Stroke Definition

A stroke mainly occurs because of two reasons, when a blood vessel in the brain ruptures and bleeds, or when there is a blockage in the blood supply in the brain. This rupture or blockage in the brain prevents the flow of sufficient blood and oxygen from reaching the brain makes it difficult to function at its best.

A stroke mainly occurs due to the insufficient supply of oxygen to the parts of the brain as brain cells get damaged and may die due to a lack of oxygen even for a few minutes. 

Immediate medical attention or prompt treatment is required at the time of stroke to avoid brain damage or any other severe complications, such as memory problems that will affect the function of other organs of your body.

The Centers for Disease Control and Prevention(CDC) reports a stroke to be the fifth leading cause of the deaths in the United States, resulting in more than 140,000 deaths every year. This indicates that 1 out of every 20 deaths because of a stroke.

Stroke statistics show that every 40 seconds, someone in the United States experience a stroke, and every 4 minutes a person dies because of the stroke. The stroke graph also indicates that more than 795,000 people in the United States suffer from stroke and out of these, about 610,000 are at the initial phase of the stroke.

The reason for these deaths was examined and found that 87% of all these strokes were because of ischemic stroke, a kind of stroke in which the blood flow to the brain gets blocked.

Everything costs, so do a stroke. The annual treatment for these strokes was figured to be around $34 billion US dollars. It includes the costs of health care services, medications, procedures, and the cost of loss of work of the patient.

Stroke has become the leading cause of severe long term disability, reducing mobility in more than half of people who survived from a stroke of age 65 and above.

Facts About Stroke

  • The risk of developing a stroke varies with race and ethnicity.
  • The risk of having a first stroke is nearly twice as high in blacks as compared to whites. As a result, blacks have a higher rate of death due to stroke.
  • But nowadays, when the rate of deaths due to stroke has been declined among all the races and ethnicities, Hispanics have seen an increase in death rates since 2013.
  • The risk of developing a stroke increases with age, but that doesn’t mean the stroke will not occur in young people. Still, it can occur at any age.
  • One of the reports shows, in 2019, 34% of people got hospitalized because of stroke, and these people were less than 65 years old.
  • Hypertension, high cholesterol, smoking, obesity, and diabetes are the primary causes of developing a stroke. The sad part is, 1 in every 3 U.S adults have at least one of these conditions or habits, which increases the chance of developing a stroke.

Stroke Warning Signs

As discussed earlier, the stroke is caused due to lack of supply of oxygen to the brain cells making some parts of the brain malfunctioning. These parts of the brain that are affected by the stroke do not function well, showing stroke signs.

It is essential to seek immediate medical help for a person experiencing a stroke because as soon as the patient will receive the treatment, the chance of getting better increases. Therefore, it is beneficial to know the stroke symptoms to get immediate help if required.

The general symptoms of a stroke are:-

  • Paralysis
  • Weakness in the arms, face, and legs. Especially on one side of the body.
  • Difficulty in speaking and understanding speech
  • Hindrance in mental functioning
  • Slurring speech
  • Loss of vision, such as difficulty in seeing one or both eyes, vision, blackened, or double vision
  • Difficulty in walking
  • Loss of balance or coordination
  • Dizziness
  • Unknown sudden headache

Please note, if anyone is suffering from a stroke trying to get immediate medical help in order to avoid severe complications, such as:-

  • Brain damage
  • Long term disability
  • Death

Stroke Symptoms In Women

Women are at higher lifetime risk of developing stroke as compared to men and have considered the fourth-leading cause of death in the U.S.

Some stroke symptoms are general in both men and women, but some are more common in women, such as:-

  • Vomiting or nausea
  • Hallucination
  • Pain sensation
  • Weakness
  • Trouble breathing
  • Loss of consciousness
  • Seizures
  • Lack of responsiveness
  • Behavioral changes, such as agitation

Women are more likely to die from stroke. Hence it is essential to identify stroke symptoms so that the victim will be able to get immediate medical help and can prevent severe complications.

Stroke Symptoms In Men

Stroke has been considered the fifth leading cause of death in men. According to the National Institute of Health, young men are more likely to be affected when compared to women, but they are less likely to die from it.

Stroke symptoms that are most common in men are:-

  • Drooping on one side of the face
  • Difficulty in speaking and understanding speech
  • Weakness in arm and muscles, especially on one side of the body

Some symptoms differ in men and women; hence it is essential to know the symptoms so that preventive measures can be arranged on time.

