• 14Nov

    How to identify a stroke?

    Stroke is a sudden onset of focal or sometimes global neurologic deficit brought about by an underlying pathology.  This should be differentiated from transient ischemic attack (TIA), which is a temporary episode of neurologic dysfunction caused by focal ischemia of brain, spine or retina, without evidence of pathologic damage. However, ITA is an unstable condition and the risk of stroke occurrence is high.

    Warning signals

    There are number of warning signs of stroke and that should be considered while identifying and those include: weakness on one side of the body, numbness in face, arm or leg, slurring or loss of speech, loss of vision particularly on one eye or double vision, dizziness and loss of balance, and severe, unusual headache.

    There are 2 types of stroke: ischemic and hemorrhagic.

    How to identify ischemic stroke?

    Ischemic stroke occurs when the blood supply in an area of the brain is limited. Ischemia may progress to infarction in which pathology can already be seen on imaging studies.

    Ischemia may be caused by atherosclerosis in which fatty deposits are present inside the arterial walls, thus narrowing the arteries. It may also be caused by thrombosis, which means that there are clots of coagulated blood formed and attached to the walls of blood vessels.

    There is another subtype of ischemic stroke called lacunar infarct. In this condition hyaline is deposited on the walls of small vessels, decreasing its diameter and reducing blood supply. This is commonly caused by hypertension and diabetes mellitus since these conditions weaken the vessels.

    Surviving a stroke is a second chance at live

    Surviving a stroke is a second chance at live

    Cardioembolic infarct is another subtype commonly caused by rheumatic heart disease, valvular diseases and atrial fibrillation. In this case, the vessels are intact but thrombus or clots from the heart goes to the brain and gets lodged in a vessel there. 15% of the output of the heart for each pump goes to the brain, which leads to the possibility of the clots getting lodged there.

    The brain does not store any blood so the blood flow there should remain constant. There could be irreversible damage when the blood flow in the brain is cut off for a long time. With decreased cerebral blood flow, there is decreased oxygen and glucose level in the brain, resulting in a decrease of neural activity.

    How to identify hemorrhagic stroke?

    Aside from ischemic stroke, another type is hemorrhagic stroke, induced by bleeding in the brain. The most common cause of this is chronic and uncontrolled hypertension. Other causes that can ease identification include vascular malformation, aneurysms, blood diseases, head injury and tumor bleeding.

    The symptoms may be similar to that of ischemic stroke. What is more, the symptoms can give a clue towards identifying the location of bleeding. For instance, motor difficulties, preferential gaze of eyes to one side, and inability to use or understand language points to a problem in a part of brain called the basal ganglion, which is a common site of bleeding. Vomiting, dizziness and inability to coordinate voluntary muscle movements can indicate a problem in the cerebellum. A comatose state and abnormal respiratory patterns point to a problem in the brainstem.

    What should be done?

    It is not easy to identify a stroke early. Warning signs of stroke should be recognized right away by a stroke victim itself or a witness. Assuming you are the witness and you suspect someone is having a stroke, ask him/her to smile. Does the face look uneven? Ask him/her to raise both arms. One arm drifting down indicates weakness on that side. Ask him/her to repeat a phrase. Does the speech sound unclear and strange? If someone is identified to have these signs, the witness should bring the patient to the nearest emergency room or hospital which can provide management for stroke.

    Stroke management

    Management for ischemic stroke includes administration of aspirin within 48 hours to prevent recurrence. Antiplatelets and anticoagulants prevent neurologic worsening and complications. The blood pressure, blood sugar level and temperature should also be monitored and regulated.

    Management for hemorrhagic stroke includes complete bed rest, analgesics for headache, anti-emetics for vomiting, mannitol for the increased pressure inside cranium, stool softeners to avoid straining and calcium channel blockers to prevent spasms of blood vessels to name a few.

    Remember that numerous neurons die every minute while a stroke is not treated. Time lost is brain lost.

    Anna L.

    It’s all about health!
    I have academic background in drugs related Chemical Technology, as well as extensive professional experience in pharma and medical companies. My main area of interest is everyday life medicine. The goal of my articles is to give people informative answers to the questions that bother them, to dispel doubts and some common misbeliefs and also to inspire everyone to keep healthy lifestyle.

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