.
The result for all forms of emboli is the same: lack of blood flow beyond the embolus causes a loss of oxygen and nutrients to the body's tissues. This is called ischemia (pronounced iss-scheme-ee-uh), or in the brain, ischemic (iss-scheme-ick) stroke. The other way an ischemic stroke can occur is if there is reduced blood flow to the brain, such as when a person is in cardiac arrest or has great blood loss from a major trauma. In these cases there is too little blood getting to the brain, which causes a loss of oxygen and nutrients to the cells and they die. It is known that about 85-90% of strokes annually are due to ischemic events.
A hemorrhagic stroke is a form of stroke that occurs when a blood vessel in the brain ruptures or bleeds. Like ischemic strokes, hemorrhagic strokes interrupt the brain's blood supply of oxygen and nutrients because the bleeding vessel can no longer carry the blood to the brain tissue. As the bleeding continues, it causes increased pressure in the brain, which physically impinges on the tissue and further restricts blood flow into the brain. For this reason, hemorrhagic strokes are more dangerous than the more common ischemic strokes.
There are two types of hemorrhagic stroke: intracerebral hemorrhage, and subarachnoid hemorrhage; Senator Johnson suffered from an intracerebral hemorrhage from a ruptured AVM. Intracerebral hemorrhage (ICH) is bleeding directly into the brain tissue, forming a gradually enlarging pool of blood. A Subarachnoid hemorrhage is bleeding into the cerebral spinal fluid in the space between the brain lining and the brain itself.
Unfortunately most AVMs are not found until they cause a problem, or they are discovered accidently because the brain is scanned for another reason. Senator Johnson was very lucky; his AVM was discovered early on and surgery was performed right away, giving him the best chance of a full recovery.
Despite the commentary from the newsies and political pundits, it is much too early to speculate on Senator Johnson's ability to make a full recovery or whether or not he will resume his duties in Washington. In an interesting side note, in 1969 another South Dakota senator, republican Karl Mundt, suffered a stroke while in office. Mundt continued to serve until the end of his term in January 1973, although he was unable to attend Senate sessions and was stripped of his committee assignments by the Senate Republican Conference in 1972. Senator Johnson, who was elected in 1996, holds the same seat previously held by Mundt.
Personal stroke prevention is similar to heart disease prevention: controlling high blood pressure, blood sugar and blood cholesterol levels, not smoking, and getting regular exercise all help to prevent stroke.
It is also important for you to recognize the signs and symptoms of stroke in others, so that you can assist them to seek early treatment. In the same way that early intervention in heart attack saves muscle, early intervention in "brain attack" can save brain cells.
Researchers at the University of North Carolina-Chapel Hill School of Medicine developed this one-minute, three-step stroke assessment test to enable bystanders to quickly screen for a possible stroke diagnosis. Learn this 3-step stroke assessment and pass it on to all your friends:
You may remember the steps to this test by thinking of the first three letters of the word stroke, S-T-R
S: Ask person to "Smile broadly, showing your teeth." This "smile test" is to look for one-sided facial weakness or paralysis, shown as a drooping on one side of the lips.
T: Ask the person to "Talk" to you by repeating a simple phrase, such as "don't cry over spilled milk, " or "it is a rainy day." This is a check for difficulty speaking or understanding speech or following basic instructions.
R: Ask person to close their eyes, Raise their arms in front of them and hold them out for a count of ten. This is to test for arm weakness or paralysis (if standing it can also test for leg weakness, paralysis, dizziness, or loss of balance.)
If any or all of the above are noted to be true, the person should be taken by ambulance to the nearest emergency department for evaluation for a stroke. Doing this quickly could prevent a person from living with a lifetime of neurological deficits or from death.
For more information, please see the Web MD Stroke Health Center
Take care, Laurie
Related Topics:
Technorati Tags: Tim Johnson, Senator, South Dakota, stroke, AVM
Senator Johnson's illness is rooted in a congenital (from birth) defect in the brain which causes arteries and veins to grow abnormally large and become tangled. AVM is believed to affect about 300,000 Americans, according to the National Institute of Neurological Disorders and Stroke. This institute's Web site reports that only about 12% of people (36,000 individuals) with this condition experience symptoms. Researchers believe that each year between 2 and 4 percent of all AVMs hemorrhage, like Senator Johnson's did.
AVMs can cause a wide range of specific neurological symptoms that vary from person to person, depending upon the location of the malformation. These symptoms may include muscle weakness or paralysis, loss of coordination, difficulty carrying out tasks that require planning, dizziness, visual disturbances, problems using or understanding language, abnormal sensations (such as numbness, tingling, or spontaneous pain), memory deficits, mental confusion, hallucinations, or dementia.
