Everything you need to know about stroke.

STROKE: SYMPTOMS, CAUSES, TREATMENT AND DIAGNOSIS 

A stroke occurs when a blockage or bleed of the blood vessels either interrupts or reduces the supply of blood to the brain. When this happens, the brain does not receive enough oxygen or nutrients, and brain cells start to die.

Stroke is a cerebrovascular disease. This means that it affects the blood vessels that feed the brain oxygen. If the brain does not receive enough oxygen, damage may start to occur.

This is a medical emergency. Although many strokes are treatable, some can lead to disability or death.

Facts

• Treatable by a medical professional
• Diagnosed by medical professional
• Often requires lab test or imaging
• Can last several years or be lifelong
• Common for ages 60 and older
• May be dangerous or life threatening
• Urgent medical attention recommended

Know More

Types of stroke:

Ischemic stroke: It refers to the neurological symptoms and signs that occur due to sudden interruption or reduction in the blood supply to a part of the brain.

• Hemorrhagic stroke: It may arise from coup and contrecoup injury during brain deceleration following head trauma, chronic hypertension which results in bleeding from small vessels, transformation of prior ischemic infarction, metastatic brain tumor like choriocarcinoma, malignant melanoma, renal cell carcinoma and bronchogenic carcinoma, blood coagulopathies, angiopathy following degenerative disease of intracranial vessels, or intake of sympathomimetic drugs like cocaine and amphetamine especially in younger individuals.

Hemorrhagic stroke is of two types – intracerebral hemorrhage, which occurs within the brain tissue, and subarachnoid hemorrhage, where the leaked blood occupies the subarachnoid space. The bleed may be small or large

• Transient ischemic attack: A transient ischemic attack (TIA) refers to transient neurological symptoms that occur due to temporary ischemia to a part of the brain.

Symptoms

As different parts of brain control different parts of the body, symptoms will depend on the part of brain affected and the extent of damage.

The main symptoms are:

• Paralysis or numbness or inability to move parts of The face, arm, or leg - particularly on one side of The body

• Confusion- including trouble with speaking

• Headache with vomiting

• Trouble seeing in one or both eyes

• Metallic taste in mouth

• Difficulty in swallowing

• Trouble in walking (impaired coordination)

• Dystonia

• Alexia

• Agnosia

Causes

COMMON

Stroke occurs when blood supply to brain is interrupted or reduced. This deprives oxygen and nutrients supplied to the brain, causing brain cells to die. Some people may experience only a temporary disruption of blood flow to the brain. Stroke may be caused by the following:

• Ischemic stroke: The obstruction to blood flow is usually due to a thrombus or an embolism within The blood vessel

• Hemorrhagic stroke: Hemorrhagic stroke is a type of stroke that follows bleeding in The brain

• Transient Ischemic attack: TIA is caused by same conditions that cause an Ischemic stroke like thrombosis, embolism, or other conditions like arterial dissection, arteries or hypercoagulable states. TIA does not leave lasting symptoms because blockage is temporary.

The risk factors include:

• Overweight

• Sedentary life

• Binge Drinking

• Diabetes

• Smoking

• High blood pressure

• High cholesterol

• Family history of stroke

• Cardiovascular diseases

• Age - people above age 55 are at higher risk

• Gender - men are at high risk of stroke than women

Diagnosis

COMMON

IN SOME CASES

IN SEVERE CASES

To determine the most appropriate treatment for stroke, an emergency team needs to evaluate the type of stroke a person is having and the areas of brain affected.

        Physical examination

Patient's symptoms, medical history, blood pressure and blood vessels at the back of the eyes are checked.

Blood test

To find out time taken for clotting of blood.
CT scan
Images of brain can show a hemorrhage, tumor, stroke or other medical conditions.
Ultrasound
To check the blood flow in the carotid arteries and to check for plaque, if any.
Magnetic resonance imaging (MRI)
MRI of brain tissue to diagnose ischemic stroke or brain hemorrhages.
Cerebral angiogram
Dyes is injected to get detailed view of brain and neck blood vessels visible under X-ray.
Echocardiogram
To check for any sources of clots that could have traveled to the brain and lead to stroke.

Treatments

Treatment is based on the type of stroke. For ischemic stroke or transient ischemic attack, medication or surgery or both can be recommended and for hemorrhagic stroke, surgery is recommended.

Complications

Stroke may lead to severe complications:

• Paralysis or loss of muscle movement: Patient may become paralyzed on one side of the body, or lose control of certain muscles, such as those on one side of face or one arm

• Difficulty in talking or swallowing

• Memory loss or thinking difficulties: It also affects thinking, making judgments, reasoning and understanding concepts

• Emotional problems: stroke survivors may develop depression

• Changes in behavior and self-care ability: Stroke survivor may become more withdrawn and less social or more impulsive. They may need help with grooming and daily chores

Prevention

Many stroke prevention strategies are the same as the strategies to prevent heart disease. In general some preventive tips for stroke patients are follows:

• Diet and healthy eating: Following a proper diet may avoid the risk of second stroke.

• Decreasing the amount of cholesterol and saturated fat in your diet.

• Controlling Diabetes

• Monitoring blood pressure: As high blood pressure exerts continuous pressure on the walls of the arteries it may lead to arterial block.

• Avoiding illicit drugs

• Exercising: Consult your doctor before starting an exercise program.

• Quit smoking and alcohol.

Questions To Ask Your Doctor

• How long should I continue the medication?

• Can I stop medication once the symptoms subside?

• How frequently should I do the follow-up check?

• What are the foods to avoid?

• When can I start going for work?

Nutrition

FOODS TO EAT

FOODS TO AVOID

Foods to eat:

• Fruits and vegetables: eat plenty of fruit and vegetables; between 5-7 servings per day

• Whole grain breads and cereals containing fiber and vitamins: They may reduce the risk of stroke

• Lean protein: Limiting the amount of cholesterol is another important step in reducing the risk of another stroke

• Choose low-fat meats or other protein

• Limit salt: Eating too much salt/sodium may cause you to retain water and raise your blood pressure

Foods to avoid:

• Heavy cholesterol foods

• foods rich in salt and sugar

• Alcohol