Stroke
Stroke In Nagpur definition refers to the obstruction of the blood supply in the brain. It is usually caused by either blockage and rupture of a blood vessel that causes bleeding, cutting off the flow of blood and oxygen to brain tissues.
Stroke ranks as one of the leading causes of death in the United States, according to the CDC. More than 795,000 Americans suffer a stroke yearly.
Without air, brain cells and tissues will begin to die in just minutes from lack of oxygen.
Types of Stroke
- Ischemic Stroke (most common, about 85% of cases):
- Occurs when a blood clot or plaque blocks an artery supplying blood to the brain.
- Subtypes:
- Thrombotic Stroke: A blood clot forms in one of the arteries supplying blood to the brain.
- Embolic Stroke: A clot or debris forms in another part of the body (commonly the heart) and travels to the brain, blocking a smaller artery.
- Hemorrhagic Stroke:
- Occurs when a blood vessel in the brain ruptures, causing bleeding into and around the brain.
- Subtypes:
- Intracerebral Hemorrhage: Bleeding within the brain tissue.
- Subarachnoid Hemorrhage: Bleeding in the space between the brain and the thin tissues covering it, often due to a ruptured aneurysm.
- Transient Ischemic Attack (TIA) (also called the mini-stroke):
- A temporary blockage of blood flow to the brain, typically lasting only a few minutes to an hour.
- Although symptoms resolve quickly, TIAs are warning signs of a potential future stroke.
Stroke symptoms
This may cause damage to tissues in the brain, where the condition results in symptoms of stroke in affected parts of the body. It is therefore essential to identify the symptoms so that initial intervention can be provided as any delay would surely not help but instead worsen the case. Some common symptoms of stroke include:
- Paralysis
- Numbness or weakness in the arm, face, and leg on one side of the body
- Difficulty in speaking or in understanding language
- Speech slurred
- Disorientation or confusion
- Abrupt mood swings, which would typically worsen restlessness
- Eye disturbances: blurred vision, or vision darkened in one or both eyes, or the eyes may double
- Impairment in walking
- Loss of balance
- Dizziness
- Sudden, very severe headache without apparent cause
- Seizure
- Nausea or vomiting
Accuracy and awareness of such symptoms would allow for prompt response and potentially even lifesaving treatment.
At our Neurosys Multispeciality Center, we perform several key procedures including Craniotomy, which is primarily for the excision of brain tumors; V-P Shunt Surgery for treating hydrocephalus; surgeries for epilepsy; and operations targeting brain stem glioma. Beyond these, we offer a range of other neurosurgical services. If you have any questions that are not answere, please contact us through our Contact Us or Book your Appointment.
Stroke treatment
Treatment for stroke differs with the type of stroke:
Ischemic stroke and TIA Most of these strokes, resulting from blood clots or blood blockages in the brain, are treated similarly, which involves:
- Thrombolytic agents: Such as tissue plasminogen activator, tPA that rapidly dissolve blood clots in the arteries supplying the brain, stop the stroke from progressing, and minimize damage to the brain. tPA has been shown to be the “gold standard” for the treatment of acute ischemic stroke, with better chances of recovering and lower disability.
- Mechanical thrombectomy: In this, a catheter is placed in one of the major blood vessels in the head to extract the clot using specialized devices. It’s most effective when performed within 6 to 24 hours after the stroke begins.
- Stents: If the doctor determines that the weakened walls are of the artery, the doctor implants a stent to open the narrowed artery and give it structural support.
- Surgery: In some cases, when other treatments have failed, surgery must be employed to remove clots and blockages in the arteries. The surgery may be done via catheter or by opening up an artery for the removal of larger clots.
Hemorrhagic stroke For those strokes that are caused by bleeding or leaking within the brain, stroke treatment approaches are different:
Drugs: Unlike the ischemic strokes, hemorrhagic strokes must promote blood clotting. Medications may be given to reverse blood-thinning medications and to:
- It lowered blood pressure.
- Could decrease brain pressure
- It can reduce risk of seizures
- It can prevent constriction of blood vessels
Coiling: In this procedure, a long tube is passed into the area where the bleeding is occurring or the weak vessels are located. Then, some sort of coil-like tool is placed in that region to block the blood flow and reduce further bleeding.
Risk Factors for Stroke:
- High Blood Pressure (hypertension): The most significant risk factor.
- Heart Disease: Atrial fibrillation (irregular heartbeat), heart attacks, or heart valve disease.
- Diabetes: Increases the risk of the atherosclerosis, which can lead to strokes.
- High Cholesterol: Can contribute to plaque formation in arteries.
- Smoking: Damages blood vessels or increases clotting risk.
- Obesity and Sedentary Lifestyle: Contribute to other stroke risk factors like hypertension and diabetes.
- Family History: A family history of stroke and heart disease increases the risk.
- Age and Gender: Stroke risk increases with age, and men are more likely to suffer strokes, but women are more likely to die from them.
- Previous Stroke or TIA: History of a previous stroke or TIA increases the risk of future strokes.
Diagnosis of Stroke:
- Physical Examination: Neurological examination to assess strength, reflexes, coordination, and sensory function.
- CT Scan: Quickly detects bleeding in the brain, used to differentiate between ischemic and hemorrhagic strokes.
- MRI: Provides detailed images of brain tissue and can detect smaller areas of brain damage.
- Carotid Ultrasound: Assesses blood flow through the carotid arteries, which supply blood to the brain.
- Echocardiogram: Evaluates the heart for any source of blood clots that could travel to the brain.
- Blood Tests: Measure blood clotting factors, blood sugar, and cholesterol levels.
Treatment Options:
1. Ischemic Stroke Treatment:
– Clot-Busting Medications: Tissue plasminogen activator (tPA) can dissolve clots and restore blood flow if given within 3 to 4.5 hours after symptoms start.
– Mechanical Thrombectomy: A procedure to physically remove the clot using a catheter inserted through a blood vessel.
– Anticoagulants and Antiplatelets: Blood thinners like aspirin, clopidogrel, or warfarin may be prescribed to prevent further clots.
2. Hemorrhagic Stroke Treatment:
– Controlling Bleeding and Reducing Pressure: Medications to lower blood pressure and control bleeding.
– Surgery: In cases of large hemorrhages, surgery may be needed to the remove blood or repair damaged blood vessels.
– Aneurysm Repair: For subarachnoid hemorrhage, surgery or endovascular procedures (e.g., coiling) can seal off the aneurysm.
Stroke Prevention:
- Control Blood Pressure: The most important modifiable risk factor.
- Manage Diabetes: Keep the blood sugar levels under control.
- Quit Smoking: Smoking cessation dramatically reduces stroke risk.
- Exercise Regularly: Engage in at least 30 minutes of the moderate exercise most days of a week.
- Maintain a Healthy Diet: Focus on fruits, vegetables, whole grains, and low-fat proteins. Avoid excessive salt and saturated fats.
- Limit Alcohol: Excessive drinking increases stroke risk.
- Take Medications as Prescribed: For conditions like high cholesterol, high blood pressure, and heart disease.
- Monitor Cholesterol Levels: High cholesterol can lead to the plaque buildup in arteries.