It was noted that during his phone call with reporters the Senator began having difficulty with his speech, including having problems finding the words he wanted to say and slurring his speech. Senator Johnson was displaying the signs that he was in the early stages of a stroke, in his case caused by hemorrhage from his AVM.
There are two types of stroke: ischemic and hemorrhagic. Ischemic strokes occur when the blood flow to the brain is stopped by a blood clot or by low blood pressure throughout the body. If you are talking to a medical professional, they may refer to the formation these blood clots in one of two ways, either thrombosis or embolism. A thrombosis is a clot that forms in an artery or vein and stays in the place where it forms. An embolism is a clot that forms in one place in the body (often in the heart) and then travels somewhere else (usually the brain), and becomes trapped in an artery.
There are other sources of emboli besides blood clots, such as broken off bits of arterial plaque, fatty emboli which can occur after surgery or broken bones, amniotic emboli after childbirth, and bacterial emboli from an infection in the heart called endocarditis. The most common emboli is a clot that forms in the heart of a person in atrial fibrillation and travels to the brain.
The result for all forms of emboli is the same: lack of blood flow beyond the embolus causes a loss of oxygen and nutrients to the body's tissues. This is called ischemia (pronounced iss-scheme-ee-uh), or in the brain, ischemic (iss-scheme-ick) stroke. The other way an ischemic stroke can occur is if there is reduced blood flow to the brain, such as when a person is in cardiac arrest or has great blood loss from a major trauma. In these cases there is too little blood getting to the brain, which causes a loss of oxygen and nutrients to the cells and they die. It is known that about 85-90% of strokes annually are due to ischemic events.A hemorrhagic stroke is a form of stroke that occurs when a blood vessel in the brain ruptures or bleeds. Like ischemic strokes, hemorrhagic strokes interrupt the brain's blood supply of oxygen and nutrients because the bleeding vessel can no longer carry the blood to the brain tissue. As the bleeding continues, it causes increased pressure in the brain, which physically impinges on the tissue and further restricts blood flow into the brain. For this reason, hemorrhagic strokes are more dangerous than the more common ischemic strokes.
There are two types of hemorrhagic stroke: intracerebral hemorrhage, and subarachnoid hemorrhage; Senator Johnson suffered from an intracerebral hemorrhage from a ruptured AVM. Intracerebral hemorrhage (ICH) is bleeding directly into the brain tissue, forming a gradually enlarging pool of blood. A Subarachnoid hemorrhage is bleeding into the cerebral spinal fluid in the space between the brain lining and the brain itself.
Unfortunately most AVMs are not found until they cause a problem, or they are discovered accidently because the brain is scanned for another reason. Senator Johnson was very lucky; his AVM was discovered early on and surgery was performed right away, giving him the best chance of a full recovery.
Despite the commentary from the newsies and political pundits, it is much too early to speculate on Senator Johnson's ability to make a full recovery or whether or not he will resume his duties in Washington. In an interesting side note, in 1969 another South Dakota senator, republican Karl Mundt, suffered a stroke while in office. Mundt continued to serve until the end of his term in January 1973, although he was unable to attend Senate sessions and was stripped of his committee assignments by the Senate Republican Conference in 1972. Senator Johnson, who was elected in 1996, holds the same seat previously held by Mundt.
Personal stroke prevention is similar to heart disease prevention: controlling high blood pressure, blood sugar and blood cholesterol levels, not smoking, and getting regular exercise all help to prevent stroke.
It is also important for you to recognize the signs and symptoms of stroke in others, so that you can assist them to seek early treatment. In the same way that early intervention in heart attack saves muscle, early intervention in "brain attack" can save brain cells.
Researchers at the University of North Carolina-Chapel Hill School of Medicine developed this one-minute, three-step stroke assessment test to enable bystanders to quickly screen for a possible stroke diagnosis. Learn this 3-step stroke assessment and pass it on to all your friends:
You may remember the steps to this test by thinking of the first three letters of the word stroke, S-T-R
S: Ask person to "Smile broadly, showing your teeth." This "smile test" is to look for one-sided facial weakness or paralysis, shown as a drooping on one side of the lips.
T: Ask the person to "Talk" to you by repeating a simple phrase, such as "don't cry over spilled milk, " or "it is a rainy day." This is a check for difficulty speaking or understanding speech or following basic instructions.
R: Ask person to close their eyes, Raise their arms in front of them and hold them out for a count of ten. This is to test for arm weakness or paralysis (if standing it can also test for leg weakness, paralysis, dizziness, or loss of balance.)
