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Stroke

 STROKE

A stroke occurs when the blood supply to a part of the brain is interrupted depriving the tissues of oxygen and food and thereby injuring or permanently damaging these cells.

Strokes are divided into ischemic and hemorrhagic strokes. Ischemic strokes are caused by the blockage of blood vessels supplying the brain. This can be due to fatty deposits known as plaques or it can be caused by blood clots traveling from the heart or other parts of the body to the narrow arteries in the brain.

Hemorrhagic strokes develop when the brain blood vessels burst and are unable to supply the cells with enough nutrients. Common causes of these strokes include high blood pressure and swellings in the blood vessel walls known as aneurysms.

Risk factors:

Common risk factors include diabetes, high cholesterol, high blood pressure, smoking, family history of stroke, clotting disorders, alcohol dependence, elicit drug use

Symptoms

Symptoms of a stroke include numbness or paralysis of one side of the face, one arm or leg. This can result in drooping of one side of the mouth when the person tries to smile and drifting of one arm downwards when they try to raise their hands above their head.

Some patients with strokes also develop slurred speech, become confused and have difficulty understanding the spoken word. Other patients experience trouble walking, dizziness, loss of balance and coordination. A sudden severe headache, which may be accompanied by vomiting and blurred or double vision, is another symptom of stroke.

Diagnosis

Diagnostic tests done on patients with a stroke include a computerized tomography scan (CT scan) which utilizes a series of x-rays to create detailed brain images. Magnetic resonance imaging (MRI) scans which use radio waves, can also be done to reveal the areas of the brain that have been damaged by the ischemic or hemorrhagic stroke.

Cerebral angiograms can also be done in patients with strokes. In this medical procedure the doctor inserts a thin tube in the groin and guides it to the arteries which supply the brain. Dye is then injected into this tube to reveal any blockages or leaks when the x-rays are taken.

Treatment

The treatment of ischemic strokes includes the use of medications like tissue plasminogen activator (TPA) and aspirin to reduce the clots blocking the blood vessels and prevent the formation of new ones. The doctor can also perform angioplasty by guiding a small tube with a balloon from the groin to the blocked artery. They then inflate the balloon to open the blockage.

The treatment of hemorrhagic stroke involves the use of bed rest and supportive measures as the body absorbs the blood. Patients who are taking blood thinners like warfarin are also given medications to counteract their effects. Surgery is done for patients who have bled a lot to remove the blood and relieve pressure on the brain. If aneurysms caused the bleeding, they are also repaired surgically.

After the emergency treatment, patients with both types of strokes are admitted into a rehabilitation program to help them regain the functions they have lost. This program can include physiotherapy and speech therapy.

Patients who develop spasticity of the upper limbs after a stroke are treated with botulinum toxin type A which is commonly known as Botox. This medication which is produced by the bacteria Clostridia botulinum, is injected into the muscles to paralyze them since it blocks the release of the neurotransmitter or signaling chemical known as acetylcholine which causes muscle contractions.

The treatment of strokes regardless of whether they are ischemic or hemorrhagic is important since adequate blood flow to the brain must be restored as quickly as possible to prevent the death of more brain cells.

Research

The latest studies conclude that strokes are rising in younger adults. This is thought to be due to an increase of risk factors like diabetes, obesity, high cholesterol and high blood pressure in persons who are around 40 years.

Support groups for persons with strokes in Tennessee include the Stroke Group whose contact person Shannon Tucker can be reached by phone at 615 769 7867. This group meets on the first Monday of the month at 2.00 pm at the Skyline Medical Center Auditorium B. Their address is 3441 Dickerson Pike, Nashville, TN 37207. http://www.strokeassociation.org/STROKEORG/strokegroup/public/supportGroupDetail.jsp?groupId=2229

The National Stroke Foundation also offers a toll free help line 1 800 STROKES (1 800 787 6537) and valuable resources at its website http://www.stroke.org.

 

 

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Posted on

October 3, 2014