Stroke: Causes, Symptoms, Diagnosis And Treatment

A stroke, medically known as Cerebrovascular accident (CVA) or brain attack is a severe condition occurring when the blood supply to a part of your brain reduces or interrupts. It prevents your brain tissue from getting the necessary nutrients and oxygen. Due to the lack of oxygen and essential nutrients, the brain cells begin to die within a few minutes. It is a medical emergency requiring immediate assistance from a healthcare professional. Prompt treatment can avoid complications and their severity. With early action, you can avoid brain damage as well as other health issues. The sophisticated medical technology has made it possible to prevent death due to the condition. With timely medical intervention and effective treatment, you can prevent severe disability due to brain attack.

Symptoms Of Stroke

You need to monitor the signs you or your loved one exhibit to ensure early medical help. If you suspect a stroke, then get treatment immediately as an early intervention as soon as the symptoms begin to avoid severe complications. Here are the signs and symptoms associated with the condition:

Trouble Speaking

A brain attack can cause issues with speech. People can experience trouble speaking and understand what the affected person says. They also slur their words, have trouble forming coherent words, and experience confusion.

Paralysis

Numbness or paralysis of different body parts like face, leg, or arm is another symptom associated with the condition. Paralysis occurs on one side of the body. You can easily detect the issue by raising your arms over the head simultaneously. If you feel one arm falling, then it indicates you are suffering from a brain attack. The problem can also cause one side of your mouth to droop when you try smiling.

Vision Problems

People showing early onset of brain attack have problems seeing with one or both eyes. So, it causes blackened or blurred vision. Some people see double.

Headache

An intense headache appearing out of nowhere that is accompanied by dizziness, vomiting or altered consciousness indicates brain attack.

Trouble Walking

People suffering from brain attacks tend to lose their balance and stumble. A loss of coordination and sudden dizziness also accompanies the condition.

Since stroke is a serious medical condition, you need to call your doctor as soon as you see the above-mentioned signs. Go to the emergency room for necessary medical help.

Causes Of Stroke

You suffer from stroke due to a blocked artery or when your blood vessel leaks or bursts. In some people, the blood flow disrupts only for a short period (temporarily), which does not cause lasting symptoms. Based on the cause, you can classify brain attack into the following types:

Ischemic Stroke

It is the most common type of brain attack affecting people. The condition affects people when the blood vessels in the brain become narrowed or get blocked. So, it results in reduced blood flow, known as ischemia. Your blood vessels narrow due to the buildup of fatty deposits, blood clots, or other debris traveling through the bloodstream. They get lodged in your brain’s blood vessels.

Hemorrhagic Stroke

Hemorrhagic stroke affects a person when leakage or rupturing of the blood vessel in the brain occurs. The condition can occur due to medical issues affecting your blood vessels. The factor causing the problem are:

• Overtreatment or overuse with anticoagulants (blood thinners)
• Uncontrolled high blood pressure
• Aneurysm (Development of bulges at the weak spots on the blood vessel walls)
• Suffer trauma (like vehicle accident)
• Cerebral amyloid angiopathy (deposits of protein in the walls of the blood vessel, leading to weakness of the vessel wall)
• Suffer from ischemic stroke
• Arteriovenous malformation

Transient Ischemic Attack (TIA)

The condition is referred to as ministroke. You suffer from the symptoms associated with brain attack for a short period. But, the condition does not cause permanent damage. It occurs due to a temporary decrease in the supply of blood to your brain. TIA occurs due to a blood flow block due to debris or clot.

You need to seek emergency medical attention if you have experienced symptoms of TIA before, but you feel better now. Since it is not possible to detect TIA or stroke based on your symptoms alone, you need medical assessment. So, consult a doctor to avoid any risk of a brain attack later.

Risk Factors Associated With Stroke

Several factors increase your risk of brain attack. The main risk factors leading to treatable brain attack include:

Lifestyle Risk Factors

These factors are easy to manage when you make some small changes to your lifestyle. So, the lifestyle factor includes:

• Overweight or obesity
• Binge or heavy drinking
• Physical inactivity

Medical Risk Factors

People suffering from issues need to maintain caution. Without proper care and management, the following conditions can lead to stroke:

• Exposure to direct or secondhand cigarette smoke exposure
• High blood pressure
• High cholesterol
• Obstructive sleep apnea
• Diabetes
• Cardiovascular disease (issues like heart defects, heart failure, and abnormal heart rhythm)
• Family or personal history of heart attack, brain attack, or transient ischemic attack

Other Risk Factors

People who are facing a higher risk of brain attack include:

Age

Old people (55 years or older) are more at risk of the problem compared to younger people.

