Stroke: Causes, Symptoms, Diagnosis and Treatment

Admin March 16, 2017
Stroke: Causes, Symptoms, Diagnosis and Treatment

A stroke, also called a cerebro-vascular accident, is a medical emergency. Strokes happen when there is poor blood flow to your brain that results in cell death within minutes.

Types and causes:

There are two main kinds of stroke, and both types result in part of the brain not functioning properly. An ischemic stroke is caused by a blood clot that blocks a blood vessel in the brain, and causes dysfunction of the brain tissue in that area. A hemorrhagic stroke is less common and is caused by a blood vessel that breaks and bleeds into the brain. If the symptoms last less than one or two hours, it is called a “mini-stroke” or transient ischemic attack (TIA), and this can occur when the blood supply to the brain is briefly interrupted.

Symptoms:

Strokes appear very suddenly and without warning. Look out for these typical signs:

  • Confusion, causing inability to speak or understand with clarity
  • Headache with or without vomiting
  • Sudden numbness or weakness of the face, arm or leg (particularly if it is on one side of the body)
  • Loss of vision or blurred vision in one or both eyes
  • Dizziness, trouble in walking with balance, loss of coordination of limbs
  • Some patients may also experience bladder or bowel incontinence, depression, sever pain in hands and feet, and trouble controlling emotions.

Immediate diagnosis and quick action can reduce disabilities or prevent death in the aftermath of a stroke, and help the patient to recover. A stroke patient must be treated at a hospital within 3 hours of noticing the first symptom.

An easy way to remember the symptoms of a stroke is by keeping in mind the acronym F.A.S.T.:

  • Face drooping: ask the person to smile; does one side of the face droop?
  • Arm weakness: ask the person to raise both their arms; does one arm drift downward?
  • Speech difficulty: ask the person to repeat a simple phrase; is their speech slurred or strange?
  • Time to call 911: if any of these signs are observed, contact emergency services immediately.

So when a stroke strikes, one must act FAST!

Diagnosis:

Doctors will perform the following diagnostic tests to determine the type of stroke and the treatment required:

They will first physically examine the patient and ask questions to determine the history, check blood pressure and examine the carotid arteries in the neck and the blood vessels at the back of the eyes.

Blood tests will be carried out to find out how quickly blood clots, the levels of substances in the blood and whether there is any infection.

CT scans will be taken of the brain.

MRI scans can detect damaged brain tissue.

An ultrasound may be taken to check the blood flow in the carotid arteries.

In a cerebral angiogram, dyes are injected into the brain’s blood vessels to make them visible under X-ray, and get a detailed view of the brain and neck arteries.

An echocardiogram creates a detailed image of the heart in order to check for any sources of clots that may have travelled to the brain.

As time is of the essence, if you suspect that someone has had a stroke, rush them to a hospital where these facilities are available so that diagnosis can be made and treatment started without any delay. If the patient is referred to another hospital then there will be loss of precious time and this will hamper the prognosis of the patient.

Treatment:

The treatment for each type of stroke is different, and so correct diagnosis of the kind of stroke is very important.

As Ischemic strokes are caused by arteries being blocked or narrowed, the treatment involves methods to restore adequate blood flow to the brain.

Drugs can be administered to break down existing clots, and prevent new ones from forming. This can include aspirin, or an injection of a tissue plasminogen activator (TPA) which is very effective at dissolving clots but must be injected within 4.5 hours of the initial stroke symptoms.

Surgical procedures can also be carried out to decrease the risk of future strokes or TIAs. One such procedure is a carotid endarterectomy, where a surgeon will open the carotid artery and clean out any plaque that is seen.

An angioplasty is also commonly performed, where a surgeon inflates a small balloon in a narrowed artery via a catheter. A stent is then inserted into the opening to keep the artery from narrowing again.

As Hemorrhagic strokes are caused by bleeding into the brain, the treatment focuses on controlling the bleeding and reducing the resultant pressure on the brain.

Drugs can be given to reduce the pressure in the brain, maintain overall blood pressure, prevent seizures and prevent sudden narrowing of blood vessels. In case of patients who are taking anti-coagulant or anti-platelet medication like Warfarin or Clopidogrel, drugs or blood transfusions will be given to counter the medication’s effects.

A surgical procedure can be carried out to repair any problems with blood vessels that have led or could lead to hemorrhagic strokes. Small clamps can be placed at the base of aneurysms or they can be filled with detachable coils to stop blood flow and prevent rupture.

Long-term recovery:

Strokes can be debilitating both physically and emotionally, and patients will need therapy that can include speech therapy, physical therapy, occupational therapy and support from friends and family in order to lead a comfortable life post the event. Patients can join a support group where they will be given guidance, first aid training programs and can exchange information and share experiences with others who have undergone a stroke.

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