Neuro and Spine Surgeries
Brain AneurysmWhat is Brain Aneurysm?Read more...
Brain SurgeryWhat is Brain Surgery?Read more...
Brain TumorWhat is Brain Tumor?Read more...
CraniosynostosisWhat is Craniosynostosis?Read more...
Carotid Artery DiseaseWhat is Carotid Artery Disease?Read more...
Carpel Tunnel SyndromeWhat is Carpel Tunnel Syndrome?Read more...
EpilepsyWhat is Epilepsy?Read more...
HydrocephalusWhat is Hydrocephalus?Read more...
Herniated DiscWhat is Herniated Disc?Read more...
HeadacheWhat is Headache?Read more...
Lumbar Spinal StenosisWhat is Lumbar Spinal Stenosis?Read more...
Parkinson DiseaseWhat is Parkinson Disease?Read more...
StrokeWhat is Stroke?Read more...
Spina BifidaWhat is Spina Bifida?Read more...
Spinal Cord InjuryWhat is Spinal Cord Injury?Read more...
Spinal FusionWhat is Spinal Fusion?Read more...
Spinal LaminectomyWhat is Spinal Laminectomy?Read more...
Spinal TumorWhat is Spinal Tumor?Read more...
What is a Stroke?
A stroke is a sudden loss of brain function. It is caused by the interruption of flow of blood to the brain (ischemic stroke) or the rupture of blood vessels in the brain (hemorrhagic stroke). The interruption of blood flow or the rupture of blood vessels causes brain cells (neurons) in the affected area to die. The effects of a stroke depend on where the brain was injured, as well as how much damage occurred. A stroke can impact any number of areas including your ability to move, see, remember, speak, reason and read and write.
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Types of Stroke
There are two main types of stroke -
Ischaemic strokes happen when something blocks an artery that carries blood to the brain. There are several possible causes -
Haemorrhagic strokes happen when a blood vessel bursts and bleeds into the brain (a haemorrhage). The haemorrhage may be due to -
Temporary symptoms may indicate a mini-stroke - sometimes the blockage in the blood supply to the brain is temporary, and a person will have the symptoms of a stroke for a short time, this is called a transient ischaemic attack (TIA) or mini stroke. A TIA is a sign that part of the brain is not getting enough blood, and there is a risk of a more serious stroke in future. As with major strokes, you must seek medical attention immediately.
Causes of a Stroke
Ischaemic Stroke - over 80% of strokes are caused by a blockage of an artery supplying blood to the brain. This is known as an ischaemic stroke. It is caused by a blood clot that forms in a main blood vessel (artery) to the brain. This is called a cerebral thrombosis. Clots form in arteries that already have been narrowed by a condition call atherosclerosis (hardening of the arteries). Atherosclerosis causes fatty material to build up along the inner lining of the arteries so that they become narrower and the blood flowing through them becomes more likely to clot. Lifestyle risk factors for atherosclerosis include high cholesterol, smoking, high blood pressure, diabetes, obesity and physical inactivity.
A partial clot that may form in the heart or the blood vessels of the neck which is carried in the bloodstream to the brain and gets lodged in an artery. This is a cerebral embolism.
A blockage that occurs in the tiny blood vessels deep in the heart. This is a lacunar stroke.
Hemorrhagic stroke - up to 20 per cent of strokes are caused by a bleed into the brain from a burst blood vessel. This is called a cerebral haemorrhage and causes the more serious kind of stroke.
Symptoms of a Stroke
There are many signs indicating the occurrence of a stroke that largely depends on what part of the brain is affected. Its several symptoms include -
Diagnosis of a Stroke
Time is critical when diagnosing a stroke, the first priority will be to determine whether you are having an ischemic or hemorrhagic stroke. This distinction is critical because the medicine given for an ischemic stroke (caused by a blood clot) could be life-threatening if the stroke is hemorrhagic (caused by bleeding). Your doctor will also want to rule out other conditions that have symptoms similar to a stroke and to check for complications.
The first test after a stroke is typically a computed tomography (CT) scan of the brain, which is a series of X-rays of your brain that can show whether there is bleeding. This test will help your doctor diagnose whether the stroke is ischemic or hemorrhagic. Magnetic resonance imaging (MRI) may also be done to find out the amount of damage to the brain and help predict recovery. Other initial tests recommended for ischemic stroke include -
If your doctor suspects or if other tests show narrowing of a carotid artery, he or she may want you to have a carotid ultrasound/Doppler scan to evaluate blood flow through the artery.
Your doctor may also request magnetic resonance angiogram (MRA), CT angiogram, or carotid angiogram.
If your doctor believes the stroke may have been caused by a problem with your heart, an echocardiogram or Holter monitoring or telemetry test may be done.
Treatment of a Stroke
If a stroke has occurred, treatment should begin as soon as the stroke is diagnosed to ensure that no further damage to the brain occurs. Initially, the doctor may administer oxygen and insert an intravenous drip to provide the affected person with adequate nutrients and fluids.
In cases of ischaemic stroke, it is common to give aspirin to reduce the risk of death or of a second stroke.
If the cause of the stroke was a clot, it is possible that the quick administration of certain clot-dissolving drugs, such as alteplase, may prevent some symptoms such as paralysis. However, this is not a suitable treatment for all strokes, and can increase the risk of haemorrhagic stroke, so there are strict guidelines determining the circumstances in which it should be used.
Once a stroke has permanently damaged the brain, the damage can’t be undone. However, many symptoms can improve considerably in the days following a stroke, because the areas of brain on the periphery of the stroke can recover. Also, your doctor will suggest ways to prevent a future stroke, including modifying your lifestyle to minimise your risks of stroke, and taking medications.
Depending on the type and cause of the stroke, anticoagulant drugs ('blood thinners') may be prescribed to help prevent new blood clots from forming, in order to prevent a future stroke. Examples include aspirin, aspirin plus dipyridamole (Asasantin), clopidogrel (e.g. Plavix) and warfarin (Coumadin or Marevan).
Where there is a blockage in a neck artery, surgery may be performed to remove the build-up of plaque in order to prevent a future stroke. This operation is called a carotid endarterectomy.
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