Stroke
A stroke happens when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack."
If blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen. Brain cells can die, causing permanent damage.
Causes There are two major types of stroke: ischemic stroke and hemorrhagic stroke.Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. This may happen in two ways: Ischemic strokes may be caused by clogged arteries. Fat, cholesterol, and other substances collect on the artery walls, forming a sticky substance called plaque.
STROKE RISK FACTORS
The chance of stroke is higher in people who live an unhealthy lifestyle by:
Symptoms usually develop suddenly and without warning. Or, symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse. The symptoms of stroke depend on what part of the brain is damaged. In some cases, a person may not know that he or she has had a stroke.
A headache may occur, especially if the stroke is caused by bleeding in the brain. The headache:
· Changes in hearing
· Changes in taste
· Changes that affect touch and the ability to feel pain, pressure, or different temperatures
· Clumsiness
· Confusion or loss of memory
· Difficulty swallowing
· Difficulty writing or reading
· Dizziness or abnormal feeling of movement
· Lack of control over the bladder or bowels
· Trouble speaking or understanding others who are speaking
· Trouble walking
Exams and Test A complete exam should be done. Tests can help your doctor find the type, location, and cause of the stroke and rule out other disorders. Your doctor will:
· CT scan of the brain is often done soon after symptoms of a stroke begin. An MRI may be done instead or afterwards.
· Angiogram of the head can show which blood vessel is blocked or bleeding.
If blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen. Brain cells can die, causing permanent damage.
Causes There are two major types of stroke: ischemic stroke and hemorrhagic stroke.Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. This may happen in two ways: Ischemic strokes may be caused by clogged arteries. Fat, cholesterol, and other substances collect on the artery walls, forming a sticky substance called plaque.
- A clot may form in an artery that is already very narrow. This is called a thrombotic stroke .
- A clot may break off from another place in the blood vessels of the brain, or from some other part of the body, and move up to the brain. This is called cerebral embolism, or an embolic stroke .
STROKE RISK FACTORS
The chance of stroke is higher in people who live an unhealthy lifestyle by:
- Being overweight or obese
- Drinking heavily
- Eating too much fat or salt
- Smoking
- Taking cocaine and other illegal drugs
- Atrial fibrillation
- Diabetes
- Family history of stroke
- High cholesterol
- Increasing age, especially after age 55
- Race (black people are more likely to die of a stroke)
Symptoms usually develop suddenly and without warning. Or, symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse. The symptoms of stroke depend on what part of the brain is damaged. In some cases, a person may not know that he or she has had a stroke.
A headache may occur, especially if the stroke is caused by bleeding in the brain. The headache:
- Starts suddenly and may be severe
- Occurs when you are lying flat
- Wakes you up from sleep
- Gets worse when you change positions or when you bend, strain, or cough
· Changes in hearing
· Changes in taste
· Changes that affect touch and the ability to feel pain, pressure, or different temperatures
· Clumsiness
· Confusion or loss of memory
· Difficulty swallowing
· Difficulty writing or reading
· Dizziness or abnormal feeling of movement
· Lack of control over the bladder or bowels
· Trouble speaking or understanding others who are speaking
· Trouble walking
Exams and Test A complete exam should be done. Tests can help your doctor find the type, location, and cause of the stroke and rule out other disorders. Your doctor will:
· CT scan of the brain is often done soon after symptoms of a stroke begin. An MRI may be done instead or afterwards.
· Angiogram of the head can show which blood vessel is blocked or bleeding.
- Check for problems with vision, movement, feeling, reflexes, understanding, and speaking. Your doctor and nurses will repeat this exam over time to see if your stroke is getting worse or improving.
- Listen for an abnormal sound, called a "bruit," when using a stethoscope to listen to the carotid arteries in the neck. A bruit is caused by abnormal blood flow.
- Check your blood pressure, which may be high.
- Lab tests will include:
- Bleeding time (BT)
- Blood cholesterol and sugar
- Blood clotting tests (prothrombin time or partial thromboplastin time)
- Complete blood count (CBC)
- Electrocardiogram (ECG) and heart rhythm monitoring -- to show whether an irregular heartbeat caused the stroke.
- Medicine to control symptoms such as high blood pressure
- Special procedures or surgery to relieve symptoms or prevent more strokes
- Nutrients and fluids
- If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot.
- For this drug to work, you must be seen and treatment must begin within 3 to 4 1/2 hours of when the symptoms first started.