STROKE

Stroke is the commonest cause of neurological disabilities in Western countries. There are 3 major specific causes of stroke:

1. Cerebral insufficiency or lack of blood supply to a specific part of the brain.

2. Cerebral infarction caused by a thrombus (a blood clot formed within the heart or a blood vessel, and is usually caused by a slowing of the circulation or some alteration in the walls of the blood vessels). Can also be caused by an embolism, which is a fragment of matter that originates in another part of the body and is circulated to the brain.

3. Cerebral hemorrhage caused by an aneurysm which is a widening or ballooning out of part of a blood vessel, possibly due to a congenital defect in a blood vessel in the brain. A sudden bursting of this aneurysm and the resultant hemorrhage causes the stroke.

Although stroke usually affects those age 50 and above, it can strike anyone at any age depending on the causative factors involved.  A youngster with an unknown congenital aneurysm of a blood vessel in the brain is at risk during the exertion of playing sports. A young woman who uses contraceptive pills and is a smoker is also at risk. The risk factors for all will be discussed later in this article.

Diagnosing the stroke patient is usually done according to symtomatology. Usually the patient has hypertension (high blood pressure), a high cholesterol count causing atherosclerosis, causing a clogging of blood vessels, and may be a diabetic. Those cases in which there is a doubt, a CT scan or an arteriograph may be required before the diagnosis is definitive.

A stroke can occur during sleep, or anytime during waking hours no matter if you are engaged in a sports activity, or sitting at the dinner table. There can be very minor strokes and may not be apparent to the patient at the time of occurrence. These "mini-strokes" are called "TIAs", or transient ischemic attacks. The patient can undergo several such attacks lasting 2-3 minutes or up to 30 minutes, on a daily basis, or have just a few over several years. At times a TIA can occur shortly before a complete stroke.

Prevention of strokes is of course paramount in a healthy lifestyle. Knowing your body is of the utmost importance and adjusting your way of living to include the following can save your life:

1. Stop smoking and your risk of having a stroke drops almost immediately. The damage caused by smoking can be corrected in about 5 to 7 years.

2. Drink alcohol in moderation. No more than 2 drinks daily.

3. Reduce your salts. Sodium causes fluids to build up in the tissues. 

4. Reduce eating too many fats, especially animal fats and many saturated fats found in dairy products and most junk foods.

5. Check and control your blood sugar.

6. If you are overweight, lose the excess pounds.

7. Check your blood pressure regularly. If you find it high for more than a week, be sure to have your physician check it out.

8. Check your pulse regularly. If you find you have irregular heartbeats have it checked immediately. The irregular heartbeats are caused by atrial fibrillation. This causes blood to pool at the bottom of the atrium and can cause clots going up through the carotid artery into the brain.

9. Exercise regularly and stay active. Walk instead of driving if at all possible. Walk up and down the stairs instead of using the elevator whenever it is convenient.

Recognizing the signs of a stroke can save your life or someone else's life, and even prevent complete or partial paralysis. These are the signs to look for:

1. Sudden severe headache that can be excruciating.

2. A sudden blurring or decreased vision in one or both eyes, but usually in one eye only.

3. Sudden numbness or weakness in your face, arm, or leg, occurring usually on one side of the body.

4. Sudden loss of speech, slurred speech, or difficulty in understanding speech.

5. Sudden difficulty in walking or keeping your balance.

6. Difficulty coordinating an arm movement or holding an object in your hand without dropping it.

There is now a treatment to prevent the severe damage caused by the after affects of a stroke. There is only a 3-hour window of opportunity in which the treatment must be given, if the stroke is to be minimized. This treatment is usually given in emergency stroke centers. The treatment is an injection of a drug called "tPA". Therefore, upon recognizing the symptoms of a possible stroke, even if they seem to disappear, whether it is in yourself or anyone in your presence, CALL 911 immediately. When the "Para-Medics" arrive they will evaluate the patient and determine if the patient needs to be transported to an Emergency "Brain Attack" Center.

The "Brain Attack" center team is composed of a Cardiologist, Neurologist, Radiologist (for Ct scan), Pharmacist, and a Nurse Technician. This team will determine if the patient has indeed suffered a blood clot stroke. If this is the case, they will administer the "tPA" drug by injection. If the patient has been more than 3 hours in getting to the center, the drug will not be administered, because the window of opportunity has been passed and the drug will not be effective. You can see the importance of immediate action when the symptoms of stroke are present. Do not ignore them even if they seem to ease up or go away entirely. Getting the necessary treatment within the 3-hour window can save the patient untold misery and possibly death. The treatment will lessen the degree of paralysis and loss of speech and make recovery quicker and more complete.