Oscar winner Jamie Foxx opened up during his Netflix special about the mysterious illness he suffered in April 2023. While working the film Back In Action in Atlanta, he had a bad headache, asked a friend for an aspirin and had no recollection of what happened next, he recalled on stage during the stand-up special What Had Happened Was...
His sister took him to a nearby hospital, where he was evaluated and diagnosed with a brain bleed. Foxx had no memory for the following 20 days and, after waking up, required the use of a wheelchair and went through an intense rehabilitation program.
While Foxx said he was surprised that he experienced a brain bleed, there has been a steady rise in young and middle-aged adults experiencing brain bleeds in the United States. For example, a study by Houston Methodist Hospital found an 11% increase in intracerebral hemorrhage strokes from 2004 to 2018.
With such a rapid rise in brain bleeds among these demographics, it's important for the public to be aware of the risks and signs of stroke and for the medical community to institute strategies to reverse this alarming trend of disabling strokes among younger populations.
An ICH stroke, what Jamie Foxx experienced, means a vessel in or around the brain has ruptured. These are typically due to high blood pressure, aneurysms, head trauma, or an abnormal tangle of vessels known as arteriovenous malformation. Although this type of stroke only accounts for 13% of strokes in the US, ICH strokes can be disabling and fatal. Aspirin and other blood thinning medications can make these patients worse, which is why you should have a clear diagnosis before initiating treatment.
The more common type is an ischemic stroke, accounting for 87% of strokes, which is a blockage in a blood vessel that supplies oxygen and nutrients to the brain. These blood clots would benefit from the patient taking aspirin. If you get to the hospital early enough, there are special clot-busting medications that can reverse this type of stroke, and in some cases, the doctors can do a procedure called thrombectomy to remove the clot.
A stroke can happen to anyone at any time, but there are steps people can take to lower their risk. Being aware of how to prevent brain bleeds is important given its increasing impact on our society, often taking young people out of the work force.
"I think it is important to recognize that the two principal preventable causes of brain hemorrhages are trauma and high blood pressure," says neurosurgeon Dr. Jeffrey Oppenheim, my colleague from WMCHealth's Good Samaritan Hospital. "Ways to avoid head trauma include wearing seatbelts in cars and helmets on bicycles."
Fall prevention can also prevent brain bleeds, especially in older adults. Using shower bars or shower seats, non-slip mats, avoiding rolling chairs and loose rugs and wearing supportive footwear are all helpful. A home visit with a nurse or physical therapist can help make sure the home is fall-proof. Some contractors offer consultation and can ensure the home has accessible features to aid in fall prevention. Smart watches can be useful in notifying emergency medical services if the person should be alone and become incapacitated after a fall or brain bleed.
High blood pressure is often seen as a silent killer because some people may not experience any symptoms until they have had a heart attack or a stroke. Many medications treat high blood pressure, but you must first be diagnosed.
"Everyone over 30 years old should be evaluated yearly for hypertension," says Dr. Oppenheim. Eating a healthy, low-sodium diet can help prevent spikes in blood pressure. Additionally, ensuring a good mix of fruits, vegetables, whole grains and lean proteins supports brain and vascular health. Regular exercise and taking blood pressure medications as prescribed can all help control blood pressure.
Alcohol use can also contribute to brain bleeds. Chronic alcohol use can increase the likelihood of someone having high blood pressure, and it can damage the walls of blood vessels, making them more prone to rupture. Alcohol can also damage the liver, which can lead to reduced and impaired clotting factors, known as platelets. These dysfunctional platelets can increase bleeding risk and prevent bleeding from stopping as quickly.
Smoking can damage blood vessels and increase the likelihood of getting aneurysms in the brain, so quitting smoking can be a game-changer. Blood thinners like aspirin and oral anticoagulants can increase the risk of bleeding, so it is essential to follow any monitoring protocols.
There are many types of brain bleeds; depending on what caused it, the intervention may differ. In addition to head trauma, high blood pressure, tobacco and alcohol use, other causes of brain bleeds include aneurysms, arteriovenous malformations, blood thinners, brain tumors, bleeding disorders and the use of drugs such as cocaine.
Stroke symptoms typically have a sudden onset. Whether the patient is having an ICH stroke or an ischemic stroke, there are some common symptoms seen in both. "The symptoms of a brain bleed can look a lot like an ischemic stroke but are more often associated with pain," says Dr. Oppenheim. "But, you can't tell what is happening without a CT scan. So, making a rapid diagnosis at a hospital is the key to enabling treatment."
If you think you are having a stroke, you must get to an emergency room right away as there may be time-sensitive interventions available. A great way to remember stroke symptoms is the BE FAST (Balance, Eyes, Face drooping, Arm weakness, Speech problem, Time to call 911) mnemonic.
Once in the emergency room, the medical team will determine what type of stroke the patient is having.
Getting to the hospital for immediate care can significantly impact stroke outcome. For example, if the blood pressure is not controlled after a brain bleed, the bleeding may increase and lead to incapacitation or death. Foxx repeatedly thanked his medical teams for the hard work they put into his care, which allowed him to return to return to full independence.
Foxx's remarkable outcome would not have been possible had his family not acted quickly to get him to the hospital so he could get the immediate medical care he needed. He thanked his family repeatedly for their quick action. One of Jamie Foxx's first lines in the special was, "I was fighting for my life, but now I'm here in front of you." Indeed, as he seamlessly navigated the stage, showing how resilient the human brain can be while also demonstrating neuroplasticity, which is the brain's ability to be shaped and molded after experiencing a trauma like a brain bleed.
Make no mistake, Jamie Foxx was transparent about the rough road he's traveled from April 2023 to the present. He may face setbacks in the future, but he has a strong social support system and inner strength that will carry him through. Anyone who suffers from brain injury should not be afraid to reinvent themselves as they see fit. They may lose something from the brain injury, but it is important to be on the lookout for what they might have gained.