At the barbershop on Florin Road where he works, Chris Matsumoto was trimming a customer’s hair one day in 2006. He’d taken time off work a couple of weeks earlier after having dizzy spells. Suddenly, the severe dizziness returned.
“I got dizzy again, so dizzy,” he said. “And then I passed out with a client in my chair.”
As it turned out, he’d suffered an ischemic stroke: A clot had blocked blood flow to his brain, cutting off the flow of oxygen and damaging the tissue. He was left unable to speak. The months after that passed in a blur for him, from his diagnosis and hospitalization through his early therapy to relearn how to talk and read.
He was 26 years old.
Although stroke has long been considered an illness of advanced age, statistics show a startling demographic reversal in recent years. Even while strokes are on the decline in older adults, decreasing by more than 25 percent for people older than 45, according to Centers for Disease Control and Prevention figures, the chances of stroke have soared alarmingly among people in early adulthood and middle age.
From 1994 through 2007, CDC research shows, the rate of ischemic stroke jumped by 47 percent for men ages 35 to 44 and 36 percent for women in the same age group. For men in their early 20s, the number of stroke-related hospitalizations rose by more than 50 percent during that period.
Ischemic stroke, caused by clots, accounts for almost 90 percent of the 800,000 strokes that Americans suffer each year. The remainder are hemorrhagic strokes caused by brain bleeding, or aneurysms, which result in about 40 percent of the nation’s 130,000 annual deaths from stroke.
Researchers theorize that improved diagnostic technology could be responsible for at least part of the increase in stroke numbers. An American Academy of Neurology study suggests that the widespread use of highly sensitive MRIs, which can detect tiny brain blockages that CT scans miss, could account for the diagnosis of as many as half of minor ischemic strokes in younger people. But older people also undergo these same increasingly sophisticated MRI tests, and they do not show a corresponding spike in strokes.
For the young and middle-aged, the stroke numbers are high enough to cause concern for medical professionals. They point to a familiar roster of risk factors – high cholesterol and blood pressure, diabetes, obesity and lack of exercise – as the main culprits behind the rise in younger-age strokes.
“You can be 35 and have the risk factors of a 75-year-old,” said Dr. Lucian Maidan, Dignity Health’s regional medical director of neurovascular medicine. “People are getting sicker. They have unhealthy lifestyles. That’s a worrisome trend.”
As the nation’s obesity and diabetes statistics skew younger, in other words, so do stroke statistics: A common-sense diet and a half-hour of daily exercise are all it takes for most people to cut their chance of stroke by half, Maidan said.
Smoking also adds to the risk, experts know, and young women who are smokers and use birth control pills are at markedly higher risk. So are the users of recreational drugs, particularly methamphetamine. Genetic conditions can raise stroke risk, as well: heart problems, inherited arterial flaws, even blood viscosity that’s thick because of abnormalities in the clotting process.
For young and old alike, stroke symptoms are similar: weakness or numbness on one side of the body, confusion, double vision, balance problems, slurred speech or the inability to speak. The so-called thunderclap headache, a sudden onset of the worst headache of a person’s life, can be a sign of hemorrhagic stroke.
“One of the challenges that younger people face in diagnosis is that because they’re young, they deny the symptoms,” said Renee Campbell Garner, a Sutter speech therapist who works with stroke patients and leads the Sacramento Stroke Support group. “Some aren’t even aware of the risk factors, because they’re so young.”
But awareness is crucial, because time is of the essence. For ischemic stroke, quick treatment in the emergency room – including the use of a clot-busting drug called tissue plasminogen activator, or TPA, followed by a procedure to extract the clot – can drastically reduce lasting disabilities and improve the chances of recovery.
Jean Iverson was 42, a stay-at-home mother in Folsom whose kids were 8 months and 3 years old. She was talking to her children one Saturday morning eight years ago when she realized she couldn’t get the words out. What she didn’t realize was that the left side of her body had gone limp and drooped. Her husband immediately called 911. At the hospital, doctors diagnosed her with an ischemic stroke, the result of an undetected heart defect.
But because she’d had recent outpatient surgery, doctors didn’t administer TPA, she said.
“It took a lot of time for me to recover,” said Iverson, now 50. “I walk now with a brace. I live with one arm. It was tough at first with two kids in diapers, but the paralysis has improved slowly.
“Back then, I could do a lot more. I ran around and played with my kids. That’s the hardest thing. I miss what I could do with them. But at least I’m still here. They still have a mother. I’m the same me, but I look different and move different.”
Ann Koenig, a registered nurse, had given birth to her third daughter just five days before she had a hemorrhagic stroke. She was 36 and home in Elk Grove when it happened. She went to bed with a severe headache and woke up early in the morning unable to move. Doctors never pinpointed the cause of her stroke, she said. She was in an induced coma for 10 days. When she woke up, she faced months of extensive rehabilitation – both in a rehab center and at home – to deal with cognitive difficulties and to relearn how to use her right side.
“When they brought the baby in, I knew I wanted to touch my baby,” said Koenig, now 43. “I was so motivated. I woke up and thought, ‘I have a family to raise.’ I thought, ‘I’ll just work hard.’”
Today, with the support of her husband, she drives and cares for her children. She wears a brace on her right leg and walks with a slight limp, she said. She still hasn’t been able to return to work.
Stroke at any age disrupts the path of life – but the challenges for the young and middle-aged, in the midst of working and raising kids, can be especially daunting.
“Their most significant challenge is that there’s such a large economic impact,” Garner said. “Many of them become disabled during what would be considered their most productive earning years, and many are not able to return to employment. Some are forced to go on long-term disability. And a high percentage have residual difficulties with their ability to process information and communicate.
“And if you’re in your 30s or 40s, you’re raising children. Stroke survivors face the challenge of navigating parenthood and relationships with their spouses. The juggling we all do in our 30s and 40s is struggle enough. Adding the complication of stroke can be overwhelming to the entire family.”
At the hospital, doctors gave Chris Matsumoto an infusion of TPA, then extracted the blood clot. Doctors told him that his risk factors included high blood pressure and thick blood, he said. He worked steadily at his therapy to relearn how to talk, and he has found shared ground with other survivors who attend the Sacramento Stroke Support group.
“All of the doctors said I had to change my lifestyle,” said Matsumoto, now 34. “I exercise. The dieting is hard. After the holidays, man, it’s hard.
“This has been an eye-opening experience for me. Everything is still coming back slowly. It took a lot of work.”
Call The Bee’s Anita Creamer, (916) 321-1136. Follow her on Twitter @AnitaCreamer.
What to look for
Symptoms of stroke may include some or all of these:
▪ Sudden numbness or weakness on one side.
▪ Slurred speech, or the inability to speak.
▪ Blurred vision.
▪ Dizziness and/or trouble walking.
▪ Sudden intense headache.