Stroke Symptoms at Any Age: What You Need to Know

Stroke is often thought of as something that happens later in life — but more young adults are experiencing strokes, and many don’t recognize the warning signs until it’s too late.

In this episode of Baptist Health Talk, host Sandra Peebles speaks with Dr. Felipe De Los Rios La Rosa, cerebrovascular neurologist and director of the stroke program at Baptist Health Miami Neuroscience Institute, about why stroke risk is rising among younger adults and what people can do to protect themselves.

You’ll learn:

• Why strokes are becoming more common in adults under 55
 • How recreational drug use, alcohol, vaping and marijuana may affect stroke risk
 • Why being young, active or healthy does not make you immune
 • The FAST warning signs everyone should know
 • What a TIA or “mini stroke” really means
 • Why calling 911 quickly can make a major difference
 • Practical steps that may help lower your stroke risk

Dr. De Los Rios also explains why stroke symptoms can be missed in younger people, how sudden changes in speech, vision, balance or strength should never be ignored, and why prevention should start earlier than many people think.

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Host:
Sandra Peebles
Award-Winning Journalist

Guest:
Felipe De Los Rios La Rosa, M.D.
Cerebrovascular Neurologist
Director of Stroke Care
Baptist Health Miami Neuroscience Institute

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Stroke Awareness: Act FAST

Young People and Strokes: A Troubling Trend

Stroke: Every Minute Counts

Transcript

SPEAKER_00 0:00

That is something that that definitely people need to be aware that it can happen at any age, it can happen in young, it can happen in teenage kids, it can happen in older individuals as well. So knowing those, you know, signs and symptoms fast, like you know, all of a sudden a change where you lose uh ability to do things and thinking stroke can can save someone's um future outlook for sure.

SPEAKER_01 0:24

Welcome to Baptist Health Talk, a podcast on all things healthcare, powered by Baptist Health South Florida, your trusted source for health care prevention and wellness.

SPEAKER_02 0:34

Hi everyone, I'm your host, Sandra Peebles. Welcome back to a new episode of Baptist Health Talk, where we answer your most searched questions on trending health topics. Today we're talking all about stroke in young adults, why it's becoming more common, and the risk factors that might surprise you. From recreational drug use to subtle warning signs people often miss. We are breaking down what you need to know to protect yourself and recognize it early. We're joined by Dr. Felipe de los Rios La Rosa, cerebrovascular neurologist and director of the stroke program at Baptist Health Miami Neuroscience Institute. Thank you so much for being here with us today.

SPEAKER_00 1:09

Hi, Sandra. Thank you for having me.

SPEAKER_02 1:11

Okay, so let's get to the gist of it. We are seeing more strokes in younger people. Help us understand what is causing this.

SPEAKER_00 1:18

Yeah, so I mean, people might be surprised to know that stroke can happen at any age. It can happen in babies and it can happen all through life. And it is more common in older individuals. But what has been noticing since the early 2000 or so, and then thereafter, the risk of stroking younger adults, and it can be defined in slightly different ways, but for the most part, we can say in those younger than 55 has been going up consistently. So since early 2000 to about now, it's gone up about 67, 70%. Um, so that is, you know, a consistent uptrend. And it's not just in the US, it's a global um uptrend, different percentages for different populations, but it is a consistent thing.

SPEAKER_02 2:02

Okay, so let's talk about risk factors. What do you think is leading to that? Is there a consistent conduct, a behavior that that people are doing or habits that they're adopting that across the board that maybe is leading to this?

SPEAKER_00 2:16

Right. So it's not entirely clear. It might be multifactorial. Um, it's not the same trend that you see in older individuals. So in older individuals, actually, the risk of stroke might be coming down a little bit. So there's something specific to that younger um population. Um, what the studies have been seeing, and there's been some actually some interesting data from Florida as well, from here, that traditional vascular risk factors, or people even having more than one traditional vascular risk factor, tends to go up in younger adults over this time period as well. So it might be that in part younger adults are getting vascular risk factors at a younger age and therefore are exposed to this, you know, over earlier in life. Um so that's one thing. But there might be others as well. Um, we always worry about recreational drug use, um, tobacco exposure. Um, but there's others, uh, lack of uh exercise, uh being on more sedentary jobs, uh, stress, anxiety, uh, environmental factors. There might be other things that might be playing a role uh in conjunction with increased traditional vascular risk factors.

