Stroke - What Is It, What Causes It, And What Can You Do About It?

A stroke, also called a cerebrovascular disorder or stroke, is a sudden failure of one or more cerebral circulations of blood vessels that supply the brain. A stroke can disrupt oxygen supply to brain tissue and cause serious damage. For people suffering from a stroke, it is very important to restore normal circulation as soon as possible to limit damage to brain tissue.

Although the death rate from strokes has dropped significantly from about 90% in the 1950s, the number is still around 30%, and stroke is soon the most common cause of death worldwide. About half of those who survive remain permanently disabled, and many experience relapses within weeks, months or years.

Cause and incidence

A stroke usually results from a blockage of blood vessels outside the brain but inside the brain itself. Factors that increase the risk of stroke include transient ischemic attacks, atherosclerosis, hypertension, kidney disease, arrhythmia [especially atrial fibrillation], rheumatic heart disease, diabetes, postural hypertension, cardiac hypertrophy, high serum Includes a history of cholesterol, smoking, lack of exercise, long-term use of contraceptives, obesity, family history of stroke. Women have additional risk factors for stroke, such as oral contraceptives that are not present in men. Cocaine-induced ischemic stroke is currently reported in young patients.

Stroke incidence increases exponentially from age 30, etiology varies by age, 95% of strokes occur in people over 45 years, and two-thirds of strokes occur in people over 65 years The The risk of stroke is higher than women, but women begin to catch up with men 5-10 years after menopause. Stroke is most common in older people, but people of all ages and at all levels can be injured. In the case of stroke, the risk of death increases with age.

Stroke is rare in children who make up a small percentage of stroke cases each year. Childhood stroke is often secondary to congenital heart disease, abnormalities in intracranial blood vessels, hereditary diseases, blood diseases such as thrombosis.

Stroke type

Stroke can be divided into two main categories: ischemic and hemorrhagic. 80% of strokes are due to ischemia and the rest are due to bleeding.

The main causes of stroke are thrombosis, embolism and bleeding:

1. Thrombosis is the most common cause of middle-aged and elderly people because of the high incidence of arterial plague, diabetes or hypertension. It occurs especially in people with a history of rheumatic heart disease, endocarditis, cardiac arrhythmia, or at the age after open heart surgery.

2. Embolism is the second most common cause of stroke. Embolism occurs when blood vessels are blocked by blood clots, tumors, fat, bacteria, or air. Embolism usually develops within 10-20 seconds without warning, and when it reaches the brain, it stays in a narrow part of the artery, blocking the circulation, causing swelling and tissue death.

3. The third most common type of hemorrhage of stroke is more common in women than in men. Embolism can occur suddenly at any age. This is due to an aneurysm that causes chronic hypertension or a sudden rupture of the cerebral artery.

Signs and symptoms of stroke

Stroke generally presents with loss of sensation and motor function on one side of the body [85% of ischemic stroke patients have hemiplegia], vision changes, ability to walk or speak or understand, or sudden severe headache The

The clinical features of stroke depend on: Affected blood vessels and the parts of the brain that blood vessels supply, the severity of injury, and the ability of the affected area to compensate for the decreased blood supply due to collateral circulation Strokes on the left side of the brain primarily affect the right half of the body and vice versa. Most forms of stroke are not associated with headaches, except subarachnoid hemorrhage and cerebral venous thrombosis, and sometimes intracerebral hemorrhage.

Symptoms are usually classified according to the affected blood vessel.

1. Middle cerebral artery: difficulty in swallowing, difficulty in speaking, visual field reduction, especially paralysis on one side of face and arm.

2. Carotid artery: weakness, paralysis, numbness, visual impairment, headache, change in consciousness level, difficulty speaking, eyelid drooping.

3. Vertebral basilar artery: weakness, numbness of lips, visual field cut, double vision, poor coordination, difficulty swallowing, obscure language, dizziness, memory loss.

4. Anterior cerebral artery: confusion, weakness, numbness [especially lower limbs], incontinence, loss of coordination, impaired motor and sensory function, personality change.

