Stroke

Stroke

A stroke occurs when blood flow to a part of the brain is interrupted, leading to cell damage or death due to lack of oxygen and nutrients. Sometimes referred to as a "brain attack," strokes can cause lasting harm.

Causes, Incidence, and Risk Factors

The two primary types of stroke are ischemic stroke and hemorrhagic stroke.

Ischemic stroke happens when a blood vessel supplying the brain is obstructed by a clot. This blockage can occur in two ways:

- A clot forms in an already narrowed artery, termed thrombotic stroke.
- A clot breaks free from elsewhere in the body and travels to the brain, causing an embolic stroke.

Ischemic strokes are often linked to arterial blockages caused by plaque buildup.

Hemorrhagic stroke results from the rupture of a weakened blood vessel in the brain, leading to bleeding. Certain individuals may have structural defects in brain blood vessels, increasing their susceptibility to this type of stroke.

Risk factors for stroke include high blood pressure, atrial fibrillation, diabetes, family history of stroke, high cholesterol, increasing age, race (with black individuals at higher risk), and certain lifestyle factors like smoking, obesity, heavy alcohol consumption, and illicit drug use. Additionally, birth control pills may elevate the risk, particularly in women over 35 who smoke.

Symptoms

Stroke symptoms vary depending on the affected brain region and may include sudden onset of:

- Weakness or numbness on one side of the body
- Trouble speaking or understanding speech
- Vision disturbances
- Severe headache, especially if bleeding is involved
- Dizziness or loss of balance
- Difficulty swallowing or walking
- Changes in consciousness or cognitive function

Signs and Tests

A comprehensive examination is conducted to assess various aspects of neurological function, including reflexes, sensation, and cognitive abilities. Tests such as blood pressure measurement, carotid artery assessment, and imaging studies like CT or MRI scans may be performed to confirm the stroke type, location, and cause.

Treatment

Prompt medical attention is crucial for stroke management. If the stroke is ischemic and detected early, clot-busting drugs may be administered to dissolve the clot and restore blood flow. However, this treatment is time-sensitive and typically must be initiated within a few hours of symptom onset.

In cases of hemorrhagic stroke or when clot-busting drugs are contraindicated, alternative approaches are employed. Blood thinners may be prescribed to prevent clot formation, and other medications may be utilized to manage symptoms such as high blood pressure.

Surgical interventions may be necessary to address bleeding, remove blood clots, or repair damaged blood vessels. Rehabilitation therapies, including physical, occupational, speech, and swallowing therapy, are initiated early to aid recovery and prevent complications.

Long-term treatment aims to optimize function and reduce the risk of recurrent strokes through lifestyle modifications, medication adherence, and ongoing rehabilitation efforts. Recovery timelines vary among individuals, with many experiencing improvement over time with appropriate care and support.