What You Need To Know

Dr. Ted Wein and Jamie Bussin

A stroke that results in a hospital admission or an emergency department visit occurs roughly once every 5 minutes in Canada. Although stroke remains one of the leading causes of death in our country, there has been incredible progress in recognizing stroke onset and managing post-stroke care. I recently had the opportunity to speak with Dr. Ted Wein on episode #292 of The Tonic Talk Show/Podcast. Dr. Wein is an assistant professor of neurology and neurosurgery at McGill University and active physician at the Stroke Prevention Clinic in Montreal General Hospital.

A stroke is like a heart attack in the brain. Either the artery in the brain gets blocked, in which case there is a lack of blood supply to the brain and the brain cells will die (an Ischemic Stroke) or the artery will break and people will bleed into their brain (a Hemorrhagic Stroke). According to Dr. Wein the most common causes of strokes are high blood pressure, smoking, unhealthy diets, and an inactive lifestyle. It’s been shown that if you have your blood pressure under control, exercise 30 minutes a day, keep your waistline down, don’t consume excessive amounts of alcohol and quit smoking, you can probably reduce your chances of having a stroke by 80-90%. Strokes, like heart attacks, are a disease of the blood vessel. There are genetic risk factors of cholesterol and diabetes, but unlike heart disease it is very rare to have a genetic predisposition to strokes that runs in families. Nonetheless, strokes are a preventable disease.

There are currently 880,000 Canadians surviving with strokes. And the most common complication is paralyzation on one side of the body. Depending on what side of the brain is damaged one’s vision can be impacted, speech affected, motor function affected or loss of sensation or coordination. 

Another common complication after suffering a stroke is Post Stroke Spasticity (“PSS”). “After a stroke you may be paralyzed, unable to move your arm or your leg.” says Dr. Wein “But spasticity means that the brain has not healed itself properly. And people become very stiff in the arms or the legs. It leads to abnormal posturing of the limb. Your arm might get flexed up or your foot might fall the wrong way when you walk. This leads to more complications.” 

Patients with PSS have the worst post-stroke outcomes. PSS causes spasms, cramps and pain. It inhibits you from normal activities, like getting dressed. It stops you from walking properly. It makes getting up from a seated position to standing difficult. Trips and slip-and-falls become more frequent. People with PSS typically need caregivers to overcome these complications. 

PSS can be treated with Botox which, for example, can be injected into the leg to decrease stiffness and help reposition the foot in the correct pattern and thereby make walking safer and more comfortable. There are also oral medications available such as tizanidine as well as lioresal (which unfortunately can come with the side effect of sedation). PSS can also be treated with physiotherapy to try to stretch out the muscle and keep the tendon as long as possible. Physiotherapy works in the short term but must be done daily for continued results. Unfortunately our health care system doesn’t provide us with coverage for physiotherapy in the long term, which can be quite costly.

Dr Wein thinks that the key fact that everyone should know about strokes is that it is a common disease. One quarter of stroke victims in Canada are under the age of 65. Says Dr. Wein, in conclusion; “We can beat this disease. Please control your risk factors by eating healthy, exercising and quitting smoking.”

Dr. Ted Wein is an assistant professor of neurology and neurosurgery at McGill University and a physician at the Stroke Prevention Clinic at Montreal General Hospital.


Most Canadians don’t get the treatment they need, because they don’t know that they’re having a stroke or symptoms may simply go away. So, how do you know if you’re having a stroke?

F – Face: Is your face drooping?

A – Arms: Can you raise your arms – or are they weak?

S – Speech: Are you having trouble speaking – slurring or not finding the right words?

T – Time: You must call 911 right away. There are treatments for strokes, but they must be given in the first 6-18 hours.


According to Dr. Wein many people who survive a stroke don’t know that they have PSS. To help identify if you’re suffering from PSS consider the following:

R – Restricted movement: decreased or abnormal movement

E – Early detection or intervention: better outcomes result from early detection

A – Altered function: PSS can alter what you do from day to day

C – Change in muscle stiffness or posture: the hallmark indicator of PSS

T – Talk To Your Doctor: Doctors don’t necessarily screen for PSS so raising your concern with your health practitioner is crucial