Overview – What is it?
Stroke occurs when the supply of blood to the brain is interrupted and reduced causing the brain tissues to lack enough oxygen and nutrients that help in its proper functioning. This can be due to blockage in an artery or leaking or bursting of a blood vessel. Some of the symptoms that one can experience during a stroke include problems understanding and speaking and paralysis of the face, arm or leg. Age, high cholesterol and diabetes are some of the factors that can increase the risk of experiencing a stroke.
Diagnosis is done to determine the treatment one needs for the stroke according to the type of stroke and the areas of the brain that are affected. The treatment for stroke can include medications, removing the clot surgically, and surgical blood vessel repair, among other treatments. Stroke can be prevented by using anti-platelet drugs and anticoagulants.
Causes – What causes it?
Different types of strokes are caused by different factors. The types of strokes are:
- Ischemic stroke: This is the most common stroke, representing about 80% of all strokes. It occurs due to narrowing or blockage of arteries to the brain causing severe reduction of blood flow to the brain.
- Haemorrhagic stroke: This type of stroke on the other hand, occurs when a blood vessel in the brain leaks or ruptures. It can also occur as a result of other health conditions such as hypertension, aneurysms (weak spots in the blood vessel walls) or overuse of blood thinners.
- Transient ischemic attack (TIA): Also known as a ministroke, TIA is a temporary period in which an individual may experience symptoms that are similar to those of a stroke, due to a temporary decrease in blood supply to part of the brain which can last for a short period of even 5 minutes.
Apart from the above causes, there are other risk factors that increase the chance of having a stroke. These are:
- Obesity and being overweight
- Lack of physical activity
- Using drugs such as cocaine
- Excessive alcohol consumption
- Health conditions like diabetes, high blood pressure, heart defects, personal or family history of stroke
- People aged 55 and above are at a higher risk of getting stroke than those who are younger
- Men are more likely to get stroke than women
Symptoms – What do you feel?
The symptoms for stroke include:
- Paralysis or numbness of the face, arm or leg
- Problem with vision in one eye or both eyes
- Trouble speaking and understanding
- Trouble walking; lack of balance and unstable walking
Diagnosis – How do you diagnose it?
- Initial consultation: The doctor gets to understand a person’s medical history and performs a physical exam to check the blood pressure, pulse, the lungs, heart and nerves.
- Laboratory tests to measure blood sugar, salt balance, white blood cell count and kidney function.
- Imaging tests:
- Computerised tomography (CT scan) to give images of the brain which helps in identifying the area of the brain that is affected by ischemic stroke.
- Magnetic resonance imaging (MRI) which gives more detailed images of the brain especially if the CT scan in inconclusive.
- Electrocardiogram to look for any irregularities in the heart.
- Urinalysis which is used to look for any abnormalities or infections in the kidney.
Treatment – How do you treat it?
The treatment for stroke depends on the type of stroke one has suffered.
- Ischemic stroke treatment is done to restore blood flow to the brain. These treatments include:
- Using medication to burst the blood clots thereby increasing the chances for survival
- Carrying out emergency endovascular procedures using medications that are delivered directly to the brain or by removing the clot with a stent retriever.
- Angioplasty and stents to expand the narrowed artery using a balloon which is inflated after being passed through the carotid artery in the neck. A stent is then inserted to support the open artery.
- Carotid endarterectomy is a procedure by which plaques are removed from the arteries which are found along the side the neck to the brain.
- Haemorrhagic stroke treatment is done to control the bleeding and reduce pressure in the brain. The treatments are:
- Being given drugs or transfusions of blood products to counteract the effect of blood thinning drugs.
- Repairing blood vessels surgically through;
Coiling by guiding detachable coils into the aneurysms that cause blockage of the blood vessels causing blood clots.
- Surgical clipping which is done at the base of an aneurysm to stop blood from flowing to it.
- Stereotactic radiosurgery which involves using multiple beams to repair vascular malformations.
- Surgical AVM removal to remove smaller arteriovenous malformations that are in a more accessible area of the brain to eliminate the risk of it rupturing and reduce the risk of haemorrhagic stroke.
After emergency treatment, the recovery process begins depending on the impact of the stroke. The recovery treatment may include:
- Physical therapy
- Physiatry assistance
- Neurological assistance
- Ensuring a healthy diet
- Speech therapy
Prevention – How do you prevent it?
Prevention of stroke highly depends on reducing the risk factors by:
- Lowering your cholesterol and intake of foods that have a lot of saturated fats
- Controlling your blood pressure
- Not smoking
- Not using illicit drugs like cocaine
- Avoiding excessive alcohol intake
- Maintaining a healthy diet rich in fruits and vegetables
- Controlling your blood sugar level
- Exercising regularly
- Treating obstructive sleep apnea (OSA)
- Taking anti-platelet drugs
- Taking anticoagulants