SPEAKER_02 3:23

Well, very interesting. And when we speak about what has changed, I think technology has changed. And you mentioned sitting at the desk. You think that perhaps it it could there be a technology factor involved in this? Stress, the stress of the modern world?

SPEAKER_00 3:35

Yes, I mean, it could definitely be playing a role. Uh, we do know that regular exercise helps lower your risk of stroke and cardiovascular disease. Uh, being sitting down, not moving much for prolonged periods of time is not good for your body in general and can increase your cardiovascular risk. Um, so if there are more jobs where you're just sitting all day or most of the day, not moving much, or people are doing less exercise, being less outdoors, and things like that, that can increase your risk.

SPEAKER_02 4:04

There is research that links cardiovascular health and stroke risk to recreational drug use. Can you break that down for us?

SPEAKER_00 4:13

Yes. So there are many recreational drugs that are known to significantly increase the risk of stroke. Um, they can cause the arteries to narrow, they can cause inflammation of the arteries, they can cause changes at the heart level. So your heart might be pumping faster, um, your coronaries might be getting a little smaller, and that can increase your risk of heart disease and stroke as well. So, cocaine, for example, is a uh a well-known one, amphetamines. Um, there's many synthetic drugs as well. It's, you know, that are not the classic drugs or so, and that they're might be harder to detect on testing, that can increase your risk as well.

SPEAKER_02 4:49

Cannabis is also on that list, marijuana use. Is the explain to us the risk of using marijuana and is it in the smoked form or is it because I know there's people that there's different ways to do edibles and other ways. Right. Is it the smoking factor?

SPEAKER_00 5:03

You know, the data for marijuana is not as consistent as it is for others.

SPEAKER_02 5:07

So interesting because it's legalized now in many places, and you would think we would know more.

SPEAKER_00 5:11

Yes, yes, and there's a lot of exposure. Um, but the data is not as conclusive as it is for other things, like for example, cocaine or stimulants. Um but there are some data that shows that it can increase your risk, especially if you use it heavily, which is defined as more than 10 days a month, uh, and specifically in younger adults that have less traditional vascular risk factors. Um, and some other studies don't find that association as clearly. Um, you know, that it I think there's different things that can play into that as well. Uh, one of them is well, what type of marijuana are you using? Is it from a dispensary? Is it contaminated if you buy it from you know the street or from somewhere else? Um but sure, marijuana can be laced with so many other can there can be contaminants, you know, on the product or other things. Or just yeah, or just contaminants from the manufacturing process of it or how it's packaged and and and sold. Um, so uh all of those things need to be factored in into your health risks. But but I think it's it's very possible that it does increase your risk. And, you know, if you do use it, um it would be wise to not use it very often, ideally not use it uh if there's any concern that could be you know adverse effects to your health. But uh using it less often, there there might be a dose response to it as well. So using it less would be a good idea. And some people are also concerned how you tease that apart from other use, right? So some people say, well, maybe you're more prone to use marijuana, you might also be using other things, or your lifestyle might be different than people who don't use it. So all those factors need to be taken into account when you're estimating your, you know, the risk of stroke in particular.

SPEAKER_02 6:58

So when we let's put this in context, the younger seeing uh strokes in the in the younger population, uh, as far as the physiology say, how is the brain different? How is the response different? Because maybe an older person is more aware of what uh the symptoms might be and might be quicker to react. And we know that that window is very small, right? Reacting to a stroke system, uh symptom. So are those factors also affecting uh the intervention for young younger patients?

