Symptoms, Causes, and Treatments of Stroke | Neurology

Stroke

What is a Stroke?

A stroke occurs when the blood supply to a part of the brain is cut off or reduced, preventing the brain tissue from receiving oxygen and nutrients. Brain cells die in minutes. It is a medical emergency and prompt treatment is very important. Proactive action reduces brain damage and other problems.

Other names

  • Brain attack
  • Cerebrovascular accident (CVA)
  • Hemorrhagic stroke (includes intracerebral hemorrhage and subarachnoid hemorrhage)
  • Ischemic stroke (includes thrombotic stroke and embolic stroke)

Signs/symptoms of stroke

  • Unexpected numbness or weakness in the face, arms, or legs, especially on one side of the body.
  • Sudden confusion, trouble speaking, or trouble understanding speech.
  • Sudden trouble seeing with one or both eyes.
  • Sudden trouble walking, loss of balance, dizziness, or lack of coordination.
  • Sudden, severe headache for no apparent reason.

Types of strokes

The treatment for stroke depends on its type. The three main types of stroke are:

  • Ischemic attack: It is one of the three types of strokes. It is also known as cerebral ischemia and cerebral ischemia. This type of attack is caused by a blockage in the artery that supplies blood to the brain. The blockage reduces blood flow and oxygen to the brain, leading to damage or death of brain cells. If circulation is not restored quickly, brain damage can be permanent.
  • Hemorrhagic attack: Hemorrhagic attack when blood from an artery begins to bleed into the brain. This occurs when weak blood vessels break and bleed into the surrounding brain. The pressure of the filtered blood damages the brain cells, and as a result, the damaged area becomes unable to function properly.
  • Transient ischemic attack (a warning or “mini-stroke”): Transient ischemic attack (TIA) is an attack that lasts only a few minutes. This occurs when the blood supply to a part of the brain is briefly blocked. Symptoms of TIA are similar to other stroke symptoms, but they don’t last long. They happen suddenly.

Causes of stroke

It can treat certain conditions for which you can have a stroke. Other things that put you at risk will not change:

Hypertension: Your doctor calls this blood pressure. If your blood pressure is usually 140/90 or higher, your doctor will discuss treatments with you.

Tobacco: Smoking or chewing can increase your chances of having a stroke. Nicotine makes your blood pressure go up. Cigarette smoke increases fat in the main cervical artery. It also makes your blood thicker and more likely to clot. Secondhand smoke can affect you too.

Heart disease: This condition includes defective heart valves, as well as atrial fibrillation or irregular heartbeat, which account for about a quarter of all strokes in most adults. You can also have arteries clogged by fatty deposits.

Diabetes: People who suffer from it tend to have high blood pressure and are overweight. Diabetes can damage your blood vessels, making you more likely to have an attack. If you have a stroke when your blood sugar levels are high, your brain injury is high.

Risk factors of stroke

Main risk factors:

  • Hypertension
  • Diabetes
  • Cardiovascular diseases- Coronary heart disease, atrial fibrillation, heart valve disease, and carotid artery disease.
  • High levels of LDL cholesterol
  • Smoking
  • Brain aneurysms or arteriovenous deformities (AVM). AVMs are malformed arteries and veins that open to the brain.
  • Inflammatory infections or conditions such as lupus or rheumatoid arthritis.
  • A stroke can occur at any age, but the risk is higher in children and adults younger than 1 year. In adults, the risk increases with age.
  • At a younger age, it is more common in women than in men. But women live longer, so the risk of stroke is higher during their lifetime. birth control pills or use hormone replacement therapy can cause a stroke. Women are also at higher risk during pregnancy and during the postpartum weeks. High blood pressure during pregnancy, due to pre-eclampsia, increases the risk of stroke later in life.
  • Race and ethnicity: It is more common in African American, Alaska Native, American Indian, and Hispanic adults than in white adults.
  • Family history and genetics: If your parents or other family members have had a stroke, you are at special risk of having a stroke at a young age. Certain genes can affect your risk of stroke, including those that determine your blood type. People with blood type AB (which is not normal) are at higher risk.

Other risk factors that can be controlled, including:

  • Anxiety, depression, and high levels of stress. Working long hours and not having much contact with friends, family, or others outside the home also increases the risk of this disease.
  • Living or working in areas with air pollution.
  • Other medical conditions such as bleeding disorders, sleep apnea, kidney disease, migraine, and sickle cell anemia.
  • Other medicines that cause blood thinning or bleeding.
  • Other unhealthy lifestyle habits such as eating unhealthy foods, not engaging in regular physical activity, drinking alcohol, sleeping too much (more than 9 hours), and using illicit drugs such as cocaine.
  • Excess weight and delays or extra weight load around the waist and abdomen.