Race

Compared to other races, African Americans face a higher risk of brain attack.

Sex

Women face less risk compared to men. Advanced age can make women susceptible to brain attack. Women who suffer from brain attacks are likely to die compared to men.

Hormones

Women who undergo hormone therapies or use birth control pills containing estrogen face the risk of brain attack.

Complications Due To Stroke

A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part was affected. Complications may include:

Loss Of Muscle Movement/Paralysis

Brain attacks can result in paralysis of one side of the body or affected people lose control of some muscles like one arm or one side of the face.

Trouble Talking/Swallowing

The brain attack can result in losing control of the muscles in the throat and mouth. So, it makes it difficult for the person to eat, swallow, or talk properly. It also affects your language as you find it difficult to speak, understand the speech of others, read or write.

Thinking Difficulties/Memory Loss

Due to brain attack, people who have suffered it experience thinking difficulty, trouble making judgments, reasoning, and understanding concepts. They also suffer from memory loss.

Emotional Problems

People who have suffered from brain attacks suffer from depression or have trouble controlling their emotions.

Pain

One of the complications associated with brain attack is the numbness, pain, or other unusual sensations triggering in different body parts. So, after the attack, you can feel such an issue.

Change In Self-Care Ability And Behavior

People who have suffered from brain attacks become withdrawn and depressed. They also require help to complete their daily chores or for grooming due to loss of functions.

Diagnosis Of Stroke

Stroke is a medical emergency that requires immediate attention from doctors. So, you need to go to the emergency room for prompt treatment. Once you reach the hospital, healthcare workers tend to detect the type of brain attack you are having. So, you need to undergo imaging tests like CT scans or other immediately upon arrival. Doctors need to rule out other conditions with similar symptoms like drug reaction or brain tumor for proper treatment. So, you need to undergo the following tests:

Physical Examination

The doctor performs a thorough physical examination to check for the signs and symptoms you suffer. You need to undergo a neurological exam to check how the condition is affecting your nervous system.

Blood Tests

You need to provide a blood sample for various tests. The tests include the time taken for your blood to clot, your blood sugar levels, and CBC (to check for infection).

Imaging Tests

Using sophisticated imaging tests, your doctor can see the current status of your brain. It helps detect any problem. The tests include:

CT Scan

Computerized Tomography is the imaging test using several x-ray images to get a detailed image of the brain. Show it can show any bleeding, presence of a tumor, or an ischemic stroke. At times, the doctors can also inject a dye into the blood to get a clear picture of the blood vessels in the neck and brain. This is known as computerized tomography angiography.

Magnetic Resonance Imaging (MRI)

An MRI uses a powerful magnetic field and radio waves for a clear picture of the brain. So, it can detect any damage to brain tissue. A dye is injected into your blood vessel to get a clear image of veins, arteries, and the blood flow (it is known as magnetic resonance venography or magnetic resonance angiography).

Carotid Ultrasound

It uses sound waves to generate a comprehensive image inside of carotid arteries. These arteries are present in your neck. So, using the test, your doctor can detect the plaques (fatty deposit buildup) as well as blood flow in the carotid arteries.

Cerebral Angiogram

It is the common test used to offer a detailed imaged of the arteries in the brain as well as the neck. During the test, the doctor inserts a thin, flexible tube through an incision in the groin and passes it through the major arteries. It is passed into the vertebral artery or carotid artery. Then, a dye is injected into the blood vessels for making them visible under x-ray imaging.

 Echocardiogram

Using sound waves, echocardiogram creates detailed images of the heart. It is used to detect the exact source of the clots in the patient’s heart that may have traveled to the brain and resulted in a stroke.

Treatment For Stroke

The emergency treatment for brain attack depends on the type of problem you suffer. So, for different types of stroke, the treatment differs. The treatment options are:

Treatment For Ischemic Stroke And TIA

For ischemic brain attack and TIA, the doctor tries to quickly restore blood flow in your brain. So, it is achieved by the following methods:

Emergency IV Medication

The doctor provides drugs through IV within four and a half hours (4.5 hours) from the starting of the symptoms. It is better to give the medications sooner for achieving positive results. Quick treatment not just improves the patient’s chances of survival but also reduces complications. The drugs help dissolve the clot triggering the brain attack and restores blood flow. Removing the underlying cause of a brain attack, helps you recover fully from the condition.

Emergency Endovascular Procedures

Some doctor treats the condition by handling the blocked vessel directly. Endovascular therapy improves the outcomes of the treatment. It also reduces long-term disability caused due to the brain attack. So, the procedures performed as early as possible are:

• Medication is delivered directly to the brain.
• Use a stent retriever to remove the clot.