SPEAKER_00 7:26

Of course, of course. The symptoms tend to, for the most part, present similarly, meaning most of the time what you would experience is a lack of a sudden lack of function of something, you know, because the brain is what permits you to relate to your environment and for things to work. So if there is a lack of blood flow to an area of the brain and that area is injured, it's not going to function. So you lose you lose abilities. You can lose ability to see, to speak, to coordinate, strength, sensation, all of a sudden. We're fine, and then all of a sudden you're not. Um, and the acronym that we use for that is is fast. Um, so F is for one side of your face being weak, A is for arm or leg being weak, S is for speech changes. It could be difficulty speaking or understanding, people don't understand you very well. And then the T is for time because, like you mentioned, stroke is a very time-sensitive condition. And there are therapies that we can do to prevent brain damage from a stroke, but it is very time dependent. So the odds of benefit are much higher if you do this early than if you do it later. Um, but by no means should you not go to the hospital, even if there's a concern later, because the risk of having another stroke is higher at the beginning. So even if there was a minor stroke or so and you were doing very well, if if there if you realize or someone tells you that that might be something that you should be worried about, you do want to go to the hospital and get it checked out because your risk of having another, maybe more severe stroke is highest up front. Um, so fast is the main way to teach and recognize, and that recognizes, you know, most for the vast majority of of all strokes in both young adults and older adults.

SPEAKER_02 9:05

My fear is that younger people aren't really listening to that because we think that young people are healthy. If a young person is healthy, they're working out, they're eating right, they're just not subject to this. It doesn't really pertain to them, and they might not be listening. So let's talk about that idea the idea that young, healthy people can't get strokes.

SPEAKER_00 9:21

Yeah, and what you're mentioning is exactly what happens because people might not be thinking stroke in a younger individual, and the person then themselves might not be necessarily aware of how strokes present. So if they do have symptoms, it usually can be attributed, oh, you know, I just slept on my arm and that's why my arm is weak, or maybe I didn't drink enough water and that's why my speech is slurred. And the physicians themselves, when they see patients, young patients with stroke symptoms, might be thinking on some other things or intoxication. So, well, maybe the person is having problems with balance because they just, you know, drunk too much when it's actually a stroke. And that can lead to misdiagnosis and delayed treatments and so forth. So that is something that definitely people need to be aware that it can happen at any age. It can happen in young, it can happen in teenage kids, it can happen in older individuals as well. So, so knowing those, you know, signs and symptoms fast, like, you know, all of a sudden a change where you lose uh ability to do things and thinking stroke can can save someone's um future outlook for sure.

SPEAKER_02 10:30

And that period is just a matter of seconds. When we say when you lose your ability to speak, it's not a day or two. You're speaking about what's the span of time.

SPEAKER_00 10:38

Well, the the symptoms classically will start abruptly. So so this is not usually something that is slowly worsening over periods of weeks or or months or so. Is you were fine or you went to sleep fine, and then you woke up and things were not working like they were before. Um, now things can can worsen, so people can can deteriorate or can have another stroke. That can definitely happen. But the key piece is that it starts all of a sudden, and that's where the term stroke, you know, kind of comes from.

SPEAKER_02 11:09

And do people bounce back more quickly if they're younger, if the patient is younger?

SPEAKER_00 11:14

Yes, yes, there is more probability for for improvement, um, and people can get better, but sometimes you don't fully recover and you can be left with symptoms that don't allow you to go back to work. So some studies have said that or have found that young adults that have a stroke, about half of them can't return back to work, for example. And if you factor it in this this young population, they have lots of productive years ahead of them. Of course. Not being able to return to work is you know a very big impact at that age, of course.

SPEAKER_02 11:46

So to the individual and to society.

SPEAKER_00 11:50

Yeah, it impacts everyone.

SPEAKER_02 11:51

Yes. Um, let's address the misconception that if you're active and you eat well, you're protected from a stroke and from other things for that matter, but stroke specifically.

