Stroke

Stroke or brain attack, the second major cause of death in people after 60 years of age and afflicting over 17 lakh in India annually, is preventable and treatable, according to an expert. "Stroke kills more people than malaria, tuberculosis and AIDS together. In 80 per cent of cases, the cause is high blood pressure and hypertension, which needs to be controlled to a permissible level.

• A stroke occurs when the blood supply to part of brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. Within minutes, brain cells begin to die.
• A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.

Every six seconds, someone somewhere will die from stroke and one in six persons will suffer a stroke in their lifetime.

Symptoms

Watch for these signs and symptoms if think someone else may be having a stroke. Note when signs and symptoms begin, because the length of time they have been present may guide treatment decisions.

• Trouble with walking: Experience sudden dizziness, loss of balance or loss of coordination.
• Trouble with speaking and understanding: Experience confusion. Slurring words or be unable to find the right words to explain what is happening to you (aphasia). Try to repeat a simple sentence. May be having a stroke.
• Paralysis or numbness on one side of your body or face: Develop sudden numbness, weakness or paralysis on one side of body. Try to raise both arms over head at the same time. If one arm begins to fall, may be having a stroke. Similarly, one side of mouth may droop when try to smile.
• Trouble with seeing in one or both eyes: May suddenly have blurred or blackened vision, or may see double.
• Headache: A sudden, severe "bolt out of the blue" headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate having a stroke.

If notice any signs or symptoms of a stroke, even if they seem to fluctuate or disappear. Call 108 or your local emergency number right away. Every minute counts. Don't wait to see if symptoms go away.

The longer a stroke goes untreated, the greater the potential for brain damage and disability. To maximize the effectiveness of evaluation and treatment, its best get in to the emergency room within 60 minutes of first symptoms.

• If suspect someone is having a stroke, watch the person carefully while waiting for emergency assistance.
• Need to Begin mouth-to-mouth resuscitation if the person stops breathing
• Turn the person's head to the side if vomiting occurs, which can prevent choking
• Keep the person away from eating or drinking
• There are two chief types of stroke.
• The most common type — ischemic stroke — results from blockage in an artery.
• The other type — hemorrhagic stroke — occurs when a blood vessel leaks or bursts.

A transient ischemic attack (TIA) — sometimes called a mini stroke — temporarily disrupts blood flow through brain.

Ischemic stroke

Almost 90 percent of strokes are ischemic strokes. They occur when the arteries to brain are narrowed or blocked, causing severely reduced blood flow (ischemia). Lack of blood flow deprives brain cells of oxygen and nutrients, and cells may begin to die within minutes. The most common ischemic strokes are:

Thrombotic stroke

This type of stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to brain. A clot usually forms in areas damaged by atherosclerosis — a disease in which the arteries are clogged by fatty deposits (plaques). This process can occur within one of the two carotid arteries of neck that carry blood to brain, as well as in other arteries of the neck or brain.

Embolic stroke

An embolic stroke occurs when a blood clot or other debris forms in a blood vessel away from brain — commonly in heart — and is swept through bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus. It's often caused by irregular beating in the heart's two upper chambers (atrial fibrillation). This abnormal heart rhythm can lead to pooling of blood in the heart and the formation of blood clots that travel elsewhere in the body.

Hemorrhagic stroke

Hemorrhage is the medical term for bleeding. Hemorrhagic stroke occurs when a blood vessel in brain leaks or ruptures. Brain hemorrhages can result from a number of conditions that affect blood vessels, including uncontrolled high blood pressure (hypertension) and weak spots in your blood vessel walls (aneurysms). A less common cause of hemorrhage is the rupture of an arteriovenous malformation (AVM) — an abnormal tangle of thin-walled blood vessels, present at birth. There are two types of hemorrhagic stroke:

Intracerebral hemorrhage

In this type of stroke, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging cells. Brain cells beyond the leak are deprived of blood and are also damaged. High blood pressure is the most common cause of this type of hemorrhagic stroke. Over time, high blood pressure can cause small arteries inside brain to become brittle and susceptible to cracking and rupture.

