A stroke, sometimes called brain seizure, occurs when the blood supply to the part of the brain is blocked or when a blood vessel burst into the brain.
It reduces the oxygen and nutrients in the brain tissue and then within a few minutes, the brain cells begin to die. In both these cases some parts of the brain are damaged or die. Stroke can lead to permanent brain damage, long-term disability, or even death.
Stroke is a medical emergency, in which immediate treatment is important. Immediate treatment and early action can reduce brain damage and potential risk of complications.
According to WHO:
In the world wide, cerebrovascular accidents are the second leading cause of death and the third leading cause of disability.
According to research study :
Stroke is one of the leading causes of death and disability in India.
The estimated adjusted prevalence rate of stroke range, 84-262/100,000 in rural and 334-424/100,000 in urban areas. The incidence rate is 119-145/100,000 based on the recent population based studies.
Stroke also known as cardiovascular accident (CVA) is a disruption in cerebral perfusion causing neurological deficit.
Types of strokes:
Thrombotic ischemic stroke:
When cerebral arteries blocked by blood clot.
Embolic stroke :
Impaired cerebral perfusion due to embolism, vasospasm or atherosclerotic plaque.
Due to ruptured or leaking aneurysm, intravenous malformation, bleeding disorder, arterial rupture or trauma.
Sign and symptoms of stroke /CVA:
Sign and symptoms depends on the affected artery and severity of damage.
•carotid artery :
Bruits over carotid artery,
Altered LOC (level of consciousness),
•anterior cerebral artery :
Impaired sensory and motor function,
Loss of coordination,
•middle cerebral artery :
Aphasia (inability to comprehend or formulate language),
( difficulty in writing example :child like hand writing) ,
Dyslexia ( difficulty in reading) ,
Dysphagia:(difficulty in swallowing food or liquid),
Visual fields cuts.
Posterior cerebral arteries :
Paralysis usually absent,
Cortical blindness and
Visual field cuts.
If you experience any of the above stroke symptoms, you should seek immediate treatment. Stroke can be fatal so don’t neglect it.
Think about “Fast” (FAST) and do the following:
FACE (face) : Ask the person to smile and see if the face is tilted to one side.
ARMS (left) :Speak to raise both hands, does one hand fall down? Or unable to raise a hand?
SPEECH :Ask a person to repeat a simple phrase. Do you feel asymmetry in his speech such as slowness or ambiguity.
Ask a person about time :like, what time? If unable to answer?
If you see or feel any of these signs, go to the doctor immediately.
Causes of stroke /CVA:
Stroke occurs when the blood supply to your brain is disrupted or reduced. It deprives your brain of oxygen and nutrients, destroying your brain cells.
Stroke may be due to blocked artery (ischemic stroke) Or
may be due to rupture or tearing of the blood vessel (hemorrhagic stroke)
For some people this can only be due to the temporary disruption of blood flow to their brain (transient ischemic attack or TIA).
Diagnosis of stroke /CVA:
Your doctor may use a number of tests to determine the stroke, including:
Physical Examination :
Your doctor will ask you
a member of your family .
what your symptoms have been,
when you started .
evaluate whether these symptoms still exist.
want to know what medicine you take and have you ever suffered any head injury. asked about your personal and family history of heart disease, transient ischemic attack or stroke.
check your blood pressure and listen to your heart and the air-sensing sound (BRT) on your neck (carotid) arteries, which indicates atherosclerosis; Will use a stethoscope.
use an eye structure to check for signs of small cholesterol crystals or clots in the blood vessels behind your eyes.
Blood tests :
You may have several blood tests, which will tell your doctor how quickly your blood clots are formed, how high or low your blood sugar level is, the important chemicals in the blood are out of balance. , Or if you may be infected. Taking care of and managing the time and sugar levels and other important chemicals in your blood clots helps to prevent your stroke.
Computerized tomography (CT) scan :
CT scan uses a series of X-rays to create a detailed image of your brain. CT scan can show bleeding, tumor, stroke and other conditions.
Magnetic Resonance Imagine :
MRI uses powerful radio waves and magnets to create a detailed view of your brain. MRI can detect brain tissue damaged by ischemic stroke and brain bleeding. Your doctor may use a dye (magnetic resonance angiography, or magnetic resonance map) in a blood vessel to see the arteries, nerves, and blood flow.
Carotid ultrasound :
In this test, a detailed picture of the inside of the carotid arteries is shown through the sound wave. This test shows the flow of blood into fatty deposits and into your carotid arteries.
Treatment of stroke :
Anticoagulant are contraindicated in patient with hemorrhagic shock but useful in nonhemorrhagic shock.
•Anticonvulsant :to prevent seizure.
•Analgesic :to relief pain.
•surgical evacuation of clot or hematoma.
•carotid endarterectomy to remove plaque.
Prevention of stroke :
You can prevent stroke by
1.reducing the amount of cholesterol and saturated fat in your diet.
Cholesterol and fats, especially saturated fats and trans fats, increase fatty coagulation (plaque) in your arteries. If you cannot control your cholesterol and fat levels with diet, your doctor may prescribe medicines.
2.avoid smoking and tobacco chewing Using tobacco and smoking increases the risk of stroke. Even for those who indirectly carry harmful .
3. Control diabetes.
You can control of diabetes with diet, exercise, weight control and medication.
4. Maintaining a healthy weight is essential. Overweight are at risk of other strokes, such as hypertension, heart disease and diabetes.
5.Eating a diet rich in fruits and vegetables daily reduces the risk of stroke. Then eat a Mediterranean diet that contains olive oil, fruits, nuts or pods, vegetables and whole grains.
6.Exercising regularly like aerobic or “cardio” exercises can reduce the risk of stroke in several ways.
Exercise can lower your blood pressure, increase high-density lipoprotein cholesterol levels, and improve the overall health of your blood vessels and heart.
It also helps you lose weight, control diabetes and reduce stress. Slowly exercise for up to 30 minutes of activity –
such as walking, jogging, swimming or cycling, if not daily, then do most of the day.
7.Drinking more alcohol increases the risk of stroke.
Even if you drink it,drink less. Drinking more alcohol increases the risk of hypertension, ischemic stroke and hemorrhagic stroke.
However, drinking less alcohol, such as one drink a day, can help prevent ischemic strokes and reduce your blood clotting tendency. Alcohol can also cause side effects to other medicines you are taking.
8.Take rest or sleep properly.
Resistant sleep apnea obstructive sleep apnea (OSA) – Your doctor will examine you to see if it is you and treat it immediately if found.
9.Avoid illicit drugs such as cocaine and methamphetamine, as these are the determining risk factors for TIA or stroke. Cocaine reduces blood flow and can thin the arteries.