Stroke

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22 Oct 2013

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  • Cardiovascular, Stroke

What is stroke?

The father of medicine, Hippocrates, first recognized stroke over ~2,400 years ago, referred to as apoplexy, meaning “struck down by violence” in Greek. Medicine has evolved since then and stroke is now referred to as a “brain attack”, which conveys an urgent call for immediate action and emergency treatment. Today, there is vast information on the cause, prevention, risk, and treatment of stroke. Research has significantly improved our ability to provide immediate treatment, supportive care, and rehabilitation to improve the quality of life for stroke victims for survival and recovery. Stroke is one of the leading causes of morbidity and mortality in the world and contributes to escalating costs of healthcare.

Types of stroke:

A stroke or “brain attack” is a sudden loss of neurologic function resulting from either

  1. decreased blood flow when a blood clot or cholesterol plaque blocks one of blood vessels in the brain, called an ischemic stroke, or
  2. rupture of a blood vessel in the brain causing bleeding into surrounding brain tissue, called a hemorrhagic stroke.

Ischemic strokes accounts for approximately 80% of all strokes, whereas hemorrhagic strokes account for the rest 20%.

strokeimage

 

Signs and symptoms:

Typical symptoms associated with loss of brain function due to either a blood clot disrupting oxygenation or rupture of a blood vessel causing bleeding, include impaired thinking, memory, speech, movement, eating, walking, bowel and bladder control, emotional control and personality changes.

Risk factors:

There are genetic and environmental factors that contribute to stroke. There are many risk factors for stroke that can be managed and treated to prevent stroke. Some risk factors such as age, race, gender, and genetics cannot be changed. However, those risk factors associated with life style can be managed.

Diagnosis:

When a patient presents to the emergency room with stroke symptoms, a neurologist obtains and history and examines the patient. Then imaging tests are used to assess for the type of stroke and these include often a computed tomography (CT scan) of the head in addition to magnetic resonance imaging (MRI) of the brain and blood vessels.

Treatment:

Specific treatment for stroke is determined by the patient’s age, medical history, timing of symptoms, as well as type, size, and location of the stroke. Emergency treatment of stroke include medications used to dissolve the blood clot that is causing ischemic stroke as well as other life support measures including ventilators to assist with breathing, IV fluids, blood pressure control, nutrition, and prevention of complications. Ultimately, the goal is to treat acute stroke, evaluate cause of the stroke, and prevent further stroke from happening in the future. There are also different types of surgeries that may be performed to help treat stroke or prevent future stroke from occurring.

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