Stroke

What is Stroke?

  

Signs and symptoms that are experienced due to lack of blood supply to certain part of brain. It can be due to blockage of one of the artery supplying brain or due to bleeding in the brain due to tear or rupture of the artery supplying the brain.

It's an emergency. Time is very crucial in it. Each passing minute after stroke without treatment, increases the chances of permanent disability.

Symptoms

-Sudden slurring of speech
-Facial paralysis / One side of face droops down when attempting to smile
-Sudden inability to move one sided upper and or lower limb
-Sudden balance problem with inability to stand steady
-Nausea, vomiting associated with Severe Headache

Sort form to remember is FAST that is developed by American stroke association.
1. Facial droop
2. Arm weakness
3. Speech difficulty
4. Time to call 911 in USA or 108 in India
https://www.stroke.org/understand-stroke/recognizing-stroke/act-fast/

Causes

Uncontrolled High blood pressure
Blood clot usually traveled from heart 
Aneurysm/ abnormal dilatation of blood vessels supplying brain

Treatment

Its based on weather its due to a block or bleeding.  CT scan of brain is needed to find it out. Treatment is like a two way sword in a stroke.

1. Block in vessel due to clot

Thrombolytic agents should be ideally given within 1 hour of last well known time but can be given up to 4 hours. NOT after it. Higher chances of full recovery if given in first hour but it also have risk of bleeding.

Also, thrombectomy, a surgical procedure to remove clot, can be done in first 24 hours in eligible patients. But only few doctors are trained to do it at very few hospitals.

After 24 hours of stroke, any treatment given is a supportive care to prevent another stroke. Intense physical therapy might help with recovery rate.

2. Bleeding 

Any agents like aspirin or any blood thinner increase further chance of bleeding. Immediately stop it. They usually put a drain in the brain called EVD to decrease intracranial pressure. Also some supportive treatment like controlling blood pressure is highly important.

Take home message: With any of above mention symptom of stroke, immediately call 911 in USA or 108 in India, and go to the hospital where CT scan facility is available.

Prevention: 

Controlling blood pressure and healthy life style are keys to prevent stroke.


More information about the stroke can be found on the following website by American Heart Association/ American Stroke Association.
https://www.stroke.org/understand-stroke/