If any or all of the above are noted to be true, the person should be taken by ambulance to the nearest emergency department for evaluation for a stroke. Doing this quickly could prevent a person from living with a lifetime of neurological deficits or from death.
For more information, please see the Web MD Stroke Health Center
Take care, Laurie
Related Topics:
Technorati Tags: Tim Johnson, Senator, South Dakota, stroke, AVM
11 Comments:
too much to read. didn't read it. waiting for the cliff notes version.
My spouse has a AVM, located in the inter spinal core. NIS in Washington,D.C., said that no surgery could be done evere, and gave a life of 5 years, back then 1999, was the fifth year. But God has other plans and still is having a normal life, but unable to walk.
I'm not sure if you're the one I should be asking? I'm a stroke survivor. The stoke was caused by liver disease, with portal hypertension. The stroke was almost two years ago, but I'm still aphasic. My question is: With all the news about brain exercisers software available(NBC Today, NYTimes, Wall St Journal,) has any one thought about using this software for stroke survivors? I have Nintendo Brain Age, but I was told by my neurologist/psycho-pharmacologist to stop using it. My doctor thought my speech and cognitive therapy was enough, and the addition of the Brain Age was too much.
I understand that stroke awareness is very important,but what is done for people that can't the rehab that they need because everybody tends to give up on them.This diease is a burden to all family's.I have learned that some of the best stroke & rehabs centers are in Calif.What are we doing to stroke rehabs in some of the countries that need them also?We in america spend money on alot of uneeded things.Then u have alot of people who do alot of private funding,how about taking some of that money and really putting to good use.My father is a 56 year old male,who has had a stroke/a brain anurysm,it has been 2years since then.He is in a skilled nursing home/rehab center,that can'give him the special care that he needs.sure you might say well put him somewhere else, again where is the stroke center,well if they don't offer long term care ,what do you do??If it wasn't for "GOD" AND MY MOTHER WHO IS TRUELY AND ANGEL.And to help where ever i can.I have tired to find a rehab in N.C AND NO ONE IS WILLING TO GIVE PEOPLE LIKE MY DAD A CHANCE to regain any of their sense of well being.Thats whats wrong with us we give up to easy on each other instead of praying and taking action to save people,sure awareness is great ,but to really save lifes we must do what is needed to provide for stroke patients and make it afforable as well accessable for them also to recieve the care that they need.Yes he does remember his wife ,his kids,his mind is very strong even after all that he has went through,he moves his right arm,moves his right toes,turns his head,licks his tongue out,understands every word that is being said,and his greatest accomplishment is sitting up on the edge of the bed by himself with a little help.To "GOD" be the glory and my MOTHER.If we didn't have to put him there he would not be there,it's not like we put him there and leave he see's his wife's face each and everyday,and i'm there when i can,SO what advice can be given to a person like me,who has tired eveything possible.All because i feel like we as loving,caring ,Godly people give up on so many things that would benefit our elderly people,and people who need special care,not knocking nursing homes or people who try as such as my mother and myself,but are trying the best that they can to work with what the get from the system!!! thank you something to really think about.we are losing to many people to dieases that are a burden.
I WAS DIAGNOSED WITH AVM ON MY BRAINSTEM AND ONE DEEP WITH IN CLOSE TO THE WHITEMATTER OF MY BRAIN..BOTH HAVE BLEED AND LEFT LESIONS...I ALSO HAVE ONE AT THE TOP OF MY SPINE...WHAT SHOULD I BE LOOKING OUT FOR CONCERNING MY SPINAL ONE?
IF THEY BLEED AGAIN WILL I DIE?
To the previous poster, be sure to ask your doctors about this; they know your medical condition and history and would be best able to answer your question.
To you and to anyone who has questions about their own condition in this regard and for support, please post on our Stroke: Support Group message board.
Miles asked. "25 years ago at the age of 52 while riding a bike I lost my balance and almost fell off. Dizzy & double vision. Stopped, and in a few minutes was OK & continued.
Over the years would occasionaly
have trouble focusing, double vision, lost balance, all lasting a few minutes.
Blood pressure now 165/85. wt maybe
185-90, hike, stairs, yard work,
feel pretty good. Good diet.
Comments please.
My neurologist said that I have deep brain ischemia. I understand the physical aspects of ischemia; however, what impact does the "deep brain" location have on my prognosis and/or potential need for surgery?
my wife just died of AVM about 2 months ago i was just curious on what AVM is.
Hi, i'm 27 and had an avm removed from my brainstem last july. I use a walker now because I have no balance and little coordination. Does this get better? Is their anything I should be doing in therapy to help regain this? If anyone has answers please respond lynnsey79@hotmail.com
very good...I had an AVI about one year ago.
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