What is a stroke?
Stroke, which is also known as a cerebrovascular accident or CVA, is when part of the brain loses its blood supply and the part of the body that the blood-deprived brain cells control stops working. This loss of blood supply can be ischemic because of lack of blood flow, or haemorrhagic because of bleeding into the brain tissue. Because stroke can lead to either permanent disability or even death, it is considered to be a medical emergency. Though there are opportunities to treat ischemic strokes, it needs to be started within the first few hours of having signs of a stroke. If stroke is suspected, the patient, family, or bystanders should immediately call 9-1-1 and activate emergency medical services.
A transient ischemic attack (TIA or mini-stroke) describes an ischemic stroke that is short-lived where the symptoms resolve spontaneously. Though short-lived, it also requires emergency assessment to minimize the risk of a getting a stroke in the future. If all symptoms of stroke were to be resolved within 24 hours, it would be classified as a TIA.
What is the NIH Stroke Scale?
All strokes affect the brain differently and the symptoms and signs of the stroke depend on which part of the brain was affected.
For example, for most people, if speech and comprehension is affected, the stroke is most likely located in the left half of the brain. Having a weaker or weakness with the right side of the body is also associated with it.
A stroke on the right side of the brain would affect the left side of the and depending on where in the brain the injury occurred, the affected areas could be the face, arm, leg or a combination of the three.
The NIH Stroke Scale tries to score how severe a stroke might be. It also monitors whether the person's stroke is improving or worsening as times passes as the patient is re-examined.
There are 11 categories that are scored and include whether the patient
· is awake,
· can follow commands,
· can see,
· can move their face, arms and legs,
· has normal body sensations or feelings,
· has speech difficulties, or
· has coordination problems.
What are the risk factors for stroke?
Overall, the most common risk factors for stroke are:
· high blood pressure,
· high cholesterol,
· diabetes, and
· increasing age.
If stroke where to occur to younger individuals (less than 50 years old), less common risk factors include illicit drugs, such as cocaine or amphetamines, ruptured aneurysms, and inherited (genetic) predispositions to abnormal blood clotting.
What are the warning signs and symptoms of a stroke?
Before stroke occurs, there may not be any warning signs, which is why high blood pressure (hypertension), one of the risk factors for stroke, is called the silent killer.
Some patients who experience transient ischemic attack (TIA) believed or assumed that the stroke had solved itself. The symptoms may be either mild or dramatic and can mimic a stroke with the same symptoms such as weakness, numbness, facial droop, and speech difficulties, but only lasting few minutes. This however, should not be ignored as there is no guarantee that the symptoms of stroke would resolve on its own and they may also offer an opportunity to look for potentially reversible or controllable causes of stroke. For that reason, a TIA should be considered an emergency and medical care should be accessed immediately.
Amaurosis fugax describes the temporary loss of vision in one eye that occurs because of an embolus of blood clot or debris to the artery that supplies the eye. While it only involves vision, this situation should be considered a type of TIA.
Symptoms of stroke depend upon what are of the brain has stopped working due to loss of its blood supply. Often, the patient may present with multiple symptoms include ng the following:
· Acute change in level of consciousness or confusion
· Acute onset of weakness or paralysis of half or part of the body
· Numbness of one half or part of the body
· Partial vision loss
· Difficulty speaking or understanding speech
· Difficulty with balance and vertigo
This happens when an artery in the brain is being blocked or obstructed, thus preventing oxygenated blood from being delivered to the brain cells. The artery can be blocked in various ways, such as the narrowing of the artery due to cholesterol build-up called plaque, and if it were to rupture, a clot would be form and it prevents blood from passing through to the brain cells.
A stroke caused by debris or a clot that travels from the heart or another blood vessel is called an embolic stroke. An embolus or embolism is a clot, a piece of fatty material or other object that travels within the bloodstream that lodges in a blood vessel to cause an obstruction.
Blood clots that embolize usually arise from the heart. Atrial fibrillation is one of the most common. It is where the upper chambers of the heart, the atria, do not beat in an organized rhythm, causing the atria to jiggle like a bowl of jelly. While blood still flows into the hearts lower chambers, some of the blood along the inner walls of the atrium can form small blood clots, which if broken off, may flow to the brain, where it can block the flow of blood and cause a stroke.
When a blood vessel leaks and spills blood into brain tissue, those brain cells stop working. The bleeding or haemorrhage is often due to poorly-controlled high blood pressure that weakens the wall of an artery over time. Blood may also leak from an aneurysm, a congenital weakness or ballooning of an artery wall or from an AVM (arteriovenous malformation), a congenital abnormality where an artery and vein connect incorrectly. The bleeding can form a hematoma that directly damages brain cells and may also cause swelling that puts further pressure on surrounding brain tissue.
What causes a stroke?
· high blood pressure (hypertension),
· high cholesterol,
· diabetes, and
· Embolic stroke
Can strokes be prevented?
Prevention is always the best treatment, especially when the illness can be life-threatening or life-altering. Ischemic strokes are most often caused by atherosclerosis, or hardening of the arteries, and carry the same risk factors as heart attacks (myocardial infarction, coronary artery disease) and peripheral vascular disease. These include high blood pressure, high cholesterol, diabetes, and smoking. Stopping smoking and keeping the other three under lifelong control greatly minimizes the risk of ischemic stroke.
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