What is stroke | Everything you need to know about stroke.

Stroke, also called a stroke or stroke, is a sudden alteration in cerebral circulation in one or more of the blood vessels supplying the brain. Stroke interrupts the supply of oxygen to brain tissue and can cause serious damage. For anyone who has suffered a stroke, it is extremely important to restore normal circulation as soon as possible to limit damage to brain tissue.

Although mortality from stroke was significantly reduced by about 90% in the 1950s, the number still hovers around 30% and stroke may soon be the most common cause of death worldwide. Of those who survive, about half remain permanently disabled and many experience recurrences within weeks, months or years.

Causes and incidence

A stroke results from an obstruction of a blood vessel, usually outside the brain, but sometimes inside the brain itself. Factors that increase the risk of stroke include a history of transient ischemic attacks, atherosclerosis, hypertension, kidney disease, arrhythmias (especially atrial fibrillation), rheumatic heart disease, diabetes, postural hypertension, enlarged heart, high cholesterol, smoking, lack of exercise, long-term contraceptive use, obesity and a family history of stroke. Women have additional risk factors for stroke such as oral contraceptives that are not present in men. Cocaine-induced ischemic stroke is now reported in younger patients.

The incidence of strokes increases exponentially from age 30, and the etiology varies by age, 95% of strokes occur in people 45 and older, and two-thirds of strokes cerebral occur in the over 65 years. Men have traditionally had a higher risk of stroke than women, but women start to catch up with men five or 10 years after menopause. Although stroke is more common in the elderly, people of all ages and fitness can suffer from the injury. A person who is at risk of dying if they have a stroke also increases with age.

Stroke is rare in children who represent only a small percentage of stroke cases each year. Stroke in children is often secondary to congenital heart disease, abnormal genetic disorders of the intracranial vessels, and blood disorders such as thrombophilia.

Types of Stroke

Stroke can be classified into two main categories: ischemic and hemorrhagic, 80% of stroke is due to ischemia, the rest is due to hemorrhage.

The main causes of stroke are thrombosis, embolism and hemorrhage:

1. Thrombosis is the most common cause in middle-aged and elderly people, as they tend to have a higher incidence of plague, diabetes or hypertension. It can occur at any age, especially in those with a history of rheumatic heart disease, endocarditis, arrhythmia or after open heart surgery.

2. Embolism is the second cause of stroke. Embolism occurs when a blood vessel is blocked by a clot, tumor, fat, bacteria, or air. Embolisms usually develop in 10 to 20 seconds without warning and when they reach the brain, they cut off circulation by becoming lodged in a narrow part of an artery causing swelling and tissue death.

3. Hemorrhage is the third most common type of stroke, which is more common in women than in men, as embolism can occur suddenly at any age. It results from chronic hypertension or aneurysms which cause a sudden rupture of a cerebral artery.

Signs and symptoms of stroke

Stroke is usually manifested by loss of sensory and motor function on one side of the body (85% of patients with ischemic stroke have hemiparesis), a change in vision, gait or ability to talking or understanding or sudden and severe headaches.

The clinical features of stroke vary by; the affected blood vessel and the part of the brain that the vessel supplies, the severity of the damage and the ability of the affected area to compensate for the decrease in blood supply through collateral circulation. Strokes on the left side of the brain mainly affect the right half of the corps, and vice versa. Most forms of stroke are not associated with headaches, with the exception of subarachnoid hemorrhage and cerebral venous thrombosis and sometimes intracerebral hemorrhage. When symptoms start appearing consult with best neurophysician. Symptoms are usually classified according to the affected blood vessel;

1. Middle cerebral artery: difficulty swallowing, difficulty speaking, reduced visual field and paralysis on one side, especially in the face and arm.

2. Carotid artery: weakness, paralysis, numbness, visual disturbances, headache, altered level of consciousness, difficulty speaking and a drooping eyelid.

3. Vertebrobasilar artery: weakness, numbness around the lips, visual field cuts, double vision, poor coordination, difficulty swallowing, slurred speech, dizziness and amnesia.

