Stroke

What is Stroke?

A stroke is a "brain attack". It can happen to anyone at any time. It occurs when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells die during a stroke, abilities controlled by that area of the brain such as memory and muscle control are lost.

Stroke1

How Does a Stroke Occur? There are two types of stroke.

-Ischemic stroke is similar to a heart attack, except it occurs in the blood vessels of the brain. Clots can form in the brain's blood vessels, in blood vessels leading to the brain, or even in blood vessels elsewhere in the body and then travel to the brain. These clots block blood flow to the brain's cells. Ischemic stroke can also occur when too much plaque (fatty deposits and cholesterol) clogs the brain's blood vessels. About 80% of all strokes are ischemic.

-Hemorrhagic (heh-more-raj-ik) strokes occur when a blood vessel in the brain breaks or ruptures. The result is blood seeping into the brain tissue, causing damage to brain cells. The most common causes of hemorrhagic stroke are high blood pressure and brain aneurysms. An aneurysm is a weakness or thinness in the blood vessel wall.

What Are the Symptoms of Stroke? The most common symptoms of a stroke are:

-Weakness or numbness of the face, arm, or leg on one side of the body -Loss of vision or dimming (like a curtain falling) in one or both eyes -Loss of speech, difficulty talking, or understanding what others are saying -Sudden, severe headache with no known cause -Loss of balance or unstable walking, usually combined with another symptom

Controllable Risk Factors for Stroke:

-High blood pressure -Atrial fibrillation -Uncontrolled diabetes -High cholesterol Smoking Excessive alcohol intake Obesity Carotid or coronary artery disease

Uncontrollable Risk Factors for Stroke:

Age (>65) Gender (Men have more strokes, but women have deadlier strokes) Race (African-Americans are at increased risk) Family history of stroke

Stroke Treatment

79572

hc_stroke_landing_treatment

Treatments for stroke vary depending on whether the stroke is caused by a blood clot (ischemic stroke) or a brain bleed (hemorrhagic stroke).

Not matter the type of stroke, acting fast and seeking treatment as quickly as possible is key to reducing the risk of permanent brain damage.

Treatment for Ischemic Stroke

Ischemic strokes happen when a blood clot in an artery blocks the flow of blood and oxygen to a portion of the brain.

With this type of stroke, the goal is to restore blood flow to the brain as quickly as possible.

A number of medications may be given at the hospital to help break up the clot and prevent the formation of new clots.

These medications may include:

Tissue plasminogen activator (tPA, alteplase):Alteplase or tPA is a thrombolytic medication, often referred to as a "clot buster."

These drugs must be started within a few hours after stroke symptoms first appear.

They will quickly break up or dissolve blood clots that are blocking blood flow to the brain.

This type of medicine is given through a catheter or IV tube in the arm.

Aspirin: Aspirin won't dissolve existing blood clots, but it will help to prevent new clots from forming.

Doctors may give aspirin within 48 hours of the start of stroke symptoms.

Anticoagulants: Anticoagulants, such as heparin, may be used to help prevent more blood clots from forming.

Treatment for Hemorrhagic Stroke

Hemorrhagic strokes happen when blood vessels in or around the brain rupture or leak.

This puts too much pressure on the surrounding brain tissue, cutting off circulation and starving the brain of oxygen.

Treatment for hemorrhagic stroke will depend on the cause of the bleeding and what part of the brain is affected.

Bleeding around the brain is often caused by abnormally formed blood vessels, called aneurysms.

Bleeding in the brain is often caused by high blood pressure.

Non-surgical treatments for hemorrhagic stroke may include:

• Controlling blood pressure

• Stopping any medications that could increase bleeding (e.g., warfarin, aspirin)

• Blood transfusions with blood clotting factors to stop ongoing bleeding

• Measuring pressure within the brain using a device called a ventriculostomy tube that's inserted in the skull

Surgical treatments for hemorrhagic stroke may include:

Endovascular treatment: A long tube is slid into a blood vessel in an arm or leg, and passed all the way up to the blood vessels in the brain, where a coil or clip is placed to prevent further bleeding.

Revascularization refers to procedures that restore blood flow through a blocked artery.

Aneurysm treatment: This may involve removing a small piece of the skull to locate the aneurysm and put a small clamp around it to stop the bleeding.