When a stroke or heart attack occurs, rapid response is needed to prevent catastrophic damage.  In the case of a cerebrovascular accident (CVA), there is a critical golden hour in which particular clot busting drugs must be initiated to minimize permanent brain damage.  Every moment that treatment is delayed, further tissue damage occurs.  Quite literally time is tissue; the longer treatment is delayed, the more tissue is destroyed.  Once a CVA or myocardial event occurs the clock begins to tick, and the patient needs to be treated as soon as possible to prevent major irreversible damage.

Patients may be compelled to visit a chiropractor’s office for treatment of neck pain, dizziness, or severe headaches when they are experiencing the early symptoms of a stroke.  It is paramount to identify stroke patients and get them to an emergency room (preferably a comprehensive stroke center) as soon as possible.

Be prepared in advance for an ischemic event.  Know which medical facilities are best equipped to treat a CVA and keep their number accessible. Alert your staff to inform you immediately of any patients entering your clinic with signs or symptoms of an ischemic event.  Teach your staff to be able to identify the tell-tale signs of a stroke:  weakness or one sided paralysis, speech problems, facial muscle weakness, drooling, numbness, balance disorders, difficulty swallowing or visual disturbances.

Be proficient in quickly performing a neurological exam assessing motor strength, cognitive response, reflexes, and cranial nerves.   If a CVA is suspected, initiate an emergency response: call for emergency medical transportation.  Do not adjust a patient you suspect is having a CVA.  Call ahead to the medical facility and explain your observations to the staff.  This will save time in initiating care. If the symptoms of a CVA started after an adjustment, make sure that you share this information. 

It is a mistake to delay care.  Do not have the patient wait while you monitor their condition.  Remember time is tissue.  Every minute that emergency treatment is delayed increases the likelihood of irreversible brain damage. A CVA is a medical emergency call 911.

Identifying and Minimizing Stroke Risks

Ischemic cerebrovascular events are the third leading cause of death in the United States.   There are well established risk factors for ischemic CVAs that can be identified by a dutiful practitioner:  Smoking, diabetes, high blood pressure, obesity, sedentary lifestyles, arterial disease, the use of birth control pills, heart disease, and stress. People over 65 account for two-thirds of strokes, men have more strokes than women, and African Americans have a higher rate than Caucasians.

Promoting wellness lowers the risk of stroke.  Partner with your patients to help reduce their risk of stroke.  Encourage them to limit salt consumption, quit smoking, to exercise,   maintain a healthy body weight, improve their diet, and consult their physician about alternatives to the use of oral contraceptives.  It may be that promoting an active mobile lifestyle may be one of the best ways to promote vascular health.