5. Posterior cerebral artery: no sensory disturbance, visual field loss, dyslexia, com sleep, cortical blindness, no paralysis.

Diagnosis

For those referred to the emergency room, early recognition of stroke is considered important because it can facilitate diagnostic testing and treatment. Strokes due to thromboembolism or ischemic arterial spasms are usually severe and often must be distinguished from strokes caused by fatal bleeding. Stroke is diagnosed through several techniques, including observation of clinical features, neurological examination, CT or MRI scan, Doppler ultrasound, and arteriography.

Processing

Surgery to improve cerebral circulation, tissue plasminogen activator [tPA] for clot lysis, anticoagulants and anticonvulsants are commonly used to treat stroke. Treatment that destroys the blood clot that is the main cause of the stroke should begin within 3 hours of the stroke to be effective. tPA should be given within 3 hours of the stroke event. Therefore, patients who have awakened from stroke symptoms are not eligible for tPA therapy because the time of onset cannot be determined accurately. Patients with thrombosis-related [thrombotic or embolic] stroke who are not eligible for tPA treatment may be treated with heparin or other blood thinners, or in some cases aspirin or other anticoagulants.

In patients with nonvalvular atrial fibrillation, anticoagulants reduce stroke by 60%, and antiplatelet drugs reduce stroke by 20%. Anticoagulants and antithrombotics are key to the treatment of ischemic stroke and can exacerbate bleeding and cannot be used for intracerebral hemorrhage. In addition to definitive treatments, acute stroke management includes control of blood glucose levels to ensure that patients receive proper oxygenation and proper intravenous fluids.

Painkillers, stool softeners that prevent tension, and corticosteroids that minimize associated edema can also be used. Recently, complications with the FDA listed power taps used in combination with related marine phytoplankton nutritional patches that help the body regulate the immune system, improve blood flow, and eliminate toxins There are reports of successful mitigation. Another new course of action that is meaningful for both stroke prevention and rehabilitation is to supplement redox cell signaling molecules. These molecules that are native to the body when you are young are used by your body to repair damage wherever they need it.

Prevention

In general, there are three treatment stages for stroke: prevention, treatment immediately after stroke, and rehabilitation after stroke. Treatments that prevent primary or recurrent strokes are based on the treatment of individuals underlying the risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Lowering blood pressure has finally been shown to prevent both ischemic and hemorrhagic stroke. Aspirin prevents the first stroke of patients with myocardial infarction. Nutrition, especially a Mediterranean-style diet, has more potential than halving the risk of stroke.

Acute stroke therapy attempts to stop the progression of the stroke by quickly lysing the blood clot that causes ischemic stroke or by stopping bleeding in a hemorrhagic stroke.

Post-stroke rehabilitation can help individuals overcome obstacles resulting from stroke damage. The most common classes of drugs used to prevent or treat stroke are antithrombotic drugs [antiplatelet and anticoagulants] and thrombolytic drugs.

Rehabilitation

Stroke can cause problems with thinking, awareness, attention, learning, judgment, and memory. Survivors often have problems understanding and shaping speech and may have difficulty controlling emotions or expressing inappropriate emotions. You may also feel numbness or strange sensations.

Stroke rehabilitation is the process of receiving treatment to help disabled stroke patients return to normal life as much as possible by regaining their daily life skills and re-learning. New advances in imaging and rehabilitation show that the brain can compensate for functions lost as a result of stroke. Therefore, stroke rehabilitation should be started as soon as possible.

After a stroke, both stroke survivors and their families are often afraid to go home and get used to life after the stroke. Because stroke survivors have to get used to doing things differently and can affect intimacy, relationships, work and hobbies, for most stroke patients, physical and occupational therapy are The basis of the rehabilitation process.

Because 30-50% of stroke survivors suffer from post-stroke depression characterized by lethargy, irritability, sleep disturbances, reduced self-esteem, and withdrawal, some stroke management teams have at least 3 Showing post-stroke depression in 1 in 1 patients.