Stroke Types

Strokes are mainly categorized into three categories, such as:-

  • Transient Ischemic Attack(TIA)
  • Ischemic Stroke
  • Hemorrhagic Stroke

These categories are subdivided into further categories which are as follows:-

  • Embolic stroke
  • Thrombotic stroke 
  • Intracerebral stroke
  • Subarachnoid stroke

Let’s know more about these types:-

  • Transient Ischemic Attack(TIA): Doctors consider Transient Ischemic Attack(TIA) a warning sign or ministroke in which the flow of blood gets blocked for a temporary period of time. 

The symptoms of Transient Ischemic Attack(TIA) are similar to those of a full stroke, but the only difference is, these symptoms occur for a short period of time. When it continues for long, it is called a full stroke.

Transient Ischemic Attack(TIA) is usually caused by blockage due to blood clots. Never ignore the Transient Ischemic Attack(TIA) because it is a sign of full stroke. 

The CDC reports more than one-third of people who experienced Transient Ischemic Attack(TIA) and left untreated had suffered a major stroke within a year.

Transient Ischemic Attack(TIA) is so severe that 10%-15% of people experiencing this have to suffer from a severe full stroke within three months.

  • Ischemic Stroke: In this type of stroke, the arteries supply blood to the narrow vessels of the brain or sometimes get blocked. These blockages are caused due to clotting of blood or reduced blood flow. It is also caused because of the pieces of plaque due to breaking off atherosclerosis.

The most common types of ischemic strokes are:-

  • Embolic stroke: When blood clots or debris is formed in other parts of the body that further travels to the brain causes a stroke.
  • Thrombotic stroke: It occurs when blood clots in one of the arteries supplying blood to the brain, which further passes through the bloodstream and becomes lodged, blocking blood flow.

The Centers for Disease Control and Prevention(CDC) reports that 87% of the strokes are categorized as ischemic stroke.

  • Hemorrhagic Stroke: It is a type of stroke in which the artery of the blood breaks, which further gets open and starts to leak blood. This blood after rupture creates pressure in the skull, swelling the brain causing damage to the brain cells and tissues.

Hemorrhagic stroke is further categorized as:-

  • Intracerebral stroke: It is one of the most common types of hemorrhagic stroke in which the brains fill with blood due to artery burst.
  • Subarachnoid stroke: It is a rare type of stroke which is caused due to bleeding between the brain and the tissues that cover it.

The American Heart Association reports that 13% of the strokes are hemorrhagic. 

Stroke Risk Factors 

The National Heart, Lung, and Blood Institute reports, the more risk factor you have, the chance of developing the stroke increases. These risk factors include:-

1. Diet: The unhealthy food items that increase the risk of stroke is one that is rich in:-

  • Salt
  • Saturated fats
  • Trans fats
  • Cholesterol

2. Inactivity: Inactivity or lack of exercise increases the risk of stroke. Regular exercise is beneficial for health, and the CDC suggests performing a daily workout or aerobic exercise for at least 2.5 hours every week.

3. Alcohol consumption: Consuming too much alcohol increases the risk of stroke. Therefore alcohol consumption should be done in moderation. The optimum consumption of alcohol is considered one drink per day for women, and not more than two drinks in the case of men. 

Consuming alcohol more than that the recommended can triggers the blood pressure level along with triglyceride levels causing atherosclerosis.

4. Tobacco: Consuming tobacco in any form increases the blood pressure that automatically triggers the risk of stroke. Blood pressure increases while smoking because it contains nicotine.

5. Personal Issues: Apart from the points mentioned above there are several other factors that are responsible for increasing the risk of stroke and are not in our hands, such as:-

6. Family history: The risk of stroke increases if any member of your family has genetic health issues, such as hypertension.

7. Sex: The CDC reports that both men and women can have the chance of having a stroke, but women are more likely to be stroke as compared to men.

8. Age: With the increase in age, the chance of having a stroke increases.

9. Race and Ethnicity: The Caucasians, Asian Americans, and Hispanics have a low chance of having a stroke as compared to African-Americans, Alaska Natives, and American Indians.

10. Medical history: Some medical conditions trigger the stroke, such as:-

  • TIA or previous stroke
  • Hypertension
  • High cholesterol
  • Heart disorder, such as a coronary artery disease
  • Heart valves defects
  • Enlarged heart chambers
  • Improper heartbeat
  • Sickle cell disease
  • Diabetes

How Is Stroke Diagnosed?

For stroke diagnosis, the doctor will be interested in knowing about your medical history, symptoms, and the preventive measure you might had taken while experiencing the signs and other queries, such as:-

  • Medications
  • Current blood pressure
  • Heartbeat

The doctor might ask you to undergo specific physical exams to evaluate your condition, such as:-

  • Balance
  • Coordination
  • Weakness
  • Numbness in the body parts
  • Confusing behavior
  • Loss of vision

The doctor may diagnose you with the help of specific tests that will help the doctor to determine your past medical conditions, such as:-

  • If you had a stroke
  • Cause of the stroke
  • Part of the brain that is affected by the stroke you ever had
  • To confirm the bleeding in the brain

These tests are also helpful in determining the cause of the other symptoms if you might have/had experienced.

