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Magazine
HEALTH WATCH
Attack on the brain
STROKE is the second most common cause of death and major disability worldwide. It is the result of cerebrovascular disease or a disease of the blood vessels in the brain. There are two types. Ischemic stroke is the most common. This happens when there is a sudden lack of blood flow to some part of the brain, usually due to a blood clot blocking an artery or blood vessel. About 80 per cent of all strokes are ischemic.
Haemorrhagic stroke is bleeding in the brain from a broken or leaking blood vessel. A haemorrhagic stroke may be due to an aneurysm — a thin or weak spot in an artery that balloons out and can burst. About 20 per cent of strokes are hemorrhagic. Either type can cause brain cells to die. Like a heart attack, a stroke is an emergency and should be treated as quickly as possible.
Stroke is diagnosed through several techniques: a short neurological examination, blood tests, CT scans, MRI scans, Doppler ultrasound, and arteriography.
A "mini-stroke" refers to a transient ischemic attack (TIA). In a TIA, there is a short-term reduction in blood flow to the brain. This causes temporary stroke symptoms (often just for a few minutes) such as weakness or tingling in an arm or leg. TIAs don't cause brain damage, but they are important warning signs. If you have a TIA, you should seek medical care right away to prevent a full stroke.
Stroke risks are higher in people who have: High blood pressure, heart disease, diabetes and high cholesterol. Other risks include heavy alcohol consumption, smoking, illicit drug use, and genetic or congenital conditions. Some risk factors apply only to women. Primary among these are pregnancy, childbirth, and menopause.
Not everyone gets all the following warning signs. Sometimes these signs go away and return. Treatments are most effective if given within an hour of the beginning of the attack. The warning symptoms are:
Sudden numbness or weakness of face, arm, or leg, especially on one side of the body.
Sudden confusion or trouble speaking or understanding speech.
Sudden trouble walking, dizziness, or loss of balance or coordination.
Sudden severe headache with no known cause.
Blurred or double vision, drowsiness, and nausea or vomiting.
Generally, there are three treatment stages for stroke: Prevention, therapy immediately after stroke and post-stroke rehabilitation.
The best ways to prevent a stroke are:
Eat a healthy diet low in saturated fat and rich in fruits, vegetables, and whole grains. Don't overeat, and keep your weight under control.
Get regular exercise (30 minutes a day, most days of the week, or more).
Find ways to manage stress in your life.
If you have high blood pressure, take your blood pressure medicine as prescribed by your doctor.
If your cholesterol level is too high, talk to doctor about ways to lower it.
Stop smoking.
If you have heart disease or diabetes, take good care of yourself. See your doctor and take your medicine as prescribed.
Get help if you have a TIA. Talk to your doctor to see if you need medicine or surgery.
Aspirin therapy may be useful, but check with your doctor before starting to take aspirin on a daily basis.
Strokes caused by blood clots can be treated with clot-busting drugs such as tissue plasminogen activator (TPA). TPA must be given within three hours of the start of a stroke to be effective, and tests must be done first. This is why it is so important for a person having a stroke to get to a hospital fast. Other medicines are used to treat and to prevent stroke. Anticoagulants and antiplatelet agents such as aspirin interfere with the blood's ability to clot and can play an important role in preventing stroke.
Surgery is sometimes used to treat or prevent stroke. For example, carotid endarterectomy is the surgical removal of fatty deposits clogging the carotid artery in the neck that could lead to a stroke. For haemorrhagic stroke, surgical treatment may include placing a metal clip at the base of an aneurysm or removing abnormal blood vessels.
Rehabilitation is a very important part of recovery for many survivors. The effects of stroke may mean that you must change, relearn or redefine how you live. Stroke rehabilitation is designed to help you return to independent living. Rehabilitation doesn't reverse the effects of a stroke. Its goals are to build your strength, capability and confidence so you can continue your daily activities despite the effects of your stroke. Rehabilitation services may include:
Physical therapy to restore movement, balance and coordination; Occupational therapy to relearn basic skills such as bathing and dressing oneself; and Speech therapy
A person who has a stroke may suffer little or no brain damage and disability, especially if treated promptly. But it can lead to severe brain damage and disability, or even death. The type of disability depends on the extent of brain damage and what part of the brain is damaged. Stroke may cause paralysis or weakness of one side the of the body, memory problems, mood changes, trouble speaking or understanding speech, problems with eating and swallowing, pain and depression. Rehabilitation and medical treatment can help a person recover from the effects of stroke and prevent another stroke from occurring.
A stroke is a medical emergency. Every minute counts when someone is having a stroke. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save people's lives and enhance their chances for successful recovery.
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