Diagnosis of stroke

The first step in evaluating the patient is to determine whether the patient is experiencing an ischemic or hemorrhagic attack so that appropriate treatment can begin. Head CT or MRI is usually the first test done.

Physical exam: Your doctor will perform various tests, such as listening to your heart and checking your blood pressure. They will also do a neurological exam to see how a possible stroke affects your nervous system.

Blood test: You may have several blood tests, including tests to see if your blood clots quickly, if your blood sugar is too high or too low, and if you have an infection.

Computed tomography (CT): A CT scan is done to view a detailed image of your brain. The CT scan shows bleeding, ischemic attack, tumor, or other conditions in the brain. Doctors can inject a dye into the bloodstream (CT angiography) to see the blood vessels in the neck and brain in more detail.

Magnetic resonance imaging (MRI): An MRI is done to create a detailed view of your brain. MRI can detect brain tissue damaged by ischemic attack and brain hemorrhage. Your doctor may inject a dye into a blood vessel (magnetic resonance angiography or magnetic resonance venography) to view the arteries and veins and enhance blood flow.

Carotid ultrasound: This test uses sound waves to create detailed images of the inside of the carotid arteries in your neck. This test increases fatty deposits (plaques) in the carotid arteries and increases blood flow.

Cerebral angiogram: In this abnormally used test, your doctor will make a small incision, usually in the groin, inserting a thin, flexible tube (catheter) through your main arteries and into your carotid or vertebral artery. Your doctor will then inject a dye into your blood vessels and make them visible under X-ray images. This procedure provides a detailed view of your brain and the arteries in your neck.

Echocardiogram: An echocardiogram can detect the source of clots in your heart, which can travel from your heart to your brain and cause your stroke.

Treatments for stroke

Treatment is based on the type of stroke.

Ischemic stroke: Treatment for this disease focuses on the restoration of blood to the brain.

  • You can get a freeze-thaw medicine called tissue plasminogen activator (TPA). This medicine improves recovery from a stroke. Doctors try to give this medicine within 3 hours of the start of symptoms. Some people can get help if they can get this medicine within 40 hours of the first symptoms.
  • You can also get aspirin or another antiplatelet medicine.
  • In some cases, a procedure may be done to restore blood flow. The doctor uses a thin, flexible tube (catheter) and a small cage to remove the blood clot. This procedure is called a thrombectomy.

Hemorrhagic stroke: Treatment focuses on controlling bleeding, reducing stress on the brain, and stabilizing important signals, especially blood pressure.

  • To stop the bleeding, you may receive a blood transfusion, such as medicine or plasma. These are administered intravenously.
  • Look closely for signs of increased stress on the brain. These signs include restlessness, confusion, trouble following orders, and headaches. Excessive coughing, vomiting, or other measures taken to avoid lifting or crossing stools or straining to change position.
  • If the bleeding is from a ruptured brain aneurysm, surgery may be done to repair the aneurysm.
  • In some cases, medications may be given to control blood pressure, meningitis, blood sugar levels, fever, and seizures.
  • If a large amount of bleeding occurs and symptoms quickly get worse, you may need surgery. Surgery can remove the blood that collects inside the brain and reduce the pressure inside the head.

Complications of stroke

Deep vein thrombosis (DVT): If the blood is moving too slowly through your veins, it can cause a clot or a lump in the blood vessels. When blood clots in a vein, it can cause deep vein thrombosis. DVT is more likely to occur in the lower leg or thigh, but can also occur in other parts of the body. The DVT case can be fatal if the blood clots and goes to an important organ. Medications and early mobilization treatment after stroke can prevent DVT and help a person return to walking and other activities quickly.

Convulsions: It can injure the brain, resulting in scar tissue. This scar tissue interferes with the electrical activity of the brain. Interruption of electrical activity can cause seizures. Epilepsy is one of the most common complications of ischemic attack, affecting 22% of survivors.

Pneumonia: Pneumonia is a leading cause of illness and death. According to the Indiana University School of Medicine, pneumonia is the most common cause of hospitalization. In the case of a stroke, difficulty swallowing may cause aspiration, or food or fluids may enter the airways, leading to a chest infection or pneumonia.

Cerebral edema: Inflammation is part of the body’s natural response to injury. Edema refers to inflammation due to trapped fluid. If edema occurs in the brain, it can cause serious problems. Cerebral edema restricts blood supply to the brain, resulting in brain tissue death. Inflammation of the brain is one of the major complications of ischemic attack. Getting medical treatment as soon as the symptoms of a stroke are noticed reduces the chance of developing severe brain edema.

