STROKE- A Brain Attack

Stroke is actually a brain attack. The main problem is similar to what is seen in a heart attack; a condition where there is a sudden “cut-off” of blood supply to the heart tissue. In the case of stroke, the sudden “cut off” of blood supply and oxygen results in loss of function of the areas supplied by that part of the brain. Both conditions are considered life-threatening emergencies where quick medical intervention is needed to reduce disability and save the life.

How much of a problem is this Worldwide?

It is known that 1 in 6 people worldwide will have a stroke in their lifetime.  It is the second leading cause of death for people above age 60. In the developing countries, it is actually the leading cause of death in this age group and above. Similarly, when we compare the stroke figure worldwide to what is seen in the developing countries, the number shoots up by 20%.  The number of people who die from stroke in the first 30days of admission to the hospital is as high as 40%. More women than men die from stroke. This alarming picture is accounted for by the poor access to primary care in this part of the world, as well as insufficient patient education on prevention strategies, especially on the importance of Blood pressure and Diabetic control.

Five Important Things To Know About Stroke

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(1)          It is a debilitating disease causing a great level of disability even if the individual survives the stroke

(2)          It can be prevented by maintaining a healthy lifestyle and treating underlying conditions that could be risk factors (e.g., Hypertension, diabetes, high cholesterol etc.)

(3)          Supply of oxygen and nutrients are “cut-off” from the brain, leading to brain damage

(4)          Prompt intervention is important for saving a life

(5)          The type of treatment depends on the type of strokes

What are the Symptoms of Stroke-F.A.S.T

The main symptoms of stroke can be remembered with the word F.A.S.T.:

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Face – the face may have dropped on one side, the person may not be able to smile, or their mouth or eye may have dropped.

Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of weakness or numbness in one arm.

Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.

Time – it’s time to dial 911 if you are in the U.S, 999 if in U.K or the appropriate local emergency number to your location if you see any of these signs or symptoms.

What Are The Different Types Of Strokes?

There are three main types of stroke:

(1) Ischemic Stroke

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This is the most common type of stroke. It occurs when a blood clot present in blood vessels prevent blood and oxygen from reaching the brain.  Usually, this clot develops in other organs of the body such as the heart chambers or in the legs. Under certain conditions, the clot may dislodge from their original site and travel to the brain through the bloodstream.

(2) Transient Ischemic Attack (TIA)

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TIA (also referred to as “mini-stroke”) results when there is a narrowing of the blood vessel in the neck (carotid artery). The carotid artery is the vessel that carries blood from the heart to the brain. This narrowing can be caused by the formation of plaque inside the vessel.  If a blood clot that is formed in the heart or any part of the body tries to pass through this plaque, a total blockage results. The overall effect is a “shut-down” of blood supply to the brain just as seen with ischaemic stroke.  The difference between TIA and Ischaemic stroke is that symptoms of TIA are only brief, lasting few minutes or hours. Otherwise, the symptoms are the same.

TIAs should be treated as a medical emergency jut as a stroke because:

(a)          They serve warning signs for future stokes- usually, 30% of people with TIA will develop a stroke within a year if something is not done about it.

(b)          They are pointers to the presence of dangerous clot formation somewhere in the body; usually in the heart.

(3) Hemorrhagic stroke

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This occurs when a weakened blood vessel ruptures and starts to bleed into the brain. Hemorrhagic stroke normally occurs as a result of aneurysms or abnormal development or connection in the brain called Artero-Venous malformations (AVMs). Brain aneurysms are abnormal dilation and distention of the arteries in the brain as a result of weakness in the vessel wall. Under high blood pressure, such vessels may easily rupture thus leading to bleeding into the brain

Treatment

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Treatment of strokes depends on the type and the area of the brain involved. The Doctor knows the area(s) of the brain involved by the symptoms an individual present with.  It is very important to know the type of stroke one is dealing with before treatment. The treatment use for ischaemic stroke may be harmful to other types of strokes (e.g. hemorrhagic stroke).

Strokes are usually treated with medications. These include medicines to prevent and dissolve blood clots, reduce blood pressure and reduce cholesterol levels. Aspirin can be started as soon as possible. Similarly, there are some injections that if given within 4.5 hours of the stroke incidence may increase chances of a quick recovery.

Sometimes, medications used to treat heart problems may be added. Most times, the blood clot originates from a heart that is not pumping well.

Medication to reduce brain swelling may also be given (especially in hemorrhagic stroke where bleeding into the brain may lead to swelling)

In Transient ischaemic attack, surgery may be done to remove the plaque in the vessel in the neck (carotid artery) so as to allow free flow of blood. This is in addition to the blood thinner used to dissolve the clot.

Stroke Prevention

Knowing the risk factors for stroke and avoiding them is the key to prevention. This involves living a healthy lifestyle by:

  • Eating a healthy diet
  • Taking regular exercise
  • Not smoking
  • Drinking alcohol in moderation

All these will ensure a proper functioning of your blood vessels, your heart as well as maintaining your cholesterol level at an acceptable level. These measures may also reduce your chances of forming dangerous blood clots in the body. In addition, your Doctor may place you on blood thinning medications as a way of preventing clot formation if there are conditions that may predispose you to this.

stroke prevention

In addition to putting your cholesterol level under control, proper maintenance of your hypertension and diabetes is very important.

It is also important to remember that if you have had a previous stroke or transient ischaemic attack, your chances of having another one again is greatly increased; hence the need to observe all these preventive measures.

Strokes In Children

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It is also possible for children to develop the three different types of stroke. Its cause and effect may, however, be different. These depend on how old the child is.

Stroke in children may result from other illnesses that make the formation of a clot in the blood vessels easy. These include various blood disorders and severe infections. Other causes include; head and neck injuries and problems with the blood vessels.

Strokes can also occur in babies during pregnancy up to within 28 days after birth.  This can be caused by clots breaking off from the placenta and going into the brain.

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