Understanding Stroke

There wasn’t anything unique about that day; it had started like any other. I had just begun my warm up on the bike as the rest of the class went through the beginning phases of their programing. After being there no more then 5 minutes, one of our coaches calmly walked up and said something I had hoped I would never hear, “Josh, I need you to come take a look at one of our athletes, I think she is having a stroke.” As we quickly made our way through the gym I scanned the room looking to find someone on the floor or in some level of distress. Instead I saw another one of our coaches standing beside one of our members who was sitting and leaning heavily to the left. What caught me off guard when I first saw her was the fact that she was young, less then 30 in fact. Everyone around her was incredibly comforting and attentive to her. I took one look at the situation, asked her to smile, and upon seeing her response I quickly called 911. The fire department was there shortly after I hung up and began to walk through the necessary steps of checking her vitals, obtaining medical history, and preparing her to be transported to the hospital.

After the scene had cleared and she was in good hands on her way to the hospital, several of us started to talk about what had happened. I was very curious as to how a young, healthy individual like her could have something like this happen. How did all of this unfold? Where there signs and symptoms that she was experiencing prior? As it turns out she had noticed a mild headache throughout the day and had been feeling “forgetful.” During that particular workout the athletes were breaking up a slow tempo exercise with a mobility movement, arm raises. One of the coaches noticed that she was having difficulty raising her left arm during the exercise and asked her if everything was OK. It was at that time he recognized that things were in fact not OK and helped get her to a comfortable place to sit.  Her situation demonstrates a classic presentation of how stroke signs and symptoms manifest and highlights how to effectively recognize and manage this unfortunate situation.

Closeup of a CT scan with brain and skull on it

The term stoke refers to an event in which the blood supply to the brain is significantly reduce or obstructed, depriving the brain of oxygen, which can lead to brain cell death. There are three different types of strokes, ischemic, hemorrhagic, and transient ischemic attack.

Ischemic Stroke: The vast majority of strokes will fall into the category of ischemic stroke. This type of stroke occurs when the arteries supplying the brain become narrowed or occluded, reducing blood flow. Thrombotic and embolic are subcategories of an ischemic stroke and refers to the different forms of blockage to the arteries that can occur.

Hemorrhagic Stroke: A hemorrhagic stroke occurs when a blood vessel in the brain ruptures. Based upon the location of the rupture the stroke can be referred to as an intracerebral hemorrhage, a rupture of a blood vessel in the brain, or a subarachnoid hemorrhage, occurring in the space between the skull and the surface of the brain.

Transient Ischemic Attack (TIA): This type of stroke tends to be temporary and is the result of a blockage of a blood vessel that resolves in a relatively short amount of time. Since the occlusion of the blood supply is temporary the effects are usually temporary as well and people often don’t have any residual limitations with a TIA.

In the situation I was involved in, we were fortunate to have several very attentive coaches that quickly recognized that something was not right. She exhibited sings of facial droop, arm and leg weakness, as well as difficulty speaking, In addition to these common signs, trouble walking, difficulty understanding, headache and difficulty with vision might also be other common signs. The best thing that can be done if you suspect a stroke is to recognize the signs and symptoms and get immediate help. The acronym F.A.S.T. is an easy way to quickly identify if the individual is having a stroke.

stop watchFace. Ask the individual to smile and look for facial droop

Arms. Ask the individual to raise their arms and look to see if both arms rise to same height

Speech. Ask the individual to speak their name and look for slurred speech

Time. If you notice any of these signs, call 911 immediately


There are many identified risk factors for a stroke, some of which are modifiable/treatable and some that are not. Modifiable risk factors would include things such as diabetes, smoking, drug use, binge drinking, physical inactivity, and certain types of cardio vascular diseases. Other variables such as gender, men are at a higher risk then women, over 55 years of age, and a family history of stroke may also put someone at a greater risk. This particular situation falls well outside of the “norm” as she is a fit, active, and young female.

Recovery from a stroke can be just as complex as the stroke itself. Multiple variables need to be taken into consideration with regards to the potential residual effects. The length of time it takes to start treatment, severity of the bleed, health of the individual, and location of the stroke all have an impact on the recovery process. The greater the size of the brain that is impacted, longer duration until treatment, and poorer general health tend to have worse outcomes then those that have smaller bleeds, quicker treatment time, and are in better health. This is not always the case though and time, in conjunction with therapy directed at restoring normal function, are two very important aspects of the recovery process.

In the moment your focus is on doing whatever is possible to help, there really isn’t any time for reflection of the gravity of the situation. A stoke is a very serious situation regardless of the individual. However, this particular situation pulls a little harder at my heartstrings given how young she is and that she was someone I would workout side by side with on a weekly basis. I know she is receiving the best possible medial attention. I commend all of those at the gym that day that were incredibly calm and collected as they dealt with a very serious situation and did everything right to get her the care she needed. Our thoughts and prayers are with her and her family during their time of need.

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