Young. Unsuspecting. Stroke Victim.

A Thunderclap

People can live with aneurysms and growing blockages and not know they have them. Strokes may come with no warning signs at all.

But signs such as dizziness or a sudden, severe headache are often overlooked. Take, for example, Tony Grabowske, 38, of New Brighton, who two years ago suffered a sudden, severe headache (doctors call it a “thunderclap”) while taking a shower. The driver for Northeast Towing Service took some aspirin, went to work, and made a doctor’s appointment. Over the next two weeks, he visited the doctor three times about his headaches, which came on intermittently, especially if he sneezed or coughed. But the doctor attributed them to lack of sleep and prescribed sleeping pills.

Two weeks after the first incident, Grabowske got another severe headache. This time he hit the floor and passed out from the pain.

“It felt like someone put a knife right in between my eyeballs and started turning it,” he says. His wife took him to the emergency room, where he was told he’d had an aneurysm that had ruptured. He speculates that the aneurysm was aggravated by his three-pack-a-day smoking habit, stress, and the physical strain of his jobs in construction and landscaping.

Like Miller, Grabowske was lucky. The medical literature reports that one-third of cases like his are initially misdiagnosed, and that 30 percent of patients who suffer this kind of stroke die. A computerized tomography (CT) scan showed doctors the blood on Grabowske’s brain. Then they performed CT angiography, injecting dye into his veins so his blood vessels would show up on an X-ray. That test showed that his aneurysm was a good candidate for endovascular coiling, which doctors were able to accomplish in a two-and-a-half-hour surgery. After the procedure and two weeks of recuperation in the hospital, Grabowske was free to go home.

Always Good Advice: Lose Weight

While strokes can seem to come out of the blue, there are some risk factors that anyone can know about and control. Because we’re talking about blood vessels, stroke has some of the same major risk factors as heart disease. People with high blood pressure, high cholesterol, excess weight, or who smoke all increase their odds of having a stroke.

“If your blood pressure is way high, you’re more likely to have a hemorrhagic stroke than if it’s not,” Dr. Idelkope says. He recommends one remedy to knock out most risk factors: “If you want the single most important thing people should do, it would be lose weight,” he says. “If you lose weight and exercise more, your blood pressure and cholesterol will go down, and your heart doesn’t have to work as hard.”

That can go a long way in countering risk factors that can’t be controlled: age (risk increases as we get older), gender (some sources say men are at greater risk of stroke; others note that stroke is more often fatal in women), race (blacks, Hispanics/Latinos, and Asians are at greater risk than others), or a family history of stroke and heart disease.

If you’re concerned about your risk of stroke, your doctor will check your blood pressure and cholesterol, and test you for diabetes and elevated levels of the amino acid homocysteine, frequently an indicator of stroke and cardiovascular disease. Your doctor might also wave a wand-like device over the arteries in your neck (a carotid ultrasonography) to detect narrowing, or perform a CT angiography.