Stroke: Know the Basics 

Our brain is the most remarkable and complex organ of our body which is vital for its survival. It acts as a control system that manages everything that happens in our body, from the movement of our toes to how fast our heart beats. That's why a healthy brain is necessary for our overall health. The most damaging thing that can affect your brain is a stroke. It can harm the connection between the brain and your body. It may cause sudden death or a long-term disability. According to WHO, it is the second biggest reason of death worldwide. Knowing early about the warning signs and symptoms of strokes will help you to quickly respond at the time of emergency and save you or someone you love from long-term physical and mental harm or even death. In this article, we try to provide you with all the basic information regarding strokes including their causes, types, symptoms, recovery, and prevention. If you want to know more about this fatal condition then please read on.

What is a Stroke?

Strokes which are also known as cerebrovascular accidents (CVA) happen due to the cessation or interruption of blood supply to the part of the brain. It is either due to blockage or rupture of the blood vessels. As a result, the brain tissues become deprived of oxygen and other important nutrients and this may cause damage or death of the brain cells. The consequences of stroke on your body depend upon the area of the brain that is affected and how much damage occurs to the brain tissues. It can cause lifelong brain damage, some sort of disability, or even death.

What are the Causes of Stroke?

There are many contributing factors that can lead to stroke. Some risk factors can be prevented by adopting healthy lifestyle changes or taking proper treatment while others are unchangeable.

Risk factors that can be managed are:

High Blood Pressure

Elevated blood pressure puts your blood vessels all over the body including your brain under continuous strain which damages them. It increases their risk to burst or chock which ultimately leads to a stroke. 

Diabetes

High blood sugar levels in diabetes harm your blood vessels. It builds up fatty deposits into them (atherosclerosis) and makes them stiff. This can lead to blood clot formation and if this clot reaches the brain it can cause a stroke.

Heart Diseases

Heart disorders, such as coronary artery disease increase the risk of stroke as it builds up plaques in the arteries. Other heart conditions including valve defects, irregular heartbeats, and cardiomyopathy can also lead to stroke as they help in developing blood clots that may break loose and cause blockage in the brain blood vessels.

High Cholesterol

Too much cholesterol leads to the build-up of plaque (fatty deposits) in your arteries which causes the thickening or narrowing of the arteries (atherosclerosis). This makes it difficult for the blood to flow and reaches the brain and increases the chances of stroke.

Smoking

Smoking increases your blood pressure and makes your blood more sticky, which makes your blood easily clot. That's why smokers have double the risk of getting affected by stroke as compared to non-smokers.

Obesity

Obesity leads to diabetes, high blood pressure, and other heart diseases. All of these complications increase the chances of stroke.

Alcohol Intake

Excessive alcohol consumption leads to high blood pressure and can cause atrial fibrillation. It also causes weight gain and can lead to uncontrolled diabetes. All of these put you at greater risk to have a stroke.

Use of illegal Drugs

Common illicit drugs also pose a serious threat to causing a stroke such as heroin, cocaine, and amphetamines. They can lead to stroke either by damaging the vital organs of the body like the heart or kidney or by striking the blood vessels in the brain.

Birth control pills

According to research birth control pills increase the risk of stroke and heart attack by increasing the chances of blood clot formation.

Risk factors that can’t be altered are:

Age:
A stroke can happen at any age. But the risk of having a stroke increases twice for each decade of life when you cross 55 years of age. 

Gender:
Stroke is more prevalent in men as compared to women but stroke results in higher numbers of death in women as compared to men.

Prior Stroke:
If you had a stroke in the past, the chances of having a second stroke are very high. 

Family History: 
The chances of being affected by stroke become higher if its run in your family history.

What are the Different Types of Stroke?

Strokes are usually classified into 3 types that people usually experience 

● Ischemic stroke

● Hemorrhagic stroke

● Transient ischemic attack (TIA)

Ischemic Stroke

The most common type of stroke is ischemic. It is estimated that about 87% of strokes are ischemic strokes. They happen due to the blockage of the blood vessels that supply the blood to the brain. Ischemic strokes are also divided into two types

Embolic stroke

If the blockage happens because of a clot that forms on other parts of the body and travels to the brain then this type of ischemic stroke is called Embolic stroke.

Thrombotic stroke

If the blockage happens because of a clot that forms in the brain blood vessels then it is known as a Thrombotic stroke. 

Hemorrhagic Stroke

A hemorrhagic stroke happens when a blood vessel in your brain starts leaking blood into the nearby brain tissues. In addition to the stroke, the leaking blood also builds up pressure in the brain tissues and causes more irritation, 

swelling, and damage. The major causes of hemorrhagic stroke are high blood pressure and aneurysms (bulge or ballooning in the blood vessels).

Transient Ischemic Attack (TIA)

A transient ischemic attack is sometimes also referred to as a“mini-stroke.” It causes the blockage of the blood flow to the brain only for a short period, usually no more than 5 minutes. But this type of stroke multiplies the chances of having a major stroke in the future.

What are the Symptoms of a Stroke?

The symptoms of stroke start to show up all of sudden without any warning. Identifying the signs and symptoms of stroke early is important so that you can take immediate action in case of an emergency.