Certain tests are used to diagnose strokes if you ever had experienced or you are at the high risk of developing the stroke, such as:-

Blood Tests: Blood tests are the primary step for diagnosing stroke or the factors that can increase the risk of having a stroke:-

  • The sugar level in your blood
  • To confirm if you are infected
  • To know the platelet level
  • To determine your healing process

MRI and CT scan: The doctor may ask you to undergo either one of them or both the tests, such as Magnetic Resonance Imaging(MRI) scan or Computerized Tomography(CT) scan.

The MRI test will help the doctor to determine the damaged brain cells or tissue. The CT scan will help the doctor by providing a clear picture of your brain to see any bleeding or damage is there in the brain. It will also help you in determining other brain conditions that may be the reason for causing stroke symptoms.

EKG: While diagnosing stroke, the doctor needs to know about your heart condition. Therefore he might ask you for a simple test through an electrocardiogram(EKG) that records the electrical activity, the rhythm of your heart, and the heartbeat. It can also determine other heart conditions that can cause strokes, such as heart attack or atrial fibrillation.

Cerebral angiogram: Another test your doctor may ask you to perform is a cerebral angiogram. This test helps to determine the details of the arteries in the neck and the brain that can also show blockage or clots that are responsible for the stroke symptoms.

Carotid ultrasound: It is also known as the carotid duplex scan used to show fatty deposits(plaques) in your carotid arteries, which is responsible for supplying blood to the face, neck, and brain. It can also indicate easily if your carotid arteries have been narrowed or blocked.

Echocardiogram: Strokes mainly occurred due to blockage of the nerves because of clotting in your heart. These clots might travel to your brain and may cause a stroke.

Also Read: What Is Congenital Heart Disease(CHD)?

How A Stroke Is Treated?

The stroke treatment involves proper medical evaluation, and prompt treatment is essential. The American Heart Association states, ‘Time lost is brain lost.’ Immediate medical help is required in order to cure a stroke.

Stroke treatment depends on the type of stroke occurred which is explained below in more detail:-

Ischemic Stroke and TIA: Such type of stroke is caused due to blood clot or other blockages in the brain and treatment is done accordingly, that includes:-

  • Antiplatelet and anticoagulants are usually the first line of defense against such stroke damage. It should be taken within 24 to 48 hours after the stroke symptoms begin.
  • Clot-breaking drugs such as thrombolytic drugs can break blood clots in the arteries of the brain that can further stop the stroke and prevent damage to the brain. Another drug named tissue plasminogen activator(tPA) or Alteplase IV r-tPA, is considered the standard drug for ischemic stroke treatment. 
  • Mechanical thrombectomy is a procedure in which the doctor will insert a catheter into a large blood vessel inside the head to pull the clot out of the vessel. This surgery is mainly performed 6 to 24 hours just after the stroke begins.
  • Stents are expandable coils made of metal mesh that is used in supporting the walls of the narrowed artery when their walls become weak. It is done to improve the blood flow through the artery.
  • Surgery is performed in rare cases when other treatments don’t work and the doctor has to remove the blood clot and plaques from the arteries. It is mainly performed with a catheter or in some cases, when the clot is large, the doctor may open the artery to remove the blockage.

Hemorrhagic Stroke: It is caused due to bleeds or leaks in the brain and requires treatment accordingly that involves:-

  • Medications are used to treat the blood clot. Therefore, drugs are used to counteract any blood thinners you take. The doctor may also prescribe you drugs that are used to reduce the blood pressure that automatically reduces the pressure in the brain and prevent blood vessel constriction.
  • Coliling is a procedure in which the doctor guides a long tube to the area of hemorrhage or weakened blood vessels. It is then installed in the area where the artery is weak, which blocks the flow of blood to reduce bleeding.
  • Clamping is a device used to treat aneurysm that hasn’t started bleeding or has stopped bleeding. If the bleeding has begun, the surgeon may place a tiny clamp at the base of the aneurysm. Clamp detaches the aneurysm from the blood supply and prevents it from bleeding further or from a possible broken blood vessel.
  • Surgery is mainly performed to clip the aneurysm when it bursts to prevent additional bleeding. Similarly, a craniotomy may be needed in order to relieve the pressure on the brain after a severe stroke.

Once you suspect any stroke symptoms, it is essential to attain emergency medical treatment as the clot-busting medication can only be provided in the first hours after the signs of a stroke begin. Therefore, early treatment is essential in order to reduce the risk of long term complications and disability.

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