Bladder problems: There is a lot of bladder-related problems that can arise from a stroke. Often, stroke survivors have a strong urge or need to urinate frequently. When stroke survivors are unable to reach the bathroom or relieve themselves adequately because of the inability to remove clothing, this is called functional incontinence. Consequently, when a stroke survivor is unable to empty their bladder completely, this is called urinary retention. If this happens, the person will need a catheter to make sure the bladder is completely empty.

Clinical depression: Clinical depression often occurs after a major health crisis. One in four stroke survivors suffers from severe depression. Depression can cause sadness, irritability, difficulty concentrating, helplessness, apathy, changes in appetite and sleep patterns, and sometimes even suicidal thoughts. It is important to treat depression with the help of mental health providers.

Pressure sores: When the soft tissue is pressed too hard on a hard surface such as a chair or bed, the blood supply to that area decreases. This causes the skin tissue to be damaged or die. When this happens, a sore throat can occur. Prevention with pressure sores is crucial: proper positioning and appropriate equipment are needed to prevent them. Stroke survivors should discuss appropriate equipment such as air mattresses and wheelchair cushions with their physician or therapist.

Contracts: Loss of movements over time contracts due to the abnormal reduction of soft tissue structures that extend into one or more joints. These include skin, tendons, ligaments, muscles, and joint capsules. Loss of movement in any of these structures restricts joint movement, leading to pain, stiffness, and eventually a contraction. Low-load, long-term stretch is the preferred method for contracture resolution. Such a product, Cybo Stretch, uses a revolutionary stretch technique to maintain or improve movement, while at the same time reducing joint damage and pain.

Shoulder pain: 80% of patients suffer from shoulder pain. Subluxation or partial dislocation of the shoulder, spasticity of the shoulder, tendon, and rotating cuff tears are the causes of shoulder pain. Shoulder pain can be treated by proper positioning, including joint support with orthotics, as well as early occupational and/or physical therapy intervention. In some cases, if the pain becomes chronic, the doctor may prescribe oral corticosteroids.

Waterfalls and accidents: Common impairments such as imbalance, sensory impairment, weakness, visual problems, and coordination disorder naturally increase the risk of falls and accidents. Physical and occupational therapy can help reduce this risk and restore stability and lost function. Home modifications and assistive devices can be purchased to help prevent falls and accidents while performing routine daily activities.

Prevention of stroke

The best way to help prevent a stroke is to eat a healthy diet, exercise regularly, smoke, and drink heavily.

These lifestyle changes lower your risk for problems:

  • Atherosclerosis (atherosclerosis)
  • Hypertension
  • High cholesterol levels

If you already have a stroke, making these changes can lower your risk of having another stroke in the future.

Diet: Stroke with diabetes has specific health problems that must be addressed through your diet under the guidance of a doctor. In general, the dietary recommendations for stroke recovery are similar to those for diabetics. Stroke patients are often advised to focus on eating lean protein and nutrient-rich fruits and vegetables while limiting sugar, salt, and fat. Most liquid meal replacements contain large amounts of sugar, including many yogurts, puddings, and jellies, which are delicious and very bland foods. If you have a stroke and diabetes patient, watch out for these and choose sugar-free versions.

Exercise: Exercise is a valuable component that is not yet used for post-stroke care. The American Heart Association / American Stroke Association recommends that survivors recommend exercise because they experience physical degeneration and often lead a sedentary lifestyle after a stroke.

This reduces your ability to carry out activities of daily living and increases your risk of having another stroke. Heart fitness, walking ability, and upper arm strength, as well as depression, cognitive function, memory, and memory. quality of life after a stroke can be improved by physical activity.

Stop smoking: Smoking or chewing tobacco increases your chances of having a stroke. Nicotine makes your blood pressure go up. Cigarette smoke increases fat in the main cervical artery. It also makes your blood thicker and more likely to clot. Secondhand smoke can affect it too.

Alcohol: Alcoholic beverages are high in calories and have no nutritional value. Reducing the amount of alcohol you drink can help you achieve and maintain a healthy weight.

Cut down on alcohol: Excessive alcohol consumption contributes to many risk factors for stroke. If you already have a stroke or transient ischemic attack (TIA), drinking only safe alcohol can help lower your risk of having another stroke.

High blood pressure: It is a major risk factor for stroke, and drinking too much alcohol can increase your blood pressure. Atrial fibrillation, a type of irregular heartbeat, is triggered by excessive alcohol consumption.

Diabetes: Being diabetic and being overweight increases your risk of having a stroke. Both risk factors are associated with excessive alcohol consumption.

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