What is a stroke?
A stroke is a brain attack. It is a sudden interruption of continuous blood flow to the brain. A stroke occurs when a blood vessel in the brain becomes blocked or narrowed, or when a blood vessel bursts and spills blood into the brain. This is a medical emergency and just like a heart attack, a stroke requires immediate medical attention.
Signs and symptoms for a Stroke
Stroke warning signs are clues which the body sends when the brain is not receiving enough oxygen. The key to recognizing stroke symptoms is that they appear suddenly, if one or more of the following symptoms occurs:
- Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body.
- Sudden loss of vision or trouble seeing in one or both eyes.
- Sudden confusion, trouble speaking or understanding.
- Sudden unusually severe headache with no known cause.
- Sudden trouble walking, dizziness, loss of balance or coordination.
Types of Strokes:
The main types of stroke include:
- Ischaemic Stroke: This type of stroke is the most common. It’s caused when the brain is starved of blood & oxygen due to a blood clot.
- Hemorrhagic Stroke: This type of stroke occurs when a blood vessel is damaged, resulting in an artery bleeding into the brain.
- Brain Stem Stroke: This type of stroke occurs when the base of the brain doesn’t receive blood supply. It affects your breathing and heartbeat.
- Transient Ischemic Attack: This is the mildest type of stroke. It’s normally called a “ministroke” and does not cause long-lasting damage. However, this type of stroke can be a cautionary sign of future strokes to come.
Treatments for Stroke
Treating stroke
A stroke can cause permanent damage within minutes to hours. Calling 911 immediately and arriving at the hospital in an ambulance can aid in stroke treatment and recovery.
Treatment following a stroke generally falls into three therapeutic approaches:
- Emergency medical or surgical care given immediately after a stroke to minimize the extent of injury
- Treatment to prevent a second or recurrent stroke
- Rehabilitation to improve disabilities that result from stroke
Treatment for ischemic stroke or a transient ischemic attack may include medicines and medical procedures. Treatment for hemorrhagic stroke involves finding and controlling the cause of bleeding. Remarkable progress has been made in acute stroke therapy, especially with stenting and devices for clot removal to restore blood flow in brain arteries.
Conditions and Treatments related to Stroke
Ischemic strokes – common medications for treating Ischemic stroke may include like aspirin and warfarin.
Surgical and endovascular procedures – Brain blood vessels can be accessed by inserting catheters into large arteries in the leg and threaded into the brain blood vessels (also known as catheter angiography) which is used to treat vascular abnormalities that cause stroke.
Carotid endarterectomy – involves surgical removal of obstructing plaque from the inside of a carotid artery which widens the artery. The carotid arteries, located in the neck, are the main suppliers of blood to the brain.
Stenting – involves inserting a catheter with a wire inside of it into the diseased artery and then passing a tube-shaped device made of a mesh-like material over the wire. The stent is compressed until it is threaded it into position, where it is then expanded to widen the artery and flatten the obstructing atherosclerotic plaque.
Clot removal– To obtain reperfusion (normal blood flow) in patients suffering from clot, specially trained neuro interventionalists thread a catheter (a thin, flexible tube) through the artery to the site of the blockage and use a variety of devices to open the artery. A corkscrew-like device extends from the tip of a catheter and is used to grab the clot and pull it out.
Hemorrhagic stroke – Treatment for hemorrhagic stroke involves finding the source of the blood leak and controlling it. Hemorrhagic strokes get worse with thrombolytic medications, making it important to determine the major stroke type before starting emergency treatment.
Aneurysmal subarachnoid hemorrhage – Bleeding from a ruptured cerebral aneurysm (subarachnoid hemorrhage) can cause a severe headache that comes with a split-second onset. It may cause immediate loss of consciousness, but some people only experience the thunderclap headache. Survivors are at high risk for re-rupture of an aneurysm, so they desperately need emergency care. It is critically important to treat an aneurysm that has ruptured as recurrent bleeding is almost always fatal. One such surgical procedure for treating brain aneurysms is a technique called “clipping.” Clipping involves an operation where an experienced neurosurgeon places a clamp on the aneurysm neck to prevent the chance that it will burst, often providing a cure.
Endovascular embolization -The endovascular coil technique (also known as endovascular embolization) treats high-risk cerebral aneurysms. A small detachable platinum coil is inserted through an artery in the thigh and threaded through the vessel to the site of the aneurysm. The coil is then released into the aneurysm, where it triggers clotting and an immune response from the body. This immune response strengthens the artery walls and reduces the risk of rupture.
Intracerebral hemorrhage – The most common hemorrhagic stroke subtype is intracerebral hemorrhage (ICH), which is caused by years of high blood pressure that weakens a small artery in deep brain regions. Providing Intensive care medical treatment of hydrocephalus and brain edema (swelling) is critical in the acute period and during rehabilitation.
Arteriovenous malformations (AVMs) – Intracerebral hemorrhage also may result from an arteriovenous malformation that bleeds. Arteriovenous malformations (AVMs) are abnormal, snarled tangles of blood vessels that cause multiple irregular connections between the arteries and veins. Treatment for an AVM may include conventional surgery to remove the AVM; endovascular embolization using detachable coils, tiny balloons, or fast-drying glue to block blood flow into the AVM; and radiosurgery, in which a highly focused beam of radiation is aimed directly on the AVM and causes scarring of the walls of the AVM’s blood vessels.
Cavernous angiomas are malformations that appear as small grape-like lakes of blood without obvious feeding blood vessels. They leak to cause small hemorrhages. Surgery is an option if these angiomas cause recurrent bleeding and their location is accessible to the neurosurgeon. • Clots in the brain’s venous drainage system also can cause intracerebral hemorrhage as well as edema. They are treated with careful anticoagulation and occasionally with devices to remove clots from the veins.
Rehabilitation – Rehabilitation is vital to stroke recovery. Some of the methods of rehabilitation would include
Physical therapy – Physical Therapy is the main form of rehabilitation for most people with stroke. The aim of physical therapy is to help people relearn simple motor activities such as walking, sitting, standing, lying down, and the process of switching from one type of movement to another.
Occupational therapy – helps people relearn the skills needed to perform everyday activities such as eating, drinking and swallowing, dressing, bathing, cooking, reading and writing, and toileting. This type also involves exercise and training. Occupational therapists can recommend home or workplace modifications to better help the person resume living an independent or semi-independent lifestyle.
Speech therapy – helps people with stroke relearn language and speaking skills or learn other forms of communication. Speech therapy is appropriate for people who have no problems with cognition or thinking but have problems understanding speech or written words, or problems forming speech. Speech therapy also helps people develop coping skills to deal with the frustration of not being able to communicate fully.
Vocational therapy – helps people return to the workforce. Approximately one-fourth of all strokes occur in people between the ages of 45 and 65. It may involve relearning the more complex skills that were performed on the job or learning new skills for a different job.
Psychological or psychiatric therapy – can assist many people as they recuperate from stroke. Depression, anxiety, frustration, and anger are common disabilities in people with stroke.