Stroke: Pitting Quick Action against Severity

Strokes are so common that it can happen to anybody at any given time, though some lifestyle choices play an important role in increasing the risks of getting one. Even the healthiest of us will get a stroke out of nowhere and have our lives changed forever. 

The positive note about strokes is that they are preventable. Up to 80 percent of strokes can be prevented, making it the leading cause of preventable disability. However, us and the community are not educated enough to take necessary and immediate action to decrease the sickness’s devastating impact.

A stroke is a medical emergency and the sooner a person receives treatment for a stroke, the less damage is likely to happen. This is where Stroke Awareness is important.

What is a Stroke?

The brain is a central computer that controls all the body’s functions. It needs sufficient oxygen and nutrients provided by blood to function properly. If the supply of blood is restricted or stopped, brain cells will begin to die. This can lead to brain injury, disability and possibly death.

A stroke or also known as cerebrovascular accident, CVA, or “brain attack”, is a sudden interruption or reduction in the blood supply of the brain. The brain tissue is prevented from getting oxygen and nutrients and brain cells begin to die in minutes. Part of the brain that has lost its blood supply will stop working, and this in turn leads to part of the body that the injured brain controls to stop working.

Most strokes are caused by a blocked blood vessel leading to the brain. Other strokes are caused by bleeding into brain tissue when a blood vessel bursts. The effects of a stroke depend on which part of the brain is injured, and how severely it is injured.

types of strokes

Types of Strokes and Causes

There are different types of strokes that can happen to oneself depending on the nature and the cause behind the stroke itself. The below are some of the types identified:

Types of StrokesExplanationCauses
Ischemic StrokeBroken down into two types:Thrombotic strokes: Caused by a blood clot that forms in an artery that supplies blood to your brain.Embolic strokes: Caused when a clot forms somewhere else in your body and travels through the blood vessels and gets stuck, stopping blood flow. The most common stroke happens amongst people where part of the brain loses blood flow. This means a blood vessel supplying blood to your brain gets blocked by a blood clot.A fatty substance called plaque collects in your arteries and narrows them. This process is called atherosclerosis, and it slows the flow of blood. As it pools, blood can clump and form clots — and your artery gets blocked.
Hemorrhagic Stroke Broken down into two types:Subarachnoid hemorrhage: Happens in the area between your brain and skull. Intracerebral hemorrhage: Bleeding inside the brain.Bleeding occurs in the brain and damages nearby cells. High blood pressureInjuryBleeding disordersCocaine useAbnormal blood vessels (AVMs)Aneurysm (a weak area in a blood vessel that breaks open)
Transient Ischemic Attack (Mini Stroke)Temporary blockage in blood flow to your brain. Symptoms usually last for just a few minutes or may go away in 24 hours without treatment. It is usually a warning sign that your chances of getting a stroke are higher in the near future.SmokingHigh blood pressure (hypertension)ObesityHigh cholesterolExcessive consumption of alcoholIrregular heartbeat (atrial fibrillation)Diabetes
Brain Stem StrokeHappens in your brain stem and can affect both sides of the body. One is left in a “locked in” state, unable to speak or move below the neck.Blood clotsHemorrhagesInjury to an artery due to sudden head or neck movements (rare)
Cryptogenic Stroke Stroke of unknown cause(s).Cause(s) undetermined because the event is transitory or reversible, investigations did not look for all possible causes, or because some causes truly remain unknown.

Many common medical conditions can increase your chances of having a stroke. Those who are at an increased risk in getting a stroke as stated in the different types are ones who have:

  1. High Blood Pressure (leading cause of stroke, can be due to stress)
  2. High Cholesterol
  3. Diabetes
  4. Smoking habits (Smokers)
  5. Heart Disease
  6. Heart Rhythm Disturbances/ Irregular Heartbeat (Atrial Fibrillation)

You can lower your risk for stroke by generally maintaining a healthy weight, follow a healthy diet and exercising regularly. To make it easier, just remember these ABCS of stroke prevention:

  • Aspirin
  • Blood Pressure
  • Cholesterol
  • Smoking

Symptoms in Identifying a Stroke (Before it truly happens)

brain stroke

This part of the article might be the most important in saving somebody from being paralysed or preventing one’s health from further deteriorating due to a stroke. 

Strokes may cause sudden weakness, loss of sensation or a tingling sensation, difficulty with speaking, seeing, or walking. Since different parts of the brain control different areas and functions, it is usually the area immediately surrounding the stroke that is affected. 