4. Anterior cerebral artery: confusion, weakness and numbness (especially in the leg), incontinence, loss of coordination, impaired motor and sensory functions and personality changes.

5. Posterior cerebral artery: sensory impairment, reduced visual field, dyslexia, coma, cortical blindness, but no paralysis.

Diagnostic

For people referred to the emergency room, early recognition of a stroke is considered important because it can speed up diagnostic tests and treatments. Strokes due to thrombotic embolism or arterial spasm, which cause ischemia, should be distinguished from those due to hemorrhage, which are generally serious and often fatal. Stroke is diagnosed by several techniques: observation of clinical characteristics, neurological examination by best neurophysician, computed tomography or MRI, Doppler ultrasound and arteriography.

Treatment

Surgery to improve cerebral circulation, tissue plasminogen activator (tPA) for dissolving the clot, anticoagulants and anticonvulsants are commonly used to treat stroke. Treatment for breaking a blood clot, the main cause of stroke, must start within three hours of stroke to be effective. tPA must be administered within three hours of the stroke. Therefore, patients who wake up with stroke symptoms are not eligible for tPA treatment, since the time of onset cannot be determined with precision. Patients who have had a clot-related stroke (thrombotic or embolic) who are not eligible for tPA treatment may be treated with heparin or other blood thinners, or with aspirin or other agents anticoagulants in some cases by best neurophysician.

In patients with non-valvular atrial fibrillation, anticoagulation can reduce stroke by 60% while antiplatelet agents can reduce stroke by 20%. Anticoagulants and antithrombotics, key to treating ischemic stroke, can worsen bleeding and cannot be used in intracerebral hemorrhages. In addition to definitive therapies, management of acute stroke includes blood sugar control, ensuring the patient adequate oxygenation and adequate intravenous fluids.

Pain relievers, stool softeners to avoid stress, and corticosteroids to minimize the associated edema may also be used. Lately, it has been reported that complications with the FDA-listed diet strips used with their nutritional patches associated with marine phytoplankton help the body regulate the immune system, improve blood circulation, and thus flush out toxins. Another new action plan for the prevention and rehabilitation of stroke that makes sense is to supplement with signaling molecules of redox cells. These molecules that are native to the body when you are young are used by your body to repair damage where it is needed.

Prevention

Typically, there are three stages of stroke treatment: prevention, therapy immediately after stroke, and post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating the underlying risk factors for a stroke, such as hypertension, atrial fibrillation, and diabetes. It has been conclusively shown that lowering blood pressure prevents ischemic and hemorrhagic strokes. Aspirin prevents the first stroke in patients who have suffered from a myocardial infarction. Nutrition, especially the Mediterranean style diet, has the potential to more than halve the risk of stroke.

Acute stroke therapies try to stop a stroke as it occurs by quickly dissolving the blood clot causing an ischemic stroke or by stopping bleeding from a hemorrhagic stroke.

Post-stroke rehabilitation helps individuals to overcome the disabilities resulting from the damage caused by a stroke. The most popular classes of drugs used to prevent or treat strokes are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics.

Rehabilitation

Stroke can cause thinking, awareness, attention, learning, judgment problems e and memory. Survivors often have problems understanding or forming speech, they may have trouble controlling their emotions or express inappropriate emotions. They may also have numbness or strange sensations.

Post-stroke rehabilitation is the process by which patients with disabling strokes are treated to help them get back to normal life as much as possible by regaining and re-learning life skills. New advances in imaging and rehabilitation have shown that the brain can compensate for the loss of function following a stroke. Therefore, rehabilitation after a stroke should be started as soon as possible.

After a stroke, the stroke survivor and their family are often afraid of ending up at home and getting used to life after a stroke. A stroke survivor must get used to doing things differently and this can have an impact on intimacy, relationships, work and leisure, so for most stroke patients, physiotherapy and l therapy are the cornerstones of the rehabilitation process.

Since 30-50% of stroke survivors have post-stroke depression, characterized by lethargy, irritability, sleep disturbances, low self-esteem and withdrawal, some management teams stroke may also include psychologists, social workers and pharmacists since at least one third of patients have post-stroke depression.

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