SPEAKER_00 12:00

Yeah, so having a healthy lifestyle lowers your odds of having cardiovascular disease and stroke. Um, that is something that everyone is encouraged to do, but but it doesn't give you immunity to disease, uh, for sure. And and and even if you're uh uh fit and young, you you your risk of stroke is not zero. Um and you do have to be careful about things like overexertion and dehydration. And and there's certain um activities that can increase your your risk of stroke, for example, uh dissections, which is where an artery can tear. Um that can happen also in young individuals who are very fit and exercise a lot. You mean like running marathons or yes, if you if you do if you do push your body to to extremes, um, and marathons, for example, can be one of that, especially if you do like a full marathon or so, you have to factor in things like weather, heat, altitude, uh, environmental pollution. I mean, there's there's all these other things, and it can sometimes be very hot and people can get very dehydrated, and that does increase your risk of cardiovascular disease.

SPEAKER_02 13:09

Okay, so let's address for the person that's listening, let's address, even if it sounds elementary to you, doctor, what are the symptoms of a stroke, even those that people might overlook? And I know that we've spoken about some of them, but I want to ask the question head on because someone might be watching and thinking exactly that. How do I know?

SPEAKER_00 13:24

Yes, yes. So uh, first is learning andor understanding that uh a stroke will be cut will happen with a loss of function that is abrupt. I think that's that's the key first, first thing. Any loss of function, any sudden change where the person is not functioning like they did before, you should start thinking, well, you know, could this be a stroke? And if you are thinking that, then time is going to be very important because of these time-sensitive treatments. Um within the US, we'd say call 911 because they know which hospitals are stroke centers. So not all hospitals can take care of a stroke patient. And if you go to the wrong hospital, then transferring and coordinating care takes time, takes time, and that can lead to delays. So 911 is the best way to go rather than driving yourself or having someone drive you. They also pre-alert the hospital. So those are benefits. But fast, again, face weakness, arm weakness, speech changes, time will capture about 85 or so percent. And then the other symptoms that can happen are a little bit more subtle. So you can have visual loss, for example, where you're not able to see one area of space or not see at all. Um, loss of balance. Uh, there's many things that can cause dizziness and vertigo and loss of balance, but stroke is one of them. So if you take into account, for example, all of the causes or the people that go to the emergency room with dizziness and vertigo as a symptom, stroke can explain about 5% of that, right? So most of the time it isn't. And most of the time it has something else, like lack of coordination. Lack of coordination and dizziness would be, you would be thinking more stroke. Um, so the symptoms, again, can be varied, but sudden onset, loss of function, fast. I think if you're able to get that, you you're doing really well.

SPEAKER_02 15:06

And when we speak about young people, how young are you seeing? Because you even mentioned babies can potentially.

SPEAKER_00 15:12

Yes, yes. There are there's there are certain uh uh diseases that affect the arteries in in in babies or transient artery ophies, yes. Um it sometimes is not very clear and understood, could be a viral phenomenon. There is some uh rare disorders um that can affect the arteries in in pediatrics as taken on older adults as well.

SPEAKER_02 15:34

But when when we generally speak about younger people, what ages are we looking at?

SPEAKER_00 15:38

Under 55, but like so so for young adults, we talk about under 55. And and it can happen anytime in that spectrum, but it is an age-related condition. So the older you are, the higher risk there is. Um, so it doesn't mean that it cannot happen in kids, it can or or in teenagers, it can happen, but it's going to be more frequent as we gain years.

SPEAKER_02 16:00

As we gain years. Let's clear up what is a mini stroke and what is a TIA, and tell me what TIA stands for.

SPEAKER_00 16:07

Right, yes. So TIA is transit ischemic attack. Um, so that's different from a small stroke uh or mini stroke. Although sometimes, you know, people can use the terms interchangeably, but but TIA by definition, there's no brain damage. So it was something transient, someone had something that looked like a stroke, symptoms like we spoke about, where you're thinking that there probably was an area of the brain that wasn't functioning well. And we think that it might have been because there was not enough blood flow to that specific area. But when you do the studies and everything, everything cleared up. The person is back 100% to normal, and the imaging doesn't show any areas of stroke. So that would be a TIA. Anything else than that, where there are some symptoms that linger, or maybe the symptoms went away, but you see an area of brain damage on the scans, then that would be a stroke. And the strokes can be mild or minor or mini, uh, depending on how it affects that person, right? But but it can be a little bit like uh real estate, meaning some people can have a pretty sizable area of stroke and have few symptoms that you can notice. Uh, and some people have a very small stroke, but are quite disabled by that very small stroke. So size of the infarct is not everything. Um, it depends where it is and how it affects the person to ultimately determine how disabling it is.