Other Procedures

People who have suffered one brain attack can face the risk of another or a transient ischemic attack. So, the doctor recommends the procedure to lower such risks. It involves opening the narrowed arteries due to plaque. Depending on the situation, the procedures include:

Carotid Endarterectomy

It involves removing the plaque, causing carotid artery block. These arteries are present on either side of your neck and supply blood to your brain. The surgery reduces the risk of ischemic brain attack.

Angioplasty And Stents

Your surgeon threads a catheter through an artery in your groin during angioplasty to the carotid arteries. Then, a balloon is inflated through the narrowed artery to expand it. Your surgeon places a stent to support the artery opened by the balloon.

 Treatment For Hemorrhagic Stroke

The emergency treatment for hemorrhagic brain attack focuses on stopping or controlling the bleeding. Doctors also try to reduce the pressure caused by excess fluid on the brain. The treatment options include:

Emergency Measures

People taking blood thinners for preventing clots are provided with other drugs or blood product transfusion to counter the effects of blood thinners. As an emergency measure, you are also given medications to relieve intracranial pressure (the pressure in the brain), lower blood pressure, prevent seizures, and prevent blood vessel spasms.

Surgery

For large bleeding, you need to undergo surgery to remove the blood accumulated as it puts pressure on the brain. The invasive procedure also repairs any blood vessel problems caused due to hemorrhagic brain attack. The following options are available after suffering brain attack or if problems like AVM (arteriovenous malformation), aneurysm, or other blood vessel problems lead to hemorrhagic stroke:

Surgical Clipping

To stop the blood flow into the aneurysm, the surgeon places a minute clamp. So, it lowers the risk of the aneurysm from bursting or it reduces the chances of bleeding from the recently hemorrhaged aneurysm.

Endovascular Embolization

Also known as coiling, the surgeon places detachable coils using a catheter into the patient’s aneurysm to fill it. So, it blocks any blood flow into the aneurysm, resulting in a clot.

Surgical AVM Removal

The surgeon removes the small portion of AVM from the accessible part of the brain using an invasive procedure. It eliminates the risk of blood vessel rupture as well as a lower risk of hemorrhagic brain attack. But, the procedure is not helpful when AVM is located deep in the patient’s brain as removing it can affect normal brain function.

Stereotactic Radiosurgery

The procedure uses highly focused radiation to repair the malformation of the blood vessel. Multiple beams are used for the highly advanced procedure. So, the minimally invasive procedure helps repair any issues with blood vessels

Stroke Recovery And Rehabilitation

After the emergency treatment for a brain attack, your doctor monitors your condition for at least one day. The primary focus of the healthcare providers after the treatment is to ensure the patients recover as much function as possible. They try to ensure you return to your living. But, the impact of the brain attack depends on the area of the brain it affects and the extent of tissue damage.

Extent Of Damage Due To Stroke

If the stroke affects the right side of the brain, then you can see issues with sensation as well as movement on the left side of the body. Brain attack on the left side of the brain affects the sensation as well as movement on the right side of the body. Left side brain damage can also result in speech and language disorders.

Rehabilitation After Stroke

You go into a rehabilitation program before leaving the hospital and continue it after going home. The rigorous therapy program is developed based on the age of the patient, their overall health, and the extent/degree of disability suffered due to brain attack. Your doctor develops a program based on your current lifestyle, priorities, interest, and the presence of loved ones or caregivers to guide you through the program.

Coping And Support After Stroke

Suffering from a stroke changes your life in a lot of ways. It affects your physical as well as mental well-being. You tend to feel depressed, helpless, and frustrated after the brain attack. It affects your functions, changes your mood, and suffer from low sex drive. So, you need to follow the steps suggested to ensure your mental and physical well-being.

Maintain Self-Esteem

After suffering from a brain attack, you need to maintain your self-esteem. Connect with others who offer positive energy. You can adopt several strategies for you or your loved one’s wellbeing. The steps needed to maintain self-esteem are:

Never Force Yourself

You have to take it easy after suffering from brain attack as the physical as well as emotional recovery takes time. It is tough work, so never judge your progress harshly. Celebrate even the small progress.

Join A Support Group

Meet others suffering from a similar problem as you can share your experience and exchange vital information. It will motivate you and help you build new relationships.

Communicate With Family

You have to let your family and friends know what you feel and need. Since people wishing to help you may not know what to do, you have to help them by telling them what you need. Letting them know how to help you will help you spend quality time with them by talking, attending events, or activities.