Subarachnoid hemorrhage

In this type of stroke, bleeding starts in an artery on or near the surface of the brain and spills into the space between the surface of brain and your skull. This bleeding is often signaled by a sudden, severe "thunderclap" headache. This type of stroke is commonly caused by the rupture of an aneurysm, which can develop with age or be present from birth. After the hemorrhage, the blood vessels in brain may widen and narrow erratically (causing brain cell damage by further limiting blood flow to parts of brain.

Transient ischemic attack (TIA)

A transient ischemic attack (TIA) — sometimes called a mini stroke — is a brief episode of symptoms similar to those of a stroke. The cause of a transient ischemic attack is a temporary decrease in blood supply to the part of brain. Many TIAs last less than five minutes.

Seek emergency care even if symptoms seem to clear up. TIA, it means there's likely a partially blocked or narrowed artery leading to brain, putting at a greater risk of a full-blown stroke that could cause permanent damage later. And it's not possible to tell if having a stroke or a TIA based only on your symptoms. Up to half of those whose symptoms appear to go away are actually having a stroke that's causing brain damage. Many factors can increase your risk of a stroke. A number of these factors can also increase your chances of having a heart attack.

Stroke risk factors

Personal or family history of stroke, heart attack or TIA.

• Being age 55 or older.
• High blood pressure — risk of stroke begins to increase at blood pressure readings higher than 115/75 millimeters of mercury (mm Hg). Your doctor will help you decide on a target blood pressure based on your age, whether you have diabetes and other factors.
• High cholesterol — a total cholesterol level above 200 milligrams per deciliter (mg/dL), or 5.2 mill moles per liter (mmol/L).
• Cigarette smoking or exposure to secondhand smoke.
• Diabetes.
• Being overweight (body mass index of 25 to 29) or obese (body mass index of 30 or higher).
• Physical inactivity.
• Cardiovascular disease, including heart failure, a heart defect, heart infection, or abnormal heart rhythm.
• Use of birth control pills or hormone therapies that include estrogen.
• Heavy or binge drinking.
• Use of illicit drugs such as cocaine and methamphetamines.

Because the risk of stroke increases with age, and women tend to live longer than men, more women than men have strokes and die of them each year. Blacks are more likely to have strokes than are people of other races.

Complications

A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain suffers a lack of blood flow and which part was affected. Complications may include:

• Paralysis or loss of muscle movement: Sometimes a lack of blood flow to the brain can cause a person to become paralyzed on one side of the body, or lose control of certain muscles, such as those on one side of the face. With physical therapy, you may see improvement in muscle movement or paralysis.
• Difficulty talking or swallowing: A stroke may cause a person to have less control over the way the muscles in the mouth and throat move, making it difficult to talk, swallow or eat. A person may also have a hard time speaking because a stroke has caused aphasia, a condition in which a person has difficulty expressing thoughts through language. Therapy with a speech and language pathologist may improve this disability.
• Memory loss or trouble with understanding: It's common that people who've had a stroke experience some memory loss. Others may develop difficulty making judgments, reasoning and understanding concepts. These complications may improve with rehabilitation therapies.
• Pain: Some people who have a stroke may have pain, numbness or other strange sensations in parts of their bodies affected by stroke. For example, if a stroke causes to lose feeling in left arm develop an uncomfortable tingling sensation in that arm. , sensitive to temperature changes, especially extreme cold. This is called central stroke pain or central pain syndrome (CPS). This complication generally develops several weeks after a stroke, and it may improve as more time passes. But because the pain is caused by a problem in the brain instead of a physical injury, there are few medications to treat CPS.
• Changes in behavior and self-care: People who have a stroke may become more withdrawn and less social or more impulsive. They may lose the ability to care for them and may need a caretaker to help them with their grooming needs and daily chores.

As with any brain injury, the success of treating these complications will vary from person to person.

Source : Portal Content Team