SPEAKER_02 17:31

And this might be late in the interview, but explain to me what is a stroke? Is it lack of blood reaching? Yes, yes, yes.

SPEAKER_00 17:37

That's a great question. So stroke, stroke is um there's different types of stroke, but it's an area of brain injury. If you encompass the broader term, it's an area of brain injury, but uh by a problem of blood flow. Now, 80% or so of all of the strokes are because an artery gets blocked. So that area of the brain doesn't receive blood and it dies because it doesn't have energy, it doesn't have oxygen, you know, and that area gets permanently injured. That's about 80%. Now, the other 15-20% is the other problem. There's an excess of blood. So there's bleeding. There's bleeding inside the brain or on the outer part of the brain. Um, but that will also be all of both are encompassed within the term stroke. But ischemic is the lack of blood flow, that's the most common one, and hemorrhagic is the excess of blood flow, that's the lesser common one.

SPEAKER_02 18:28

Very interesting. I should have asked you that in the beginning. It just popped in my into my mind as we're having this conversation. So let's talk about lifestyle choices again. Because we spoke about harder drug use, but what about things like alcohol, vaping, um, yeah, drug use, even marijuana? Uh how do we put all this in perspective to assess overall risk?

SPEAKER_00 18:48

I mean, those things will increase your risk of cardiovascular disease and alcohol. Yeah. Alcohol, there's this thing called holiday heart syndrome, um, where people can have uh problems with their uh heart, uh, but also stroke uh within days from uh binge alcohol drinking. So um if you um overdo it on alcohol and you drink too much, that puts this uh stress on your um on your heart. Um, there's increased risk of arrhythmias, uh, which can lead to stroke as well. Um so yes, alcohol does increase your risk as well. And alcohol will increase your risk of bleeding also. Um so increase your risk of false, but then that also increases your risk of of having bleeding inside your head from trauma. But alcohol itself will increase your risk of bleeding in general.

SPEAKER_02 19:35

So we always like to end this with giving people something that they can do, something that we can take action to prevent having a stroke. And we usually say eat better and exercise, but in this case, we've already uh had the conversation that that doesn't necessarily protect us against a stroke. So, what can people do to hopefully uh you know strengthen their bodies and prevent a stroke?

SPEAKER_00 19:55

So they can definitely diet and exercise is good for by all means. Of course, do it, do it. 80%. I mean, the good news is 80% of all stroke is preventable. Okay. So it's not like, oh, my, you know, I have family members that had a stroke, then you know you're you're destined to have a stroke, and there's there's nothing you can do. No, no, no. 80% of all stroke is preventable. Um, so there's many things that you can do to lower your risk. And diet and exercise, avoiding tobacco, sleeping well, managing stress and anxiety, um, all check going to your doctor, get your blood pressure checked, because otherwise you don't know, getting your cholesterol check, your sugars, if you have diabetes, managing that. All of these things are going to lower your risk 80%. And it's good to do it early on, you know, go to your PCP, even if you're healthy, middle-aged, you know, go to your PCP, get these things done that you wouldn't know otherwise. And that will help you lower your risk. Does it give you immunity for life? No, nothing will give you immunity for life. You there everyone's gonna have some risk, but but you're playing your odds to lower them as much as you can.

SPEAKER_02 20:58

Well, this has been so interesting. I want to broadcast this to the world. I think everyone needs to hear this conversation. Thank you so much for the work that you do and for sharing the story with us and all this information. It's been so valuable. Great conversation. Uh, thank you for again for your insight and sharing it with our audience. And remember, viewers, be sure to hit that subscribe button on our channel here to keep up with the latest health and wellness information and, of course, tips from our experts. Thank you so much for watching.

SPEAKER_01 21:23

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