Manage Communication Challenges

People suffering from brain attacks can experience communication challenges. So, people suffering from the issue can experience frustration. Here are some of the tips that caregivers or you can cope with communication challenges:

Practice Speech

You have to try to have a conversation to ensure you speak well. Try to adopt learning techniques that work best for you at least a day. You will feel connected as well as rebuild your confidence.

Take Your Time

You need to relax and make talking easier as well as enjoyable. Never rush and take time to find the right time to make it easy.

Choose Fewer Words

While recovering from a brain attack, you can communicate in your way. Choose fewer words and rely on gestures to communicate.

Use Communication Aids

You can use communication aids like cue cards showing pictures or words to communicate with your family or friends regarding your regular needs and wants.

Preventing Stroke

It is important to know the risk factors that put your life at risk. See a doctor get guidelines to reduce the risk and adopt a healthy lifestyle to prevent stroke. People who have earlier suffered brain attack or TIA, then follow instruction from the doctor. You can follow the suggestion provided below:

Control Of High Blood Pressure

Hypertension puts you at risk of brain attack. So, take steps to lower blood pressure. Making healthy lifestyle changes and taking medications as per doctor’s instructions will reduce your risk of brain attack.

Lower Cholesterol

You need to reduce the amount of cholesterol and saturated fat included in your daily diet. Try to lower cholesterol levels by changing your diet. High cholesterol results in fat to buildup in your arteries. If dietary changes do not reduce cholesterol levels, then see a doctor get medication to lower it.

Quit Tobacco

Using tobacco products raises the risk of a brain attack. So, if you smoke or exposed to secondhand smoke, then you are susceptible to brain attack. Quit tobacco products reduce risk.

Manage High Blood Sugar

Uncontrolled diabetes can result in severe complications. So, you need to take steps to manage your diabetes. Lifestyle changes like diet, exercise, and losing weight will keep your blood sugar in control. If such changes do not offer any change, then you need to take medications prescribed by the doctor.

Healthy Weight

Overweight or obese people are more at risk of brain attack as they experience high-risk factors like diabetes, cardiovascular disease, or high blood pressure.

Include Healthy Diet

Include a diet rich in fruits and vegetables. Try to include five or more servings of vegetables or fruits to reduce lifestyle diseases. You can also try following the Mediterranean diet to reduce your risk of stroke. The diet consists of fruits, olive oil, whole grains, and vegetables.

Exercise Regularly

Including exercise is beneficial for your body. So, try to include aerobic exercise to reduce the risk of brain attack. Exercise improves blood circulation and helps reduce high cholesterol, blood pressure, and body weight. You can regulate stress and improve the overall health of your heart as well as blood vessels. Try to include at least thirty minutes of moderate physical activity at least three days of the week.

Drink Alcohol In Moderation

Heavy alcohol consumption causes negative issues like high blood pressure, hemorrhagic, and ischemic strokes in people. Consuming alcohol also interacts with other drugs you take for other underlying diseases. So, control your alcohol consumption. Taking alcohol in moderation can prevent your blood’s clotting tendency and reduce the risk of brain attack. Talk to your doctor regarding consuming the right amount of alcohol.

Treat Obstructive Sleep Apnea

If you suffer from OSA (obstructive sleep apnea) that causes you to stop breathing for a short time frequently when you sleep, then get treatment. It will reduce the risk of a brain attack.

Stop Using Illegal Drugs

Recreational or illegal drugs like methamphetamine and cocaine are the established risk factors or developing a TIA or a brain attack. So, avoid using it.

Preventive Medications

People who have suffered from TIA or ischemic stroke, then you need to take preventive medication to reduce your risk of another episode. The common medications suggested for keeping patients safe from brain attack are:

Anti-platelet Drugs

Your blood forms clots due to the presence of platelets. People who have suffered from brain attacks need to avoid the clots from forming. So, they need to take anti-platelet drugs that make these cells less sticky. The common medication prescribed by doctors is aspirin.

Take Aggrenox

The drug is the combination of dipyridamole (an antiplatelet drug) and low-dose aspirin. You need to take it for some time as per the doctor’s suggestion to avoid complications.

Anticoagulants

These drugs reduce the chances of blood clotting. The common anticoagulants used are:

• Your doctors can prescribe Heparin as it is fast-acting. It is used for the short-term when you stay in the hospital.
• Warfarin is used for the long-term as it acts slowly. It is a powerful drug prescribed in the right doses. Always follow the dose and check for side effects.

Conclusion

Stroke is a life-threatening condition, triggering severe and irreversible complications. But, with early medical intervention, you can reduce the damage caused. So, see a doctor immediately when you suspect or see signs of brain attack.

View Article Sources