About stroke

About stroke , is a topic that every person must have knowledge about it. Statistics reveal  that in the year of 2019, stroke was considered the second  leading cause of death world wide . Stroke took 11 % of the total deaths. Statistics of Centers for Diseases Control and Prevention show that more than 795,000 peoples in the United States have a stroke every year. . Among them around 610,000 people have the first stroke.

Contents:

• Type of strokes.
•  Is stroke a problem of heart or  brain?
• Stroke in families.
• Stroke symptoms.
•  Stroke can be treated .
• Age and stroke.
• Silent stroke.
• All stroke are risky.
• Stroke causes long term disability.
• Stroke recovery.

Types of strokes.

There are 3 main types of attack.

• The first and most common attack is an Ischemic stroke. 87 % cases belong to this type . When blood flow through the artery that supplies oxygen to the brain become blocked, the stroke occurs.
• The second stroke is Hemorrhagic attack. A hemorrhagic stroke causes severe bleeding in or around your brain. Because this is happening inside of your skull, there’s so much space for the bleeding .High blood pressure is the main cause of hemorrhagic stroke, but other conditions like Type 2 diabetes and high cholesterol can  also contribute.
• The third type  is a Transient Ischemic  attack. It is also called a ” Ministroke “.When people use the term “ministroke,” they’re referring to a transient ischemic attack (TIA). A TIA is a brief blockage of blood flow to part of the brain, spinal cord or the thin layer of tissue at the back of the eye known as the retina. This blockage may cause temporary stroke-like symptoms.

Is stroke  a problem of heart or brain ?

Many people  believe that stroke is a problem of heart. Dr. Rafael Alexander Ortiz, Chief of Neuro-Endovascular Surgery and Interventional Neuro-Radiology at Lenox Hill Hospital made it clear that ;

• Stroke risk is linked to cardiovascular risk factor, but attack happens in the brain, not in the heart.
• Dr. Ortiz  explained in his own words  as  ” Some people think that stroke is a problem of  the heart. That is incorrect. A stroke is a problem of the brain, caused by the blockage or rupture of arteries or veins in the brain, and not the heart “. (An aneurysm is an abnormal bulge or ballooning in the wall of a blood vessel. An aneurysm can burst. This is called a rupture. A ruptured aneurysm causes bleeding inside the body and often leads to death.)
• Some people become confused that stroke is  a heart attack . Heart attack caused by  blockage in blood flow to the heart and not to the brain. For further details please read our article ” Early signs of heart failure. “
• Dr. Ortiz said that  most common cause of  stroke are hypertension, smoking, obesity, high cholesterol, diabetes, trauma to the head or neck (  a serious bodily injury  that caused by an accident or violent act)  and cardiac arrhythmias (Arrhythmias are treatable with medicine or procedures to control the irregular rhythms. If not treated, arrhythmias can damage the heart, brain, or other organs. This can lead to life-threatening attack, heart failure, or cardiac arrest.) 
• Changing  the lifestyle can help stroke risk factors . Eating a healthy diet, exercising daily , controlling alcohol consumption and controlling stress may help to reduce a person’s risk of attack. 

Stroke in families;

Single -gene disorder such as sickle cell disease may increase a person’s risk for stroke .Sickle cell disease is a group of inherited red blood cell disorders that affect hemoglobin, the protein that carries oxygen through the body. Normally, red blood cells are disc-shaped and flexible enough to move easily through the blood vessels. In sickle cell disease, red blood cells become crescent- or “sickle”-shaped due to a genetic mutation. These sickled red blood cells do not bend or move easily and can block blood flow to the rest of the body.

Genetic factors including higher risk for high blood pressure and some other cardiovascular risk factors can also indirectly increase the risk.

Families usually share environments and lifestyles. The unhealthy lifestyle factors increase attack risk among family members , especially  when coupled with genetic risk factor.

Stroke symptoms;

The common symptoms  form the acronym  “F.A.S.T.”. This is explained as under;

F—– Face dropping , when one side of face become numb, producing an uneven smile.

A —– Arm weakness, one arm become numb and when raised , drifts slowly downward.

S —– Speech difficultly or slurred speech.

T—– Time to call for help.

 symptoms.

The symptoms  are as follows:

• Numbness or weakness in the face, leg, arm or one side of the body.
• Trouble speaking or understanding speech and confusion .
• Difficulty walking, dizziness, loss of balance and coordination.
• Difficulty seeing in one or both eyes.
• Severe headaches without a known reason.

Stroke can  be treated.

Many people believe that strokes can not be treated and are irreversible. Dr, Ortiz  has a diffident opinion. He says that:

” Emergency treatment  with injection of a clot busting drug , minimally invasive mechanical thrombectomy for clot removal,  or surgery can reverse the symptoms  in many patients, especially if they arrive to the hospital early enough for the therapy( with in minutes or hours since the onset of the symptoms”)

Mechanical thrombectomy is an endovascular technique for removing blood clots from the brain after an ischemic stroke. After making a small incision in the groin, doctors thread thin tubes (catheters) through your blood vessels to the clot.

Dr Ortiz also explained that  ” longer the symptoms last, the lower the likelihood of a good outcome . It is critical that at the onset of  symptoms — ie trouble speaking, double vision, paralysis or numbness etc — an ambulance should be called for treatment to the nearest hospital. ”

As the research shows that the patients who arrived in the hospitals, within 3 hours of first symptom , typically have less disability 3 months afterward, as compared to those who arrived later.

Age and stroke.

Age is an important factor when we talk about stroke. Researchers found that stroke risk become double every 10 years after the age of 55 years. However it may occur at any age.

HealthCare’s’ data was examined by the members of one study. They found that 34 % of  the stroke patient, who were hospitalized in 2009, were under the age of 65 years.

Another review in 2013 revealed that approximately 15 % of all Ischemic stroke occur in young adults and adolescents. The researchers noted that hypertension, diabetes, lipid disorder, obesity and tobacco use are the most common conditions to occur above attack , among this age group .

Silent stroke.

It is not necessary that all stroke have symptoms. There are some symptoms free attacks  which are more common as compared to other attack . Such stroke are known as “silent stroke”.

A study in 1998 came to know that out of over 11 million strokes , 770,000 presented symptoms , and close to 10,230,000 were silent strokes.

The silent strokes are often identified during MRI scan report. Most people carry out NRI scan for headaches, cognitive issues or dizziness.

The silent attack occur without symptoms, it is very important to treat them immediately similarly  to stroke with symptoms. If not treated, silent stroke can put the people at the risk of further symptomatic  attack, cognitive decline and dementia.

Dr. Ortiz  also explained that some  people believe that ministroke  are not so risky. That is incorrect. The ministroke is a transient ischemic attack.  Dr. Ortiz said ” It is not a small attack. but an premonition that a large stroke can occur. Any symptom of acute stroke, transient or persistent, needs emergency workup and management to prevent a devastating large attack”.

Stroke causes long term disability.

Although , the attack  may cause  of long term disability, but not to  every one , who has a stroke , will face paralysis or weakness. Researchers claim that attack  can cause reduced mobility in 1/2 of attack  survivors aged 65 and above.

However, the long term impact of stroke depend on many factors such as :

• how many brain tissues were affected.
• How much brain area was affected.
• Which side of brain was affected.
• Damage to the left brain, will affect the right side of the body, and vice versa.
• If the stroke occurs in the left side of the brain, right  side of the body will be paralyzed.
• Language and speech memory loss problem can appear.
• Cautious behavior .