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Everything About Stroke

A stroke occurs when blood supply to the brain is cut off. Also known as a “brain attack”, strokes occur when vessels in the brain get ruptured or bleed out, meaning oxygen is not provided to brain cells due to lack of blood; these cells are extremely sensitive and begin to die in a matter of minutes. Strokes can be fatal; leading to death, paralysis or irreversible damage to parts of the body. There are some early symptoms displayed before a fully blown out stroke may occur and it is imperative for people to recognise these in order to afford themselves a higher chance of survival and recovery. Paralysis or numbness in some part of the body, trouble speaking or comprehending speech, feeling dazed and confused, one eye drooping, trouble with vision in one or both eyes, difficulty in walking, severe and sudden headaches. Quick response to stroke and immediate treatment are absolutely necessary for chances of survival and prevention of brain damage and disability. 

Stroke is a leading cause of death in the world, India alone loses 1 million lives a year due to this. Men are more likely to get a stroke at a younger age but women are at higher risk of dying due to a stroke. Though many symptoms are the same; some are different for men and women. Symptoms displayed more usually amongst women include vomiting or nausea, shortness of breath, hallucinations, seizures, fainting, loss of consciousness and increased agitation. More common among men include dropping experienced on one side of the face or an uneven smile, slurring of speech, inability to comprehend surroundings and words of others, arm weakness in one arm or muscular weakness on one side of the body. There are primarily three types of stroke- Ischemic, Haemorrhagic and Transient Ischemic Attack. 

Ischemic strokes account for almost ninety percent of all cases of stroke. This happens when there is blockage or thinning of the arteries because of blood clotting, next to no supply of blood or by pieces of plaque that get stuck to the arteries. Thrombotic and Embolic belong to this category of stroke. Thrombotic strokes happen when a blood clot is formed in one of the arteries (that supply blood to the brain), thereby reducing blood supply. An Embolic stroke occurs when a blood clot forms in some other part of the body, eventually reaching the brain. 

Haemorrhagic Stroke occurs when an artery in the brain bursts open or leaks out blood eventually creating a lot of pressure on the brain. The two kinds of Haemorrhagic stroke are Intracerebral (happens when tissues surrounding the brain fill up with blood due to a burst artery) and Subarachnoid (bleeding occurs between the brain and the tissue). Aneurysms in the brain are often associated causes of this stroke. 

Transient ischemic attack is a stroke warning. If left untreated, it has high potential of turning into a stroke. Temporary blockage of blood supply to the brain causes full stroke like conditions but passes over in a few hours. Usually caused due to blood clots, this stroke points towards a potential full stroke in the future. 

There are a number of risk factors that contribute towards being prone to getting a stroke. They can combine and increase blood pressure and cholesterol; which can directly block arteries. An unhealthy diet, rich in fats such as saturated fat, trans fat, salt and cholesterol. An inactive and lethargic lifestyle devoid of much physical activity coupled with poor lifestyle choices such as heavy drinking and smoking. Sometimes genetic predisposition may play a role in some people being more prone to a stroke due to family histories with diseases like high blood pressure. Ok average, more women suffer strokes in comparison to men. Race and ethnicity studies have also revealed some more prone than others. 

Diagnosis involves a series of tests that will help determine whether a person has indeed suffered a stroke and, in that case, distinguish the kind of stroke. Blood tests like sugar, platelet count, infections and clotting. An MRI will reveal whether any brain cells or tissues are damaged while a CT scan will reveal if any bleeding has occurred in the brain along with any other complications that may have arisen in the brain. An EKG will see how well the heart is working and determine whether any heart conditions are present that may offer a risk of stroke. A Cerebral Angiogram will show a map of neck and brain arteries and this can help in finding out any arterial blockage. A Cartoid Ultrasound reveals plaque deposits that can cause blockage.

Dr. Madhukar Bhardwaj
Senior Consultant
Neurology

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