Guide on Stroke (Brain Attack) What is Brain stroke? How to prevent it

Guide on Stroke (Brain Attack)

Stroke is a “Brain Attack" And a Medical EmergencyIt is critical to recognize the symptoms of stroke and seek immediate emergency attention.

Stroke – sometimes called a “Brain Attack” or “Cerebrovascular accident” is a syndrome of symptoms & signs of loss of cerebral function caused by disruption in the flow of blood to part of the brain.

What causes stroke?

A stroke occurs when a blood vessel carrying oxygen and nutrients to the brain is blocked by a clot or bursts, causing the brain to starve. If deprived of oxygen for even a short period of time, the brain nerve cells die from a lack of oxygen, the part of the body that section of the brain controls is affected through paralysis, language, motor skills or vision disturbances.

There are two types of stroke:

Blood clots that block the artery are ischemic (is KEM-ik) strokes and is the most common type causing between 70-80 percent of all strokes.

When a blood vessel ruptures, it causes a bleeding or hemorrhagic (hem-o-RAJ-ik) stroke. Such strokes are usually the result of a ruptured blood vessel or an aneurysm, a weakened area of a blood vessel that bulges or balloons out.

There are also “mini-strokes” known as TIA’s (transient ischemic attacks). People who have one TIA are likely to have another one. TIAs cause brief stroke symptoms that go away after a few minutes or hours. People often ignore these symptoms, but they are an early warning sign and 35 percent of those who experience a TIA will have full blown stroke if left untreated. TIAs should be taken as seriously as strike.

A leading cause of stroke and TIA is carotid artery disease (CAD). In CAD, a substance called plaque builds up over time in the carotid arteries, the large blood vessels on either side of the neck that supply blood to the head and brain. The buildup of plaque is a silent disease, until small particles break away and are carried to smaller arteries, where they block the flow of blood. The nature and severity of symptoms depend on how large an area of the brain is affected and whether the blood supply to the brain is completely or partially blocked.

What are the symptoms of stroke?

The most common symptoms of stroke are:

• Sudden numbness or weakness in the face, arm and / or leg, especially on one side of the body.


• Sudden trouble seeing, including double vision, blurred vision or partial blindness, in one or both eyes.


• Trouble walking, dizziness, loss of balance or coordination.


• Sudden severe, headache with no known cause.

If you experience any of these symptoms, even if they go away quickly, seek immediate emergency help.

Every minute counts. Although starved of oxygen, brain tissue does not die in the minute following a stroke. If blocked blood vessels can be opened within three to six hours, the chances of recovery are greatly improved.

What are the risk factors for stroke?

People who are higher-than-average risk for stroke include those who have:

• High blood pressure


• High cholesterol


• Heart disease

Atherosclerosis. When the carotid arteries, the major blood vessels that supply blood to the brain, become clogged with atherosclerotic plaque, the risk for stroke goes up.

Personal history of stroke or TIA.

Lifestyle risk factors. Smoking, excessive alcohol consumption and being overweight are

all significant risk factors for stroke.

Age, gender and race. The risk of stroke goes up with age & is higher in males.

Family history of stroke or TIA.

Diabetes.

How to diagnose stroke?

There are a number of diagnostic exams that can be performed to determine if someone has had a stroke or is risk for having one.

Computed Tomography (CT). The first diagnostic test performed in the emergency room is usually a CT scan. CT uses computers to generate detailed pictures of the brain, and can confirm the diagnosis of stroke and tell whether the stroke is caused by a hemorrhage in the brain.

Magnetic Resonance Imaging (MRI is a diagnostic test which may be performed to identify and further localize the site of the stroke and find the source. It may be able to quickly identify the area deprived of sufficient blood flow & guide further therapy.

Angiography. An angiogram is an X-ray in which a contrast agent, or dye, is injected into a vein to highlight the blood vessels. With this exam, radiologists can pinpoint the exact location of blockage or bleeding in the brain. Angiography also is used to guide thin tubes called catheters to the site of the problem and administer treatments.

How can stroke be prevented?

In patients at high risk of having a stroke, the narrowed section of artery may be re-opened by an interventional radiologist through angioplasty and reinforced with a stent, thereby preventing the stroke from occurring. Vascular stents are typically made of woven, laser-cut or welded metal that permits the device to be compressed onto a catheter and delivered directly into the hardened artery. In addition to diagnosing and treating those at risk for stroke, interventional radiologists use their expertise in imaging, angioplasty and stenting to treat those having an acute stroke.

Patients can also take action to prevent strokes by:

Stop smoking
Controlling high blood pressure
Lowering cholesterol levels
Maintaining healthy weight
Excercising
Utilizing appropriate medications like aspirin
Treating unruptured cerebral aneurysm or arteriovenous malformation

weight loss tips

How is stroke treated / managed?

For those having a stroke, it must first be determined which kind of a stroke the patient is having so the proper treatment can be given.

Treatment to Dissolve Blood Clots:

If the stroke is due to a blood clot, a clot-busting drug, TPA (tissue plasminogen activator) can be given intravenously to break up or reduce the size of blood clots to the brain. This technique must be performed within three hours from the onset of symptoms.

Other important medical therapies: These include anti platelet drugs for ischemic stroke, drugs for control of blood pressure & blood sugar in diabetes. Treatment also includes prevention of complications like increased intra cranial pressure, chest infection etc.

At approved stroke centres interventional radiologists (IR) that specialize in neurological procedure can provide intra-arterial thrombolysis treatment.

Treatment to Open Narrowed Carotid Arteries: If a stroke is the result of narrowing of the carotid arteries, follow-up treatment may be needed stroke. These treatments also are used to prevent stroke in people who have been diagnosed with significant blockage in the carotid artery, usually as a result of atherosclerosis, in which plaque builds up over time in the artery.
Carotid Endarterectomy Surgery.
The most common treatment for narrowing of the carotid arteries involves a surgeon making an incision in the neck, opening the carotid artery and scraping out the built –up plaque.Carotid artery angioplasty and stenting. In this technique, a catheter is inserted through a nick in the skin, usually in the groin, and threaded under X-ray guidance to the carotid artery. A balloon is inflated to compress the plaque against the wall of the blood vessel and open up the artery. Usually, a tiny wire cylinder called a “stent” is inserted and acts like a scaffolding to keep the artery open.
Interventional radiologists use X-rays toguide the placement of small, wire mesh cylinders (stents) to hold open clogged arteries.

Post Stroke Rehabilitation

Rehabilitation is a critical part of recover for many stroke survivors. The effects of stroke may mean that you must change, relearn or redefine how you live. Stroke rehabilitation helps you return to independent living.

Rehabilitation doesn’t reverse the effects of a stroke. Its goals are to build your strength, capability and confidence so you can continue your daily activities despite the effects of your stroke.

Rehabilitation depends on your need to become independent. You may work to improve you independent in many areas.

These include:
Self – care skills such as feeding, grooming, bathing and dressingMobility skills such as transferring, walking or self-propelling a wheelchair
Communication skills in speech and language
Cognitive skills such as memory or problem-solving
Social skills for interacting with other people

Under your doctor’s direction, rehabilitation specialists come together to provide a treatment program specifically suited to your needs.