Brain functions rely on oxygen and nutrients gleaned from the bloodstream. When there is a blockage, a constriction or a break in the blood vessels supplying the brain, it can disrupt the blood supply and affect brain function, leading to brain cells being destroyed and a severe reduction in brain functioning capabilities.
A stroke is an extremely serious condition that requires urgent medical treatment. The faster treatment is provided, the lower the risk of brain damage is. However, if urgent treatment is not sought, it could lead to the patient being left with a permanent disability, paralysis or loss of life.
Strokes can be categorized into two main forms – ischemic strokes and hemorrhagic strokes. Of these, ischemic strokes are the more common of the two, making up around 70% of all strokes, while hemorrhagic strokes make up the remaining 30% of cases.
Some forms of ischemic strokes are caused by high blood lipid levels, resulting in growing in amounts of fat sticking to blood vessel walls until the point where blood flow is restricted. Other types of ischemic strokes happen as a result of blood clots, which tend to be caused by either a clot in the brain’s blood vessel system itself or a clot which has formed in another part of the body and travelled up to the brain, thereby interrupting the brain’s blood flow. Additionally, there are some systemic disorders which speed up blood vessel deterioration in the brain, such as diabetes, high blood pressure, smoking.
Hemorrhagic strokes occur as a result of the patient’s high blood pressure alongside high blood lipid levels, which result in blood vessels losing their flexibility and making them prone to breakage. Such a breakage results in an immediate interruption of blood flow to the brain, which is the reason why this form of stroke is so dangerous, having the potential to cause a fatality extremely quickly.
Strokes can occur as a result of numerous factors, including factors that can and factors that cannot be regulated and changed, while age, gender and genetics all play a part.
Due to a stroke resulting in reduced brain function, the symptoms displayed vary greatly in terms of severity. That being said, the following symptoms commonly affect stroke victims:
In some cases, however, symptoms may affect the patient only temporarily before disappearing. Alternatively, symptoms could occur repeatedly before the brain is permanently starved of its blood supply. Hence, if any abnormal symptoms present themselves, immediate medical attention should be sought.
Currently, the stroke screening process is able to effectively identify the exact location of any blood vessel abnormalities, meaning that a stroke risk can be found before any symptoms present themselves. Stroke screening assesses the following:
Stroke treatments depend entirely on whether the stroke is an ischemic stroke or a hemorrhagic stroke. In cases of an ischemic stroke, the patient will be given antithrombotic medication to clear the blood vessels and allow for improved circulation. For best results, any treatment should be carried out within 4.5 hours of the stroke’s onset. This time frame may be stretched to 24 hour if the patient is at a hospital capable of catheter-based interventions for the removal of the blood clot.
With regard to hemorrhagic stroke cases, regulate the patient’s blood pressure and prevent brain damage. Some patients may be required to undergo emergency surgery in cases of severe bleeding in order to stem the bleeding and reduce pressure in the skull.
Many patients who undergo timely treatment for their stroke have a higher chance to be able to make a full recovery and return to their former lifestyle, while some patients may require an extended period to do so. All of the patients require multidisciplinary standard medical care for the recovery of their moving, eating, swallowing and communication capabilities. This is achieved by physical rehabilitation, occupational therapy, a proper nutrition plan designed by a dietician and psychological support from the medical provider and the patient’s family.
Nevertheless, the most crucial part of post-treatment care is to strictly follow the advice of doctors, take medication as prescribed and be sure to attend every doctor’s appointment thereafter. This is important because inconsistent post-treatment care has the potential to affect a patient’s recovery and result in another stroke, with potentially life-threatening consequences.
The Second Class Honors, M.D., Faculty of Medicine, Mahidol University, 2008 Faculty of Medicine Siriraj Hospital, Mahidol University , 2008