Stroke
A stroke or brain attack, is caused by the sudden loss of blood flow to the brain or bleeding inside the head. Both can cause brain cells to stop functioning or die. When nerve cells in the brain die, the function of body parts they control is harmed or lost. Depending on the part of the brain affected, people can lose speech, feeling, muscle strength, vision or memory. Some people recover completely while others are seriously disabled or die.
Time is of the essence; you can reduce your chances of death or disability, if you recognize the signs of stroke and get immediate medical help. It is very important they get to a hospital within 60 minutes of the onset of a stroke.
Stroke risk increases sharply with age doubling every decade after the age of 55. However, stroke can occur at any age. Men have slightly more strokes than women.
Strokes claim the lives of more women than breast cancer. And people with a family history of stroke and heart disease have an increased stroke risk.
There are also very important risk factors that often can be controlled:
High blood pressure
Tobacco use
Cholesterol levels
Body weight
Diabetes
See your doctor for help in addressing these risk factors.
Types of stroke
The brain is affected by two types of stroke, ischemic and hemorrhagic.
Eighty percent of all strokes are ischemic. Ischemic strokes can be caused by narrowing of the large arteries to the brain. This is also called atherosclerosis.
Ischemic strokes include:
Embolic: Clots travel from the heart or neck blood vessels and lodge in the brain.
Lacunar: Small vessels in the brain are blocked, often due to high blood pressure or damage caused due to diabetes.
Thrombotic: Clots form in the brain blood vessels often due to arteriosclerosis or hardening of the arteries
When blood cannot get to the brain cells, they die within minutes to a few hours
Hemorrhagic strokes involve bleeding into or around the brain. It includes:
Subarachnoid: Weak spots on brain arteries called aneurysms burst and blood covers the brain.
Bleeding into the brain: Blood vessels in the brain break because they have been weakened by damage due to high blood pressure, diabetes and aging.
Symptoms
Stroke symptoms may not be as dramatic or painful as a heart attack. But the results can be just as life- threatening. Common symptoms include:
Sudden numbness or weakness of face, arm or leg, especially on one side of the body.
Sudden confusion, trouble speaking or understanding speech.
Sudden difficulty seeing in one or both eyes.
Sudden trouble walking, dizziness, loss of balance or coordination.
Sudden severe headache with no known cause.
Call the ambulance immediately if you or someone you know experiences any of the above warning signs.
Write down the time the symptoms started. Sometimes these warning signs last for only a few minutes and then go away. If this happens even if you think you are getting better, call for help.
Diagnosis
Diagnostic tests to determine treatment could include:
Neurologic exam
Brain imaging to understand the type, location, and extent of the stroke
Tests that show blood flow and bleeding sites (carotid and
transcranial ultrasound and angiography)
Blood tests for bleeding or clotting disorders
EKG (electrocardiogram) or an ultrasound examination (echocardiogram) of the heart to identify cardiac sources of blood clots that could travel to the brain
Tests that measure mental function
Treatment
Immediate medical care is important. New treatments work only if given within a few hours after a stroke begins. Once the doctor completes the diagnostic tests, the treatment is chosen. For all stroke patients, the aim is to prevent further brain damage.
Rehabilitation
Rehabilitation helps regain functions lost from damage due to stroke. During rehabilitation, most people will get better. However, many do not recover completely.
Unlike skin cells, nerve cells that die do not recover and are not replaced by new cells. However, the human brain is adaptable. People can learn new ways of functioning, using undamaged brain. (Reprint)
This article has been written by medical specialists at Apollo Hospitals India
