Northside experts discuss risk factors, symptoms of stroke

Understand your stroke risks, the symptoms to watch for and what it takes for a successful recovery. 

Stroke is stealthy and fast, and it plays no favorites. Older people are its most common casualties, but stroke also strikes children, fit young adults and the middle-aged, totaling 795,000 incidences a year in the U.S. 

According to Dr. Arun Lakhanpal, a neurologist at Northside Hospital Gwinnett and Duluth, every minute of a stroke, 2 million to 3 million brain cells are destroyed.

As damage spreads, it may affect parts of the brain that control memory, speech, movement, vision or behavior—attributes that define you. 

A Ticking Clock: How a Stroke Can Affect the Brain

A study in Stroke: Journal of the American Heart Association documented the urgency of modifying behaviors that contribute to stroke and seeking immediate treatment. The researchers estimated that in one hour, an untreated stroke causes impairment to the brain equivalent to 3.6 years of normal aging. 

“That’s why they say, ‘time is brain,’" Dr. Lakhanpal says. “Cells in the central nervous system—the brain and the spinal cord—cannot regenerate. So once an area is dead, then the rest of the brain in the vicinity has to pick up the slack or rewire itself to do the best it can.” 

The study focused on ischemic strokes, the most common type. For these strokes, caused by a clot that clogs an artery supplying the brain, doctors have a short window of time to administer a drug called tPA (tissue plasminogen activator) to dissolve the clot. (The other type of stroke, called hemorrhagic, results from a blood vessel that bursts and bleeds into the brain, compressing and killing brain tissue.) 

Modifiable Risk Factors for Stroke

You can’t do much about certain factors that increase your stroke risk, but when you’re aware that you’re more susceptible, you can be extra-vigilant.

  • Your age. More than 70% of strokes occur in people older than 65.
  • Your gender. Women have more strokes, some for reasons specific to their gender and some explained by their longer life span.
  • Your race. African Americans’ risk of death from stroke is greater than that of Caucasians, in part because of their higher rates of hypertension (high blood pressure), diabetes and obesity.
  • Your family medical history. If a grandparent, parent or sibling had a stroke, you may, too.
  • Your medical history. If you have had a stroke, a transient ischemic attack (a TIA is also called a warning stroke) or a heart attack, stroke likelihood grows. 
Uncontrollable Risk Factors for Stroke

There’s plenty you can do to reduce your risk of stroke. Start by addressing the following factors, which often overlap.

  • High blood pressure. Ask your doctor about blood pressure medicine, a heart healthy diet and exercise. Practice meditation, yoga or tai chi to manage stress.
  • Smoking. Many health organizations offer nicotine replacement therapy and smoking-cessation programs. Contact your state’s “quit line” at 800-QUIT-NOW (800-784-8669) or get tips at
  • Diabetes. Follow your doctor’s advice to prevent diabetes, or if you already have the disease, about tightly controlling your glucose levels and taking medicine if prescribed. Aim to manage your weight, blood pressure and cholesterol and to increase physical activity.
  • Artery diseases, atrial fibrillation and other heart disorders. Work to achieve a heart healthy diet and increase physical activity to 30 minutes a session. Adhere to your doctor’s treatment plan if you’re already dealing with heart disease.
  • Poor diet. Keep a food diary and cut 250 calories a day from your diet. Avoid cholesterol and saturated and trans fats. Limit salt, sugary foods and red meat. Emphasize vegetables, fruits, fat-free or low-fat dairy products, olive oil, whole grains, fish, poultry, beans and nuts.
  • Inactivity and obesity. Walk, take the stairs, dance, garden, play with the kids or grandkids. Aim for at least 30 minutes at least five days a week of any activity you enjoy.
Identify Stroke Symptoms

“Most ischemic strokes are painless,” Dr. Lakhanpal explains. “That’s why a person may say, ‘My arm has gone to sleep—I may have pinched a nerve,’ so they delay in seeking attention. And valuable time is being lost.” 

Many people arrive at the hospital 4.5 hours after the onset of stroke symptoms, which is the end of the window when tPA usually can be given for the greatest chance of recovery.

“If you get to the hospital fast enough and they can make a diagnosis quick enough, then they can administer tPA to break up any clots that have formed inside the brain tissue and recover some of that brain tissue,” says Dr. Siddharth Patel, a vascular surgeon at Northside Vascular Surgery. “Typically, after a couple of hours, you lose your window of opportunity to do that.” 

The acronym BE FAST can help you remember the signs of a stroke.

  • Balance: Is the person suddenly dizzy, or having trouble with balance or coordination? Do they have a sudden headache?
  • Eyes: Is the person experiencing suddenly blurred or double vision or a sudden loss of vision in one or both eyes?
  • Face: Does one side of the face droop or is it numb? Ask the person to smile.
  • Arms: Is one arm weak or numb? Ask the person to raise both arms.
  • Speech: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, such as “The sky is blue.”
  • Time to call 911 for a ride to the hospital if you observe or experience any of these signs, even if they go away. Check the time so you can tell doctors when the first symptoms appeared.

Learn more about the Stroke Center at Northside Hospital.

Learn more about TransCarotid Artery Revascularization (TCAR) for stroke at Northside.


Media Inquiries

Northside Hospital's media relations staff look forward to assisting you with news stories whenever possible. We promise to try and meet all of your story needs.
Media Contacts

About the Authors

Dr. Arun Lakhanpal picture

Dr. Arun Lakhanpal

Specialties: Neurology

View Profile

Dr. Lakhanpal is board-certified in neurology. He received his medical degree from Maulana Azad Medical College, University of Delhi, India, a Fellowship of the Royal College of Surgeons in Ophthalmology at the Royal College of Surgeons in Edinburgh, United Kingdom, and then completed his Neurology residency training at St. Louis University Medical Center. He is a member of the American Academy of Neurology, North American Neuro Opthalmology Society and American Society of Neuro Imaging.  

Dr. Siddharth Patel picture

Dr. Siddharth Patel

Specialties: Vascular Surgery

View Profile

Dr. Siddharth Patel is a board-certified vascular surgeon who provides expert care in all facets of vascular disease, surgical and non-surgical, that is tailored to each patient and their individual needs. He has extensive technical experience, in both open and endovascular procedures, including TransCarotid Artery Revascularization (TCAR), which is a minimally invasive treatment option for carotid artery disease.

Need Help Finding a Provider?
Take advantage of Northside Hospital's free physician referral service. Available weekdays, 8:30 a.m - 4:00 p.m. EST. 404-845-5555