World Stroke Day

A stroke can happen to anyone, any time and anywhere. Stroke is the leading cause of disability worldwide and the second leading cause of death, but all strokes can be prevented. Research shows that “golden hour” patients showed remarkably more stroke deficits than later arrivals. The patients who arrived at the hospital within one-hour experiencing stroke symptoms received a powerful treatment as often as those who arrived later in the approved time window for treatment.

When does a stroke occur?
A stroke occurs when the blood supply to the part of the brain is cut off resulting in oxygen starvation, brain damage and loss of function. Usually, it is caused by a clot in an artery supplying blood to the brain, known as ischemia. Stroke can cause permanent damage which includes partial paralysis and impairment in speech, comprehension and memory.
During a stroke, 32,000 brain cells die every second, but if a patient receives treatment in time, the damage can be minimized.

The warning signs of a stroke include:

Numbness of the leg, arm or face
Confusion or trouble understanding
Trouble seeing in both eyes
Trouble walking
Dizziness
Loss of balance and coordination

Severe headache with no known cause

From the time you feel symptoms, there is only a 3 to 4 and a half-hour window (called golden hour) to use clot-busting drugs to try to restore blood supply to the affected part of the brain.

Remember FAST whenever someone is having a stroke:
Face drooping
Arm weakness
Speech difficulty
Time to call emergency

What causes a stroke?
One of the main diseases that lead to stroke is atherosclerosis. Other risk factors include:

Tobacco
Physical inactivity
Unhealthy diet
Harmful use of alcohol
Hypertension
Atrial fibrillation
Raised blood lipid levels
Obesity

Types of Stroke

There are three types of stroke:

Ischemic Stroke: They occur as a result of an obstruction in a blood vessel supplying blood to the brain which can cause a blood clot to form, called cerebral thrombosis.
Hemorrhagic stroke: It occurs when a weakened blood vessel damages and bleed into the brain. Bleed can be caused by an aneurysm or an arteriovenous malformation (AVM).
Transient Ischemic Attack (TIA or mini-stroke): TIA occurs due to the temporary disruption in the blood supply in the brain. It causes symptoms similar to a stroke, but TIA symptoms pass quickly and usually resolve within 24 hours.
In the early stages of a TIA, it is impossible to tell whether it is a stroke or not, so it is important to call emergency services.

Diagnosis of a Stroke

The doctor will perform several tests to check your heart and blood pressure. Several tests may include blood tests and sugar tests.
Imaging tests: CT scan, MRI to create a detailed image of the brain.
Echocardiogram: It uses sound waves to create detailed images of the heart.
Carotid angiogram: In this test, sound waves create detailed images of the carotid arteries in the neck.

Treatment of a Stroke

Prompt treatment is important for recovering from a stroke. According to the American Heart Association, “Time lost is brain lost”. Call emergency services immediately if you realize you may be having a stroke, or if you suspect a loved one.

Treatment of a stroke depends on the type of stroke a person is having:

Ischemic stroke and TIA: These type of strokes are treated with:
Anticoagulants and antiplatelet: These drugs should be taken within 24 to 48 hours after stroke symptoms begin.
Clot-breaking drugs: Thrombolytic drugs can break up blood clots in the brain arteries which will stop the stroke and reduce damage to the brain.

Mechanical thrombectomy: In this procedure, the doctor inserts a catheter into a large blood vessel inside your head. The surgery is most successful if performed within 6 to 24 hours after the stroke begins.

Hemorrhagic stroke: Treatment for hemorrhagic stroke includes:

Medications: In hemorrhagic stroke, the treatment goal is to make your blood clot. The doctors will give medication to counteract any blood thinners you take.
Clamping: During MRI, the doctor may find out an aneurysm that hasn’t started bleeding yet or has stopped. To prevent bleeding, a surgeon may place a clamp at the base of the aneurysm.
Surgery: If an aneurysm burst, then the doctor will clip the aneurysm and may perform a craniotomy to relieve the pressure on the brain.

Recovery from a Stroke
According to the National Stroke Association reports, 10 per cent of stroke survivors make an almost-complete recovery, while another 25 per cent recover with only minor impairments.

Stroke recovery focuses on four main areas:

Speech therapy: Stroke can lead to speech and language impairment which can be improved with the help of a language therapist. The therapist will work with you to relearn how to speak.

Cognitive therapy: After a stroke, many survivors have changes to their thinking and reasoning skills which can lead to behavioural and mood changes. An occupational therapist can help you work to regain thinking and reasoning skills and to control emotional responses.

Physical Therapy: After the stroke, you may find that you are unable to move your body as well as you could before. A physical therapist will help you to regain your strength and balance.

Ways to Prevent a stroke

Here are some steps you can take to prevent stroke:

Monitor your blood pressure
Control your cholesterol
Keep your blood sugar down
Get active
Eat better
Don’t smoke
Lose weight if required
Get regular check-ups and stay in communication with the doctor

Conclusion

If you feel that you are experiencing symptoms of a stroke then immediately seek emergency medical care. The first few hours after the stroke are very vital and the clot-busting medication can only be provided within the first hours after the signs of a stroke begin.

Early treatment is the most effective way to reduce the risk of long-term complications and disability. You can prevent a stroke, whether you are preventing a first stroke or trying to prevent a second. Consult a cardiologist near you to find ways of preventing a stroke.