Health Management

Stroke : Symptoms, Stages, Types & Treatment

Stroke

Like heart attack stroke is called brain attack. It is the ischemic injury of brain i.e., blood supply of brain is obstructed, that lead to brain damage. This whole blood deprived brain situation results in disabilities that last long sometimes throughout the life.it is the upper motor neuron lesion hence present with spastic paralysis. Stroke can affect anyone of age 15 to 49 but this condition is more common in aged males.

types

Stroke can be of three types;

  • Transient ischemic stroke (TIA)

Also called pre stroke. Temporary / transient obstruction of blood supply to brain is TIA. The blood obstruction to body shows acute symptoms in the body. This type of stroke is mainly due to clot present in some place of body that obstruct oxygenated blood supply. it does not cause permanent damage rather it is a warning sigh for full blown stroke.

  • Ischemic stroke

The commonest and most dangerous type of stroke is ischemic stroke which causes permanent damage to brain and may causes death. This type of stroke is due to narrowing of artery (atheromatous plague or clots) that lead to ischemic injury to brain. The common site for clot is carotid artery.

  • Haemorrhagic stroke

As the name indicate, this is due to any rupture in blood vessel that led to failure of blood to reach the organ (brain). The haemorrhage is

Stages of stroke

There are six stages of stroke, which are as follow,

  • Stage 1 (Flaccidity)

Initially, in this stage of stroke the tone of muscles is greatly reduced. The body appear soft and jelly like. But it should be confused with lower motor neuron lesion.

  • Stage 2 (onset of spasticity)

In this stage of stroke, muscle tone starts to increase gradually. The muscle become spastic and hard on palpation.

  • Stage 3 (increased spasticity)

The tone that started to develop in previous stage, will become adverse, resulting in spastic muscular bulk that make the movement nearly impossible.

  • Stage 4 (decrease spasticity)

Spasticity starts to decrease slowly after reaching its maximum level. In this stage the increased tone starts to become normal. But the movements are not yet returned.

  • Stage 5 (increased normal voluntary movements)

The return of muscular movement starts. The person is able to perform the complex task one again, but the spasticity is yet not complete gone. Thus, a patient may feel fatigue while carrying out normal function.

  • Stage 6 (disappearance of spasticity)

Lastly, the spasticity that started developing in first is completely resolved. The person return to normal function as before stroke.

Stroke

Risk factors

Like any disease stroke have been seen very closely related to certain risk factors which are as follow,

  • High bp
  • Heart and blood vessels diseases
  • hypercholesterolemia
  • Smoking
  • Diabetes
  • Birth control pills
  • History of TIA
  • Increased RBC (red blood cells) count

Causes

The major and leading cause of stroke is high Blood pressure. High blood pressure can cause stroke through many ways one of which is turbulent flow of blood. When the dynamicity of blood is disturbed (flow of blood become turbulent), it led to injury to endothelial lining (inner most lining of vessel, exposed to lumen) of blood vessels and to repair this injury atheroma (plaque) are formed that in turn decrease the diameter of lumen of blood vessels. This altogether result in hindrance to blood stream hence decreasing the blood flow to organs that cause ischemic injury to organ (brain in case of stroke).

Symptoms

Symptoms of stroke vary depending on the extent of tissue damage. The most common are numbness in limbs and face, weakness, immunodeficiency, lack of energy, hemiparalysis (paralysis of one side of body), visionary changes, difficulty speaking, difficulty drinking or eating through mouth, difficulty understanding, difficulty walking, sudden decrease in balance and coordination, changes in personality and modes, cognitive changes, memory loss, incontinence, etc. such patients are more prone to infections such as pneumonia. Ischemic stroke causes permanent disability and sometimes death if not treated accurately.

Diagnostic Tests

Brain CT (computed tomography) scan are used to diagnose stroke. It also shows the extent of stroke and the extent of tissue damage in brain. Blood clots or haemorrhages can easily be seen with help of CT. Another diagnostic test used for diagnosis of stroke is MRI (magnetic resonance imaging) for appropriate diagnosis. Some physicians diagnose stroke from F.A.S.T Test. In which F stands for face, here physician look for any change in facial expression when the patient is asked to smile or frown. A stands for arms, the patients is asked to raise both arms together, the stroke patient will not be able to raise ethe effected arm. S stands for speech, the stroke patient will be unable to speak when asked to talk. Whereas T stands for time, the time since when the symptoms start to appear. And after this test the diagnosis is made and then sometimes the patient is asked for CT or MRL as confirmatory test.

Complications

Complications of stroke include,
Paralysis, brain swelling thus neurological symptoms, seizures due to disturbed activity of brain, blood clots in brain or in some part that effect the blood supply of brain, dementia (memory loss), vision and hearing difficulties, bed sores due to prolonged maintained posture on bed, depression because of his own inabilities and diseased condition and permanent adhesions in joint structure making it impossible for patient to move for life long.

Stroke

Treatment

Stroke is a serious neurological condition that requires immediate attention. The enlisted medications are used for the treatment of stroke,

  • Statins to reduce the chances of thromboembolism by decreasing blood pressure.
  • Bp medicine to reduce high blood pressure.
  • Anticoagulants decrease the coagulative properties of blood and thin the blood to decrease the risk of stroke.
  • Thrombolytic injections to dissolves the blood clots that hinder blood supply.
  • Asprin is used as blood thinning to reduce the chances of intravascular coagulation.

Carotid endarterectomy is a surgical method used to reduce the risk of stroke due to carotid stenosis. In this surgical procedure the atheroma is surgically removed from carotid artery to facilitate blood supply of brain.
Thrombectomy is simply a surgical remover of thrombus (blood clot) from artery/ vein.
Physical therapy plays important role in fast recovery and early return to function. It is widely prescribed on early stages of stroke by physicians after stabilizing patients’ condition. It includes performing activities actively and passively (by therapists).

Research

The major complication of stroke is disability, and the goal is to reduce disabilities in stroke patient as much as possible. The researchers are trying to formulate new methods of stimulating limbs for movements after stroke have been treated. One of which is use of spinal stimulations for movement in upper limbs. The research has showed some promising results but is still under study until prescribed in general population.

Epidemiology

Epidemiologists claim that 1 in every 4 adult people will suffer with stroke in their lifetime globally, that is almost 25% prevalence around the globe. 12.2% people globally suffer with stroke every year out of which 6.5% die of stroke same year that make more then 50% death rate due to stroke among stroke patients world-wide.

Concluded

To prevent such dangerous and life-threatening condition, people should adapt healthy lifestyle. Smoking being the biggest red flag for stroke, should be avoided in any condition. The patient should be given medical care early as possible as any delay in provision of medical services will lead to worsening the condition and patient may die of it.

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