Stroke

Stroke, sometimes called a "brain attack," happens when blood flow is cut off to a part of the brain, stopping the cells from getting the oxygen they need to live. Brain cells may recover, but after a few minutes, they could die, resulting in permanent damage.

·        Approximately 800,000 people have a stroke each year; about one every 40 seconds

·        Strokes occur due to problems with the blood supply to the brain, either the blood supply is blocked or a blood vessel within the brain ruptures, causing brain tissue to die.

·        A stroke is a medical emergency, and treatment must be sought as quickly as possible

·        Types and causes of stroke:

·        Ischemic stroke- It happens when a blood vessel that takes blood to your brain gets blocked. Often, it's by a blood clot that travels from one part to another part of the body. For example, fatty deposits in arteries can break off, flow to the brain, and cause blood clots. It is the most common type of stroke

·        Hemorrhagic stroke-happens when a blood vessel in the brain bursts and bleeds, which can damage the tissue. They're less common but more serious. Uncontrolled High Blood Pressure and over-using blood thinners can lead to this kind of stroke.

·        Transient ischemic attack (TIA)- It is a "mini stroke" from a temporary blockage. Although it doesn't cause permanent brain damage, it may cause stroke symptoms that could last minutes or hours

Risk factors of stoke:

There are many conditions which can increase the risk of having a stroke, it may include:

• Atrial fibrillation (AFib)
• Blood disorders, such as sickle cell disease or severe anemia
• Diabetes
• Hardened arteries (also called atherosclerosis)
• Heart disease
• High blood pressure (also called hypertension)
• High cholesterol
• Being overweight or obese
• Coronary artery disease, heart failure and enlarged heart may increase the risk
• Stroke is more common in older age than in younger age
• Family history may be other greatest risk factor
• A man is at a higher risk to get stroke than a women

Symptoms of stroke:

• Confusion, including trouble with speaking and understanding
• Headache, possibly with altered consciousness or vomiting
• Numbness of the face, arm or leg, particularly on one side of the body
• Trouble with seeing, in one or both eyes
• Trouble with walking, including dizziness and lack of co-ordination.

Diagnosis of stroke:

Stroke is a medical emergency, with the appearance of symptoms, a patients must be shifted to hospital as fast as possible. Certain diagnosis includes:

• Physical examination: A doctor will ask about the patient's symptoms and medical history. They may check blood pressure, listen to the carotid arteries in the neck and examine the blood vessels at the back of the eyes, all to check for indications of clotting
• Blood tests: A doctor may perform blood tests in order to find out how quickly the patient's blood clots, the levels of particular substances (including clotting factors) in the blood, and whether or not the patient has an infection
• CT scan: A series of X-rays that can show haemorrhages, strokes, tumours and other conditions within the brain
• MRI scan: Imaging of the brain to detect damaged brain tissue
• Carotid ultrasound: An ultrasound scan to check the blood flow of the carotid arteries and to see if there is any plaque present
• Cerebral angiogram: Dyes are injected into the brain's blood vessels to make them visible under X-ray, in order to give a detailed view of the brain and neck arteries
• Echocardiogram: A detailed image of the heart is created to check for any sources of clots that could have traveled to the brain to cause a stroke.

Treatment of stroke:

·         In case of ischemic stroke:

·     Treatment can begin with drugs to break down clots and prevent further ones from forming.

·     Aspirin can be given, as a Tissue plasminogen activator (TPA). TPA is very effective at dissolving clots but needs to be injected within 4.5 hours of stroke symptoms manifesting themselves.

·  In case of emergency, TPA is directly pushed in the artery of the brain usinga  catheter, or using a catheter to physically remove the clot

In case of hemorrhagic stroke:

·    Treatment can begin with drugs being given to reduce the pressure in the brain, overall blood pressure, prevent seizures and prevent sudden constrictions of blood vessels.

·     Surgery can be used to remove small arteriovenous malformations (AVMs) if they are not too big and not too deep within the brain. AVMs are tangled connections between arteries and veins that are weaker and burst more easily than other normal blood vessels

·   Surgery can be used to repair any problems with blood vessels that have led or could lead to hemorrhagic strokes.

Rehabilitation programmes:

·     Speech therapy - To help with problems producing or understanding speech. Practice, relaxation and changing communication style, using gestures or different tones

·       Physical therapy - To help a person relearn movement and co-ordination

·    Occupational therapy - To help a person to improve their ability to carry out routine daily activities, such as bathing, cooking, dressing, eating, reading and writing

·     Joining a support group - to help with common mental health problems such as depression that can occur after a stroke.

·    Support from friends and family – To provide practical support and comfort. Letting friends and family know what can be done to help is very important.