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STROKE – Cause & Management


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.




There are three main types of stroke:

  • Ischemic stroke: This is the most common type of stroke, making up 87% of all cases. A blood clot prevents blood and oxygen from reaching an area of the brain.

  • Hemorrhagic stroke: This occurs when a blood vessel ruptures. These are usually the result of aneurysms or arteriovenous malformations (AVMs).

  • Transient ischemic attack (TIA): This occurs when blood flow to a part of the brain is inadequate for a brief period of time. Normal blood flow resumes after a short amount of time, and the symptoms resolve without treatment. Some people call this a ministroke.

Causes and risk factors

Each type of stroke has a different set of potential causes. Generally, however, stroke is more likely to affect a person if they:

  • have overweight or obesity

  • are 55 years of age or older

  • have a personal or family history of stroke

  • have high blood pressure

  • have diabetes

  • have high cholesterol

  • have heart disease, carotid artery disease, or another vascular disease

  • are sedentary

  • consume alcohol excessively

  • smoke

  • use illicit drugs

Symptoms

The symptoms of a stroke often appear without warning. Some of the main symptoms include:

  • confusion, including difficulty speaking and understanding speech

  • a headache, possibly with altered consciousness or vomiting

  • numbness or an inability to move parts of the face, arm, or leg, particularly on one side of the body

  • vision problems in one or both eyes

  • difficulty walking, including dizziness and a lack of coordination

Stroke can lead to long-term health problems. Depending on the speed of the diagnosis and treatment, a person can experience temporary or permanent disabilities after a stroke.

Some people may also experience:

  • bladder or bowel control problems

  • depression

  • paralysis or weakness on one or both sides of the body

  • difficulty controlling or expressing their emotions


Symptoms vary and may range in severity.

Learning the acronym “FAST” is a good way to remember the symptoms of stroke. This can help a person seek prompt treatment.:

FAST stands for

  • Face drooping: If the person tries to smile, does one side of their face droop?

  • Arm weakness: If the person tries to raise both their arms, does one arm drift downward?

  • Speech difficulty: If the person tries to repeat a simple phrase, is their speech slurred or unusual?

  • Time to act: If any of these symptoms are occurring, contact the emergency services immediately.

The outcome depends on how quickly someone receives treatment. Prompt care also means that they would be less likely to experience permanent brain damage or death.

Rehabilitation

Stroke is a potentially life changing event that can have lasting physical and emotional effects.

Successful recovery from a stroke will often involve specific therapies and support systems, including:

  • Speech therapy: This helps with problems producing or understanding speech. Practice, relaxation, and changing communication style can all make communicating easier.

  • Physical therapy: This can help a person relearn movement and coordination. It is important to stay active, even though this may be difficult at first.

  • Occupational therapy: This can help a person improve their ability to carry out daily activities, such as bathing, cooking, dressing, eating, reading, and writing.

  • Support groups: Joining a support group can help a person cope with common mental health issues that can occur after a stroke, such as depression. Many find it useful to share common experiences and exchange information.

  • Support from friends and family: Close friends and relatives should try to offer practical support and comfort after a stroke. Letting friends and family know what they can do to help is very important.

Rehabilitation is an important and ongoing part of stroke treatment. With the right assistance and the support of loved ones, regaining a normal quality of life is usually possible, depending on the severity of the stroke.

Prevention

The best way to prevent a stroke is to address the underlying causes. People can achieve this by making lifestyle changes such as:

  • eating a healthful diet

  • maintaining a moderate weight

  • exercising regularly

  • not smoking tobacco

  • avoiding alcohol, or only drinking moderately

Eating a nutritious diet means including plenty of:

  • fruits

  • vegetables

  • whole grains

  • nuts

  • seeds

  • legumes

Be sure to limit the amount of red and processed meat in the diet, as well as cholesterol and saturated fats. Also, moderate salt intake to support healthy blood pressure levels.

Other measures a person can take to help reduce the risk of stroke include:

  • controlling their blood pressure levels

  • managing diabetes

  • getting treatment for heart disease

As well as making these lifestyle changes, taking anticoagulant or antiplatelet medications can also reduce the risk of experiencing another stroke.

Undergoing cardiac artery, carotid artery, or brain aneurysm surgery can also lower the risk of additional strokes, as can some other surgical options still under investigation.


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©2021 by Dr Sanjeev Singh Chawla.

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