STROKE
What is a stroke?
In a healthy brain, blood vessels carry blood to all the brain’s cells, supplying nutrients and oxygen. A stroke occurs when this blood supply to one area of brain tissue is interrupted. It can occur in any part of the brain.
How does a stroke occur?
There are two types of strokes:
1.Ischemic
A blockage occurs in a blood vessel (like an accident that closes the highway), preventing blood from reaching brain tissue.
2. Hemorrhagic
Occurs when there is bleeding into the brain tissue (sort of like an oil spill that kills or injures animals in the ocean). In both types of stroke, the brain cells do not receive the nutrients and oxygen necessary to survive.
What are the symptoms of a stroke?
The symptoms of a stroke depend on where the blood supply is lost, so there are many different symptoms a person may experience. The most common symptoms include a change in our normal speech (slurring words, or trouble expressing our thoughts) along with weakness on one side of the body. Sometimes patients may notice a ‘droop’ on one side of their face.
What things increase your risk of having a stroke?
There are two types of risks. Modifiable risks are ones that we can change to try and reduce the chance of having a stroke in the future. These include:
- Cigarette smoking
- High alcohol consumption
- Physical inactivity
- Unhealthy diet
- Diabetes with poor blood sugar control
- High blood pressure
- High cholesterol
- Being overweight
Non-modifiable risks are things about ourselves that we cannot change, like our age (being older), gender (male), and family history of heart attack or stroke.
How do doctors treat a stroke?
When patients come to the hospital with symptoms of a stroke, then a picture of the brain (called a CT scan) is done. If there is a stroke, doctors who specialize in the brain (neurologists) are called. Neurologists treat a stroke differently depending on whether it was caused by a blocked blood vessel (ischemic stroke) or from bleeding (hemorrhagic stroke):
Immediate Treatment
Fixing the Blockage:
If there is a blockage, they may be able to use a medication that breaks down the blockage to try and restore blood flow. This is called thrombolysis – thrombo= clot, and lysis= break down.
Controlling the Spill:
If there was bleeding into the brain tissue, then neurologists will carefully control a patient’s blood pressure, to make sure it is not too high or too low.
Long-term treatments
After a stroke, patients may require rehabilitation to improve their function. For example, if speech was affected then a patient may work with a speech-language pathologist. If a stroke caused weakness in a patient’s right side, they may work with occupational therapy and physiotherapy. It is not always possible to regain all of the function that was lost.
Can I do anything to prevent another stroke?
YES!
1. Make lifestyle changes (all patients):
- Adopt a Mediterranean diet
- Exercise regularly
- Quit smoking
- Reduce alcohol consumption
- Lose weight if appropriate
2. Treat other medical conditions with help from your doctor (if present):
- Medication to lower high blood pressure
- Medication to control blood sugar in diabetes
- Statin medication to treat high cholesterol
- Medication to treat atrial fibrillation (an abnormal heart rhythm – see our post on this topic!)
- Surgery for large blockage in the artery of the neck, the carotid artery
3. Take a medication to help thin the blood (for those with an ischemic stroke):
Your doctor may recommend an anti-platelet medication, for example aspirin, to help thin the blood to prevent another blockage in the blood vessels of the brain
What’s the difference between a ‘TIA’ and a stroke?
A transient ischemic attack (TIA) can produce the same symptoms as a stroke, but the symptoms will resolve completely within one day (usually quite quickly). It occurs for a similar reason as an ischemic stroke: there is a blockage in the blood supply to the brain tissue. But in a TIA, the blockage resolves and the brain cells can return to normal function.