Sometimes people with stroke have obvious symptoms, but stroke can also be completely painless. You are advised to pay particular attention to the time the symptoms began. It is very important to recognise the warning signs of stroke. Some treatment options are most effective when given soon after a stroke begins.

Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to come and go or they disappear completely. 

The signs and symptoms of a stroke include:

  1. Numbness (sometimes tingling sensation) of the face, arm or leg – affecting one side of the body
  2. Weakness in lifting arm or leg – difficulty in raising both arms.
  3. Trouble speaking and understanding, slurred words confusion.
  4. Trouble walking – stumbling and losing balance, loss of coordination.
  5. Sudden and severe headache, accompanied by vomiting, dizziness or altered consciousness
  6. Vision loss or changes – blurred or blackened vision in one or both eyes, or seeing double

A simple abbreviation that is common in identifying a stroke is to think and act “FAST”:

  1. Face Drooping. Ask the person to smile. Is one part of the face drooping?
  2. Arms Weakness. Ask the person to raise both arms. Does one arm drift downward? Or is one arm unable to rise?
  3. Speech Difficulty. Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?
  4. Time to call for medical assistance immediately.

At times, these symptoms don’t last like when a mini stroke happens. However, never take these symptoms lightly because just because the symptoms go away, it doesn’t mean anybody is in the clear and that a stroke would not still happen. 

A stroke of any duration can do lasting damage. It is always better to be safe and seek treatment than to ignore the warning signs of a potentially deadly event.

Problems after a Stroke

Although stroke is a disease of the brain, it can affect motor function or the ability for the entire body to move. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability is weakness on one side of the body or hemiparesis

People who survive a stroke are often left with long-term problems caused by injury to their brain. Most are common and will improve with time and disciplined rehabilitation. Some of the few issues that are faced by stroke survivors are listed as below:

PhysicalCommunicationDepression and Emotional Changes
Right Side of the BrainLeft Side of the BrainSpeech disordersLanguage disordersCognitive-linguistic deficitsSudden mood changesFeeling anxious, worried, pessimistic, or hopelessHaving thoughts of deathLoss of energyIncrease or decrease in appetiteDifficulty sleeping or sleeping too muchDifficulty concentrating, remembering, thinking, or making decisionsHeadacheDigestive problemsSexual problems
Left-side weaknessImpulsive behaviorOverconfidence in abilitiesVision problemsRight-side weaknessSpeech and language problemsSlow behavior

Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions. Many stroke patients tend to experience depression as they will start to feel that they are not capable anymore. 

In some cases, stroke survivors may also have numbness or strange sensations. The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures.

Stroke Rehabilitation & Recovery Suggestions

There are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post-stroke rehabilitation. 

  • Therapies to prevent a first or recurrent stroke are based on treating an individual’s underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. 
  • Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving or removing the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. 
  • Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. This includes rehabilitation that helps stroke survivors relearn skills that have been lost or compromised. 
  • While learning any new skill requires patience and practice, a repetitive rehabilitation program helps the brain heal.

Treatment will depend on the type of stroke you have, including which part of the brain was affected and what caused it. Some people need a long period of rehabilitation before they can recover their former independence, while many never fully recover and need ongoing support after their stroke. The most rapid recovery usually occurs during the first three to four months after a stroke. 

Strokes are commonly treated with medication. This includes medicines to prevent and dissolve blood clots, reduce blood pressure and reduce cholesterol levels. In some cases, procedures like surgery may be required to remove blood clots. 

To assist in the stroke survivor’s journey and provide stroke care, here are some additional ways to care for them:

  • A safe and accommodative home environment
  • Monitor medications
  • Assist them in staying active physically and mentally, constant muscle movements
  • Encourage social interaction for positive motivation
  • Provide healthy diets and avoid processed sugars
  • Avoid burnout for caretakers

Both the stroke survivor and caretakers need to be physically and mentally prepared for the road to recovery. Recurrent stroke is frequent; about 25 percent of people who recover from their first stroke will have another stroke within 5 years. Therefore, it is crucial to take preventive measures (ABCS), and always be aware of the symptoms – FAST. In this matter, early intervention is key to a successful recovery.

References:

1. What is a Stroke?

2. Conditions That Increase Risk for Stroke

3. Stroke

4. Stroke Information Page

5. Stroke definition and facts

6. Stroke Health Center

7. How to Spot a Stroke: 5 Sure Signs and 4 Life-Saving Letters

8. Overview -Stroke

9. Stroke Recovery: Can the Brain Heal Itself?

10. Management of cryptogenic stroke