Stroke: All You Need to Know

Types

The most basic definition of a stroke is brain damage caused when when blood flow to the brain is either cut off, or reduced. It is also sometimes called a “brain attack.” This prevents nutrients from getting to the brain, and causes the brain cells to die very quickly. A stroke can rapidly cause death if medical assistance is not provided.

There are two main types of stroke, ischemic and hemorrhagic. An ischemic stroke happens when either a blood clot or a blockage resulting from plaque buildup in the arteries hinders the flow of blood to the brain. Having narrowed blood vessels in the brain predisposes it for a blockage that could cause an ischemic stroke.

On the other hand, a hemorrhagic stroke, like its namesake, results from a hemorrhage, or bleeding in the brain. This bleeding happens when a blood vessel in the brain ruptures or pops as a result of high blood pressure, weakened walls of blood vessels, or because of an aneurysm or an artery that has enlarged or “ballooned”.

When a hemorrhagic stroke happens, bleeding happens directly on the brain, causing pressure to build up. This pressure can kill off the brain cells and cause death if not treated immediately. 

Both types of stroke are very dangerous and require immediate medical attention.

On the other hand, a hemorrhagic stroke, like its namesake, results from a hemorrhage, or bleeding in the brain. This happens when a blood vessel in the brain ruptures or pops as a result of high blood pressure, weakened blood vessels, or aneurysms or arteries that have enlarged or “ballooned”.

During a hemorrhagic stroke, bleeding happens directly on the brain, causing pressure to build up. This pressure can worsen the lack of oxygenation, and cause death if not treated immediately. 

Both types of stroke are very dangerous and require immediate medical attention.

How common is stroke?

Worldwide, around 13.7 million strokes happen each year. And around one out of every four people over 25 will experience a stroke in their lifetime. Additionally, 60% of the strokes that happen each year are from people aged 69 and below. 

Compared to a hemorrhagic stroke, an ischemic stroke is more common, accounting for about 87% of most strokes. 

Stroke remains a leading cause of death, and one of the ways to lower the risk of stroke is to familiarize oneself with the symptoms, causes, and risk factors for stroke.

Signs and Symptoms

Signs and symptoms of stroke often develop suddenly and then may temporarily improve or slowly worsen, depending upon the type of stroke and area of the brain affected. Knowing the signs and symptoms of a stroke can be lifesaving. 

• Sudden weakness or droopiness of the face
• Weakness
• Blurring or loss of vision
• Difficulty speaking, slurred speech or loss of speech
• Confusion
• Dizziness
• Headache, sometimes with neck pains and vomiting

Stroke can also cause symptoms that are more uncommon. These include:

• Hallucinations and delusions
• Sudden changes in taste and smell
• Locked-in syndrome, or complete paralysis of the body except the eye muscles

When should I see my doctor?

A stroke is a medical emergency. If you think you or someone around you may be having a stroke, call an ambulance immediately. A few minutes of blood loss to the brain can result in permanent and severe brain damage, treatment needs to be provided.

The most important thing to remember when it comes to stroke is more prompt initiation of treatment results in higher chances of survival. So it would be best to not ignore any of the signs and symptoms of stroke.

Causes and Risk Factors

Both types of stroke are caused by different things. Ischemic strokes result from blockage in the arteries of the brain that are caused by plaque buildup or blood clots.

Atherosclerosis is a condition that causes plaque to build up in the blood vessels. Over time, this plaque can cause blood clots which can restrict or completely block the flow of blood. An ischemic stroke can be caused by a buildup of plaque in one of the arteries of the brain, or by a blood clot that broke off from another blood vessel and found its way to the brain.

Hemorrhagic strokes on the other hand, results from having high blood pressure. Having high blood pressure can weaken the blood vessels in the brain, as well as cause an aneurysm. Over time, the constant pressure that the blood exerts on these weakened blood vessels can cause them to rupture, which results in a hemorrhagic stroke.

Risk factors

What increases my risk for stroke?

There are many risk factors for stroke, namely the following:

• Having hypertension or high blood pressure
• Being obese or overweight
• Diabetes
• Heart disease
• High blood cholestero levels
• Having a sedentary lifestyle or being inactive
• Drinking too much alcohol
• Smoking and illicit drug use
• A family history of stroke
• People aged 40 or older have an increased risk of having a stroke

Diagnosis and Treatment

How is stroke diagnosed?