The symptoms of the stroke are diversified and may differ from one case to another. They depend upon which area of the brain got affected and which type of stroke is either ischemic or hemorrhagic. Some possible symptoms of a stroke are

● State of Confusion

● The problem in speaking or understanding others

● vision disturbances either in one or both eyes

● Feeling numbness or weakness, particularly on one side of the body

● Not able to walk 

● Balance issues or lack of coordination 

● Severe headache without a known reason 

● Sudden nausea or vomiting

● Seizures

● Brief loss of consciousness, such as fainting or coma

The easy way to remember all the signs and symptoms of stroke is to learn the acronym BE FAST which stands for:

● Balance

A stroke can affect the balance of a person and makes them unable to walk.

● Eyes 

A stroke can affect your vision in either one or both eyes.

● Face

A stroke can paralyze one side of the face.

● Arm

A stroke can cause numbness or weakness in one arm and make the person incapable of lifting the arm.

● Speech

A stroke can disturb the person's ability to speak. The person may have slurred speech or be unable to speak.

● Time 

It means when you notice all the above symptoms it's time to take immediate action and call for medical help.

What is the Treatment for Stroke?

The type of stroke will determine what type of treatment should be given to the patient. For example in the case of ischemic stroke and TIA where the stroke is caused by a blockage, the treatment will be focused on breaking up the blockage caused by the clot. Whereas in the case of the hemorrhagic stroke where bleeding is the reason for stroke the main focus of the treatment is to stop the bleeding by making your blood clot.

Ischemic Stroke and TIA Stroke

Ischemic stroke and TIA are usually treated with similar methods which include:

Medications
Anticoagulant drugs: Thrombolytic drugs are used for decreasing the damaging impact of stroke on your brain by dissolving the blood clots in your brain’s arteries. The most commonly used anticoagulant drug in ischemic stroke treatment is the Tissue plasminogen activator (tPA), or Alteplase IV r-tPA. It is considered the best choice in the treatment of ischemic stroke as it gives a quick response by rapidly breaking up the blood clots.

Medical Procedures 
Thrombectomy: It is a minimally invasive procedure in which a catheter is inserted into a large artery of your brain and then the blood clot is removed with the help of a device or through suction. This procedure is only helpful if the blockage happens in a large artery of the brain and is most effective if performed immediately after the stroke usually within 6 to 24 hours.

Brain Stents: Intracranial stents are revolutionary treatments in which tiny mesh tubes are permanently implanted into the brain to open clogged arteries and improve blood flow to the brain. This procedure shows amazing results in improving the condition of stroke patients.

Hemorrhagic Stroke
Treatments options for hemorrhagic stroke include:

Medications
In hemorrhagic stroke instead of giving blood thinners, those medications will be prescribed which reduces the effect of any blood thinner you already have taken. Other drugs may also be given to control blood pressure, reduce intracranial pressure, and prevent seizures.

Medical Procedures 
Endovascular Coiling: It is a procedure in which a coil-like device that is soft and flexible is inserted into the aneurysm via a catheter to seal the aneurysm and stop the bleeding.

Clamping: Clamping is another method in which a tiny clip is placed at the base of an aneurysm that either has not started to bleed yet or has already stopped bleeding. This procedure shows amazing results in preventing any new bleeding in the future.

Brain Surgery:

A craniotomy sometimes may be required after a large stroke. It is a surgical procedure in which a small portion of the skull bone is removed to reduce the pressure on the brain caused by bleeding or swelling.

What is the Recovery Period after a Stroke?

Recovery time after a stroke is not the same for everyone and depends upon the nature of the case. Some people recover in a short period whereas some people require long-term support. Some people recover completely whereas some people are left with lifelong disabilities.

Rehabilitation programs will help in the recovery process and usually start in the hospital after the patient's condition is stabilized. How long rehabilitation programs go on depends upon the recovery of the patient and may take months or even years. Which method or therapy of rehabilitation program is used depends upon the area of the brain that is affected by the stroke and the severity of the damage. The different types of therapies are

Speech Therapy

After a stroke, some patients suffer from aphasia which is difficulty in communication. They have problems speaking as well as understanding what others are saying. Speech therapists help them in gaining their ability to communicate again with the help of different exercises including reading, writing, and repeating words again and again.

Physiotherapy

 
Paralysis and loss of movement in one side of the body are common after a stroke. Physiotherapy helps stroke survivors to regain the strength of their muscles and revive their movement and coordination skills through different exercises.

Occupational Therapy 

Occupational therapy helps the stroke survivor to live independently once again by relearning normal levels of daily activities such as bathing, dressing, eating, etc. 

Psychological Counseling

Some patients suffer from anxiety, depression, or anger after a stroke. It is either because of the chemical changes happening in the brain or due to the physical disabilities they have to face after a stroke. It is important to address these issues through proper Psychological Counseling to improve their mental stability.

How to Prevent a stroke?

Taking some preventive measures in advance is always better than curing the disease. In case of stroke adopting certain healthy changes in your lifestyle can significantly lower your risk for stroke which includes:

● Maintain a healthy weight

● Eating healthy food

● Getting physical activity or a moderate amount of exercise daily 

● Keep your blood pressure under control 

● Manage your blood sugar level and cholesterol level and try to keep them under the normal range

● Quit smoking 

Conclusion 

A stroke is a medical emergency that requires immediate medical intervention. Providing early treatment can minimize brain damage and possible complications. Along with medical intervention, rehabilitation programs are also required for the complete recovery of the patient. Although a stroke cannot be prevented permanently but adopting a healthy lifestyle can reduce your chances of having a stroke significantly.

By: Dur-e-Sameen