Stroke or “brain attack” or cerebrovascular accident (CVA) occurs when blood supply to the brain is cut off or interrupted by blood clots in an artery or a blood vessel. Arteries are bloods vessels that carry oxygenated blood from the heart to the body and blood vessels are tubes through which the blood moves through the body. Due to the interruption and disturbance in the blood supply, the cells in the brain begin to die and the brain loses control of many of the abilities and functions. Strokes usually affect only one side of a human body.

The loss of the abilities due to stroke can be either partial or whole and it also depends on the part of the brain that is affected. The most visible and prominent ability loss includes speech, facial muscles, movement of limbs and hands and memory. Stroke is one of the leading causes of death in America and the leading cause of disability among adults. Majority of the strokes are preventable and reversible with timely medical care and precautions. Patients who have an attack of stroke need immediate emergency medical help. Strokes can cause permanent neurological damage, physical disability and even death. There are many risk factors of stroke and among them high blood pressure is the leading culprit and often proves fatal.

Strokes are usually medically classified into two types ischemic and hemorrhagic. Ischemic strokes are caused by interruption or lack of blood supply whereas hemorrhagic strokes are the caused by rupture of blood vessels or an abnormal vascular structure. About 85% of the strokes are caused by ischemia. Ischemic strokes are further classified as embolic strokes and thrombotic strokes. In an embolic stroke blood clot forms in the body and reaches the brain through the bloodstream and lodges itself in a blood vessel. This type of blood clot is called embolus. In thrombotic stroke, the stroke is caused by the blockage of the arteries that supply blood to the brain. This kind of blockage is called as thrombosis and the blood clot is called as thrombus. Stroke causing thrombosis can be either large vessel thrombosis or small vessel thrombosis.

Strokes can also occur due to deposits formed by plaque, fatty substances and cholesterol. Even children can have strokes and especially children suffering from sickle cell disease are at a higher risk. Every year October 29 is marked as the world stroke day.

Symptoms

 

  • Sudden numbness on one side of the body like face, arm or leg
  • Sudden problem with speech and understanding words
  • Sudden eye trouble
  • Sudden trouble with walking, balancing, coordination and feeling dizzy
  • Sudden onset of headache with no known cause
  • Difficulty in swallowing
  • Difficulty in writing or reading
  • Memory loss and confusion

Risk factors

  • High blood pressure
  • Atrial fibrillation
  • High cholesterol levels
  • Diabetes
  • Smoking
  • Alcohol
  • Hole in the heart
  • Previous stroke
  • Brain tumors
  • Atherosclerosis
  • Meningitis
  • Encephalitis
  • Physical Inactivity
  • Obesity
  • Growth of fibrous tissue in the artery walls
  • Age
  • Family History
  • African Americans have twice the risk of stroke

Treatment:

The treatment of stroke is done either by one or combination of the ways mentioned below and then followed by a rehabilitation program that includes but not limited to physical therapy, speech therapy, and preventive methods.

  • Thrombolysis or use of thrombolytic (fibrinolytic) drugs
  • Injecting tPA enzymes within three hours of stroke
  • Neurosurgery
  • Carotid artery surgery
  • Using Merci retriever to remove clots from large vessels
  • Blood thinners
  • Anticoagulants/antiplatelets
  • Angioplasty
  • Controlling and reduction of high blood pressure
  • Blood transfusion

Diagnosis:

The diagnosis of stroke is done in many ways. Some of the important techniques are:

  • Angiogram of the head
  • Ultrasound of the carotid arteries in the neck
  • CT scan of the brain
  • Neurological examination
  • MRI scans of the brain
  • Echocardiogram (ECG) and heart rhythm monitoring
  • Magnetic resonance angiography (MRA)
  • Blood cholesterol and sugar test
  • Blood clotting tests
  • Complete blood count (CBC)