What is Stroke

A stroke is a condition in which blood stops flowing to a part of the brain.
This causes damage to brain cells.
The symptoms/ effects of a stroke depend on the part and amount of brain that is damaged.

Types of Stroke

Ischemic: This is caused by a blockage in a blood vessel that supplies blood to the brain.
The blockage can be caused by a blood clot or by build-up of plaque inside wall of the blood vessel that supplies the brain [artery].
Ischemic stroke is the commonest kind of stroke seen in India.

Hemorrhagic: This occurs when an artery in the brain breaks open.
The blood flow to that part of the brain is interrupted, and the bleeding causes damage to brain cells.

Transient ischemic attack (TIA): This occurs when a small clot that blocks an artery temporarily.
Symptoms of TIA last from few minutes to usually less than an hour.
It is sometimes called warning stroke or mini-stroke because it is an important warning that a more serious stroke may occur soon.
Strokes can be mild, moderate or severe.
Severity depends on factors such as

• Type of stroke,
• Location of brain damage,
• Extent of brain damage,
• Amount of time that the brain did not receive adequate blood flow
• Time it took for treatment to be started.

Warning signs of STROKE

Stroke symptoms occur suddenly. The commonest symptoms are :

• Facial weakness. One side of the face becomes droopy or the smile becomes crooked suddenly
• Arm weakness: Difficulty in lifting up the arm. There may be difficulty in lifting the leg or difficulty in walking.
• Speech: Difficulty with speaking, finding words, or understanding what is being said.

Other symptoms may occur, like

• Numbness of face, arm or leg on either or both sides of the body
• Dizziness, loss of balance or drunken-like walking
• Loss of vision, blurred or decreased vision in one or both eyes, double vision
• Sudden memory loss or confusion
• Sudden onset of severe headache, with nausea/vomiting

Can I recognize a Stroke

Yes, the symptoms of stroke can be recognized by remembering the commonest symptoms.

Remember

• Symptoms occur suddenly.
• Stroke is an emergency.

You can recognize stroke by familiarizing yourself with any of these acronyms:

FAST

F- Face : is it drooping

A-Arms: can you raise both

S-Speech: is it slurred or is the person unable to speak

T-Time: don’t waste time. Seek immediate specialist care

BE-FAST

Treatment of Stroke

This involves

(a) Immediate Therapy

(b) Prevention

(c) Rehabilitation

Immediate Therapy

Ischemic Stroke:

Treatment for stroke is very time-dependent.

It is important that your reach a hospital AS SOON AS POSSIBLE once stroke symptoms occur.

Clots can be removed in two ways

• A clot-busting medication can be given to dissolve the clot, but only if you are at the hospital within 3 hours (upto4.5 hours for some patients) of onset of your symptoms.
• Clot can be removed by sucking it out through a catheter inserted via a blood vessel in your arm or leg. This can be done if your reach the hospital before the brain cells have died, which can be from few to several hours.

Treatment is based upon whether there are brain cells that can be saved- and this depends to a large degree on how early you reach the hospital.

Hemorrhagic Stroke:

Type of stroke cannot be recognized without a scan of your brain.

Symptoms of ischemic stroke and hemorrhagic stroke are similar. Therefore- it is important that you reach the hospital as soon as possible.

Treatment of hemorrhage involves early control of blood pressure to reduce the bleeding.

If the bleeding is very large, surgery may be required to avoid pressure on the normal part of brain.

Resources

Links to Resources

• https://www.world-stroke.org/
• https://www.stroke.org/
• https://www.heartandstroke.ca/
• https://www.stroke.org.uk/
• https://strokefoundation.org.au/
• http://www.snsa.org.sg/
• https://clinicaltrials.gov/search/term=Stroke

Stroke Risk Calculators

• http://www.cvriskcalculator.com/
• https://www.world-stroke.org/stroke-riskometer
• https://my.clevelandclinic.org/departments/neurological/depts/cerebrovascular/stroke-risk-calculator
• https://www.uclahealth.org/stroke/stroke-risk-calculator