Overview
Stroke refers to a life-threatening situations which occurs when a section or segment of the brain does not get sufficient blood flow. Stroke caused by a blood clot obstructing blood flow to the brain is referred to as an ishaemic stroke. Strokes that occur due to blood vessel rupture are known as haemorragic strokes. Mostly, it can occur due to hemorrhage within the brain (bleeding) or due to blockage of an artery. When brain cells lack oxygen(hypoxia), they begin to die.
This condition is a cerebrovascular disease. These means that vessels in the brain responsible for carrying oxygen and nutrients in blood to the brain are affected.
Many stroke conditions can be treated, managed and even prevented from happening.
Care should be prioritized when dealing with stroke patients, since this medical emergency can lead to disability and even death.
Epidemiological Facts
According to the American Heart Association;
- Stroke is the 5th leading cause of death in the United States of America
- It is a leading cause of disability in the USA
- It affects arteries leading to and also within the brain.
- Up to 75% of strokes could be prevented.
- It is non-contagious. This means that strokes cannot be spread from one individual to another
- Almost 0.8 million individuals suffer from a stroke every year in the US.
- Age-adjusted mortality rate was 37.6 in every 100,000 stroke diagnoses. This figures are for 2017.
Risks
Each form of stroke has a specific set of most likely causes.
On the general perspectives, the following list presents potential causes of stroke;
- Obesity/ abnormally high BMI
- Being more than 55 years old
- Diabetic patients
- High blood pressure typically 130/80 mmHg or higher
- Sedentary lifestyle
- Medications such as blood-thinning drugs and low-dose estrogen birth control pills
- Smoking and chewing tobacco or its related products. Whether an individual is an active or passive smoker(second hand smoke), they still can develop strokes because smoke from cigarettes builds up fat in arteries and thickening blood, increasing its likelihood to clot.
- Over-consumption of alcoholic drinks
- Having high cholesterol
- Race- There is higher chance of stroke among black Americans and hispanics as compared to other races
- Sex- men have higher risk than women
- Hormones- hormone therapies or birth control pills that have estrogen can increase risk
Types
- Ishaemic stroke: This is the most common form of stroke. It represents almost 90% of the cases. Here, a blood clot is formed which prevents a specific area of the brain from accessing oxygen and blood.
- Haemorragic stroke: It happens due to blood vessel rupturing. Apart from aneuryms, it is also caused by arteriovenous malformations.
- Transcient ishaemic attack: It is also called mini-stroke. This form of stroke has temporary effects.
Causes
The following are reasons as to why a stroke can happen;
- Atherosclerosis
- Septal defects in the heart- both arterial and ventricular septal defects
- Artrial fibrillation
- Disorders of blood clotting
- Microvascular ischaemic diseases which can lead to blockage of brain vessels
Signs and Symptoms
- Trouble choosing words or slurred speech
- Dizziness
- Vertigo
- Neck stiffness
- seizures
- Coma
- Memory loss
- Headaches
- Nausea and vomiting
- Emotional instability
- Droop on one or both sides of the face
- Blurred vision
- Inability to remain balanced while staying on the feet
For easier remembering, the acronym FAST presents a better method of remembering stroke symptoms;
- Face drooping
- Arm weakness
- Speech difficulty
- Time to act- call 911 immediately if any not he above symptoms are present
Tests for Diagnosis
Strokes are diagnosed by conducting neurological exams apart from diagnostic imaging.
The most common tests include;
- Magnetic resonance imaging(MRI) scan
- Computer Tomography scans
- Electroencephalogram(EEG) to rule out seizures
- Electrocardiogram- to rule out heart disease as a course
- Lab blood tests to check for signs of infections or damage to the heart
Management & Treatment
Due to advances in ways by which we understand the human brain, treatment ranges for stroke are widening.
Some of the most commonly utilized regimens and methods are as follows;
- Thrombolytic drugs to dissolve pre-existing clots
- Mechanical thrombectomy which is a catheterization procedure
- Blood pressure management
- Surgery for subarachnoid haemorrhages
- Stroke rehabilitation through;
- Speech therapy
- Physical therapy Occupational therapy
- Cognitive therapy
Prevention
Embrace a good lifestyle;
- Eat healthy and nutritious diets that include fruits, vegetables, whole grains and cereals, nuts, eggs, seeds and legumes. Hit a gym and perform physical exercises
- Maintain moderate weight and normal Body Mass Index(BMI)
- Avoid smoking tobacco and related products
- Drink moderate amounts of alcohol, only if necessary
- Manage health conditions early. Prevent development of conditions such as hypertension through regular monitoring of blood pressure. Also, diabetes management is advisable.