Once a person suspected of having a stroke is taken to the hospital, diagnosis needs to happen quickly. Doctors need to work fast to know if the person is indeed having a stroke, or if their symptoms could be caused by something else, such as a brain tumor.

Here are some of the ways that stroke is diagnosed:

• A physical exam will also be conducted to see how the stroke is affecting the nervous system
• A CT scan might be conducted in order to get a closer at the brain to see if a stroke has occurred
• Doctors may request for an imaging test of the blood vessels in the neck and head (called angiography) that supply the brain with blood.
• An MRI scan could also be used in order to get a better view of the brain to see which parts of it could be affected
• A procedure called a carotid ultrasound might also be done to check the blood vessels in the neck for any blockage that might be causing the stroke
• An echocardiogram is a procedure that uses sound waves to take a closer look at a person’s heart. This could show evidence that a blood clot from the heart could have broken off and traveled to the brain, causing a stroke
• An electrocardiogram (ECG) is performed in most people who are thought to be having a stroke. The ECG will help the clinician to diagnose and treat any heart problems as quickly as possible.
• Blood tests are also conducted to check your blood sugar levels, as well as how fast your blood is clotting

If one of the types of stroke has been identified as the cause of the symptoms, then doctors can immediately start working on treatment.

How is stroke treated?

For ischemic strokes

If the doctors identify that the stroke is ischemic, then their priority would be to restore blood flow to the brain. What doctors usually do is provide drugs called thrombolytics that help break up blood clots either intravenously, or by injecting it directly into the brain, which is known as thrombolysis.

In some cases, doctors might directly look for the affected blood vessel and remove the blood clot through a procedure known as thrombectomy that uses a device called a stent retriever. This procedure is usually done for people with large blood clots that can’t be broken down by drugs.

Doctors might also conduct some procedures such as placing stents in narrowed arteries, or removing plaque from other arteries in order to lower the risk of another stroke.

For hemorrhagic strokes

Treatment for hemorrhagic strokes on the other hand, is different from that of ischemic strokes. Because a hemorrhagic stroke causes bleeding in the brain, the top priority would be to minimize the bleeding and reduce the pressure inside the brain.

Drugs to reduce blood pressure in the brain might be given by doctors if the patient is suffering from a hemorrhagic stroke. If the patient is taking any blood thinners, drugs that counteract the effect of blood thinners might also be given.

If drugs can’t stem the bleeding, then a surgery would need to be conducted in order to drain the blood and relieve pressure on the brain. In some cases, surgeons could also remove aneurysms in order to prevent a future stroke from occurring.

After treatment, the patient’s state of health will be closely monitored in order to see if the procedures were successful. Patients who suffer a stroke are also provided a rehabilitation program in order to help recover from the damage caused by the stroke.

People who have had a stroke on the left side of their brain usually have trouble moving and feeling things on the right side of their body. If the stroke happened on the right side of the brain, then the left side of their body would experience difficulty in moving and feeling.

Rehabilitation helps patients restore the movement and feeling in their body. The type of rehabilitation program also depends on how severe the stroke was, the patient’s overall health and their age. 

Lifestyle Changes and Home Remedies

What are some lifestyle changes or home remedies that can help me manage and prevent stroke?

In terms of managing and preventing a stroke, there are a number of lifestyle changes and home remedies that you can do. Here are some of them:

• Engage in at least 30 minutes of exercise daily, or 150 minutes of exercise weekly. This helps keep your body strong and active, and lowers the risk of cardiovascular disease
• Have a diet that is rich in fruits and vegetables, and low in red meat, sodium, sugar, and processed foods. This helps lower your blood pressure, as well as your risk of stroke
• If you are overweight or obese, take steps to get your weight down to a manageable level. Being overweight or obese greatly increases a person’s risk of heart disease, atherosclerosis, hypertension, diabetes, and stroke
• Quit smoking. Smoking increases your risk for heart disease, high blood pressure, and stroke. The sooner you can quit smoking, the better your body will be

If you have any questions, please consult with your doctor to better understand the best solution for you.