Overview and Definition
A stroke happens when there is an alteration in brain function due to blocked or erupted blood vessels. Without enough blood and oxygen supply, the cells of the affected part of the brain start to die. This results in changes in the patient’s ability to function normally. The severity of the effect of stroke depends on the degree of damage to the brain.
Stroke is sometimes referred to as a “brain attack” to distinguish it from a heart attack, which is a similar condition that happens in the heart instead of the brain.
Types and Causes of Stroke
Ischemic stroke - This kind of stroke happens due to a blood clot that blocks the vessels in the brain. Because the blood vessel becomes narrowed and clogged, there is not enough blood supply to bring oxygen that is needed to keep the brain alive. The most common cause of ischemic stroke is related to arteriosclerosis, a build-up of plaque (cholesterol-containing fat deposits) along the walls of the blood vessels. Plaque buildup is in turn caused by various reasons including high cholesterol and high blood pressure. Ischemic strokes can also be caused by small blood clots that travel through the bloodstream and clog the arteries.
Hemorrhagic stroke - This type of stroke occurs when the blood vessels become brittle and weak that they burst, leading to blood leaking out into the brain. The presence of blood leak in the brain causes pressure to build-up, which is difficult to counter as the brain is enclosed by the skull. Hemorrhagic strokes are more serious than ischemic ones and lead to more severe damage in the body. It can even be fatal, with deaths occurring in 30% to 50% of stroke patients.
Symptoms of a Stroke
Depending on the location of the stroke area and the amount of blood involved, signs of a stroke may vary. Stroke symptoms almost always happen very quickly and suddenly. An onset of stroke may cause one or a combination of the following symptoms:
Sudden change in vision
Sudden tingling, weakness or numbness, or loss of movement in the arm, leg, and face. This usually affects just one side of the body (either left or right)
Sudden difficulty in talking or speaking straight
Sudden confusion and difficulty in understanding
Sudden difficulty in remembering very basic things like counting or alphabet order
Sudden coordination problems, such as in balancing or walking
A sudden, excruciating headache with no apparent cause
When to See a Doctor
People who experience stroke signs must be taken to the doctor right away. Some of the symptoms of stroke can go away quickly while some can persist for a few hours. In some cases, patients may experience what is called a mini-stroke or a transient ischemic attack (TIA), which is a warning that a more serious stroke may happen thereafter. It is best to get early treatment to prevent a stroke.
A few of the aforementioned signs of stroke can also be symptoms of other cardiovascular conditions such as high blood pressure, blood sugar level changes or even stress.
A general practitioner can recommend you to a neurologist and cardiologist if you are experiencing or have experienced a stroke.
Diagnosis and Treatment of Stroke
In order to accurately diagnose and treat stroke, it is important for a patient to undergo a physical examination and diagnostic procedures. The doctor will ask about your risk factors such as heart disease, high blood pressure, smoking, and family medical history. Depending on your symptoms, various tests will also be conducted. These may include a brain CT scan, brain computed tomography, MRI (magnetic resonance imaging), carotid ultrasound, carotid angiography, EKG (electrocardiogram), echocardiography and blood tests. Results of these tests can clearly show whether or not a stroke has occurred, and if it did, which part of the brain is damaged and the extent of damage. These tests can also detect related cardiovascular conditions.
Treatment of stroke, on the other hand, will depend on the type and severity of the stroke.
Treatment for Ischemic Strokes: Ischemic strokes are usually treated with tissue plasminogen activator (tPA), a medicine that breaks up blood clots and which is given within 4 hours from the onset of symptoms. Your doctor may also prescribe blood-thinning medications and anticoagulants to prevent further blood clots. Medical procedures such as angioplasty or other newer treatments such as intra-arterial thrombolysis may also be performed.
Treatment for Hemorrhagic Strokes: The first treatment step for hemorrhagic stroke is controlling or stopping the bleeding in the brain through medication. Surgical interventions such as aneurysm clipping, arteriovenous malformation repair or coil embolization may be recommended to prevent further leaking and to prevent blood vessels from bursting again.
Since a stroke is usually followed by problems with movement, coordination, thinking or memory, language, and other limitations, your doctor will recommend you to physical, occupational and speech therapists for rehabilitation. Therapy can help stroke patients recover faster to restore their normal physical and everyday function. The kind, frequency, and duration of therapy sessions will depend on the extent of damage the stroke has caused. Stroke rehabilitation may involve:
Strengthening motor skills through physical activities
Improving communication and speech through functional electrical brain stimulation and use of devices to simulate real-time environment
Psychological evaluation and treatment, including counseling for emotional adjustment
Stroke rehabilitation is recommended as soon as 24-48 hours after stroke.
After suffering a stroke, a patient will be strongly advised to lead a healthier lifestyle, even if it means complete lifestyle and routine changes. They are also educated on what causes a stroke so risk factors can be controlled effectively. This entails following a healthy well-balanced diet, maintaining a healthy weight, and being physically active. The support and participation of loved ones are also strongly encouraged for faster recovery.
www.nhlbi.nih.gov National Heart Lung and Blood Institute “Explore Stroke”
Davis, Charles Patrick, MD. PhD. (2013). “Stroke” http://www.emedicinehealth.com/stroke
Goldstein LB, et al. (2010). Guidelines for the primary prevention of stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. Published online December 2, 2010 (doi: 10.1161/STR.0b013e3181fcb238). Also available online: http://stroke.ahajournals.org/content/42/2/517.full.