A stroke is a lesion that occurs when normal blood flow to an area of the brain stops. This causes the cells to stop oxygenating and thus they die. A stroke can be caused by a ruptured artery or by a bloodstream blockage, it can be mild or severe and the consequences can be temporary or permanent.
Stroke: What are the types?
There are two main types of stroke: ischemic and hemorrhagic.
Ischemic stroke
It is the most common stroke caused by the obstruction of blood flow due to a blood clot, which may be present anywhere in the body (usually in the heart) and then detaches and reaches the brain causing the stroke.
Hemorrhagic stroke
It occurs when a blood vessel in the brain ruptures allowing blood to fill the space between the skull and the brain or when an artery ruptures and fills the tissues in the area with blood. In both cases, blood flow to the brain stops and blood accumulates by putting pressure on the brain. Hemorrhagic stroke is usually caused by an injury and there is no way to prevent it.
What are the main causes leading to a stroke?
There are some factors that increase the risk of having a stroke
- Age
- Sex. Stroke is more common in men
- Genetics
- Blood pressure
- Cholesterol
- Obesity
- Diabetes mellitus
- Atrial fibrillation is a heart condition that can cause an ischemic stroke
- Smoking
Which are the symptoms of a stroke?
Within the first minutes after a stroke, the cells die and the first symptoms start to appear. Some symptoms may be:
- Numbness or paralysis in some part of the body such as the hand or face
- Dizziness, difficulty in walking and lack of balance
- Confusion and difficulty in speech
- Severe headache
- Difficulty in vision
- Convulsions
- Loss of conscience
The sooner symptoms are recognized, the chances for early treatment and complete recovery increase. Milder strokes may not cause severe symptoms. But even in this case they will cause damage to the brain tissues.
What is cerebral ischemia?
The term cerebral ischemia describes the reduction of blood flow to the carotid arteries. This is a very serious condition, which is the third leading cause of death.
What is carotid disease?
Carotid arteries are the ones that carry blood to the brain. They start at the aorta and end at the skull. They are located to the right and left of the neck and each end up in the corresponding hemisphere of the brain. The cause of carotid disease is the accumulation of atherosclerotic plaque leading to narrowing or blockage of these arteries. Atherosclerotic plaque is formed by the deposition of cholesterol and other substances in the arteries walls. The larger the atherosclerotic plaques, the greater the stenosis, and therefore the possibility of a stroke due to atherosclerosis or obstruction.
What are the symptoms of carotid disease?
If patient presents symptoms it means that the narrowing of the carotid artery has led to a stroke. Depending on the affected area of the brain, the person may have difficulty speaking, semi-paralysis, loss of vision, etc.
First aid
There are some simple things that we can do until the ambulance arrives:
- Keep the patient lying down, as this facilitates blood flow to the brain.
- Don’t give the patient any food or beverage/water.
- In case of vomiting, turn the patient to the side to avoid the risk of aspiration.
How can a stroke be diagnosed?
The diagnosis of stroke is based on the development of the symptoms. There are specific symptoms associated with the perfusion of certain arteries in the brain and are a sign of a stroke. The sooner the patient receives treatment the greater the chances of limiting the extent of the lesion. The tests that are done to check the blood vessels are
- Carotid ultrasound
- Computed tomography
- MRI
- Magnetic angiography
What is the treatment for a stroke?
Thrombolysis
In the case of ischemic stroke, the clot that has been formed must be dismantled immediately to prevent necrosis of part of the brain. Thrombus dissolution (thrombolysis) is performed by intravenous treatment with rtPA. When administered within three hours of the start of the episode, thrombolysis is very effective. However, the results might be different in cases of thrombosis in large arteries.
Stent
Over the years and with the development of medicine, another method has been developed to restore blood flow to the brain, in which the clot is removed completely through a special catheter. During the operation, the catheter is inserted transdermally into the femoral artery and reaches the point of the clot through the cerebral arteries. The stent is in the form of a wire mesh that traps the clot and removes it. This technique is very effective and is performed after the thrombolysis process. Patients taking an anticoagulant, which is a contraindication to thrombolysis, are excluded from the procedure.
Stroke prevention
By changing daily habits we can prevent stroke. Your doctor will recommend you to:
- quit smoking
- monitor regularly your blood pressure
- test your heart
- reduce salt
- maintain a normal weight
- exercise regularly
- reduce alcohol consumption
- beware of hormone therapies
- avoid stress and anxiety