A stroke can be called a “brain attack” when blood flow is cut off to a certain part of the brain, just as it does in the heart.
Similarly, the brain cells are deprived of oxygen and start dying, leading to loss of central nervous control of the relevant body areas. The severity of the stroke depends on the location of the stroke and how much damage it has caused. Minor strokes may cause just weakness of an arm or leg, and major strokes can cause paralysis of one side of the body or loss of speech, etc.
Different Types of Stroke for which treatment is needed:
An Ischaemic stroke is when a clot blocks a blood vessel supplying blood to that part of the brain and treatment is given to dissolve the clot. This accounts for more than 85% of all strokes. The commonest causes of this type of stroke are atherosclerosis (cholesterol deposition), causing gradual narrowing of blood vessels and deposition of blood cells to form clots. This can happen in the brain itself and is called a thrombotic stroke. If this phenomenon happens distally, dislodges and travels into the brain causing a blockage, it is termed an embolic stroke. Blood clots can be formed in the heart due to arrhythmias or abnormal heart valves that can travel to the brain. Uncommon causes are drug addiction, trauma to blood vessels of the neck, and clotting disorders.
A haemorrhagic stroke is when a blood vessel ruptures within the brain and treatment is given to stop this bleed. Uncontrolled hypertension (high blood pressure), aneurysms (selling of blood vessel walls), and arteriovenous malformations (abnormal clustering of blood vessels), all weaken blood vessels leading to a rupture.
Treatment for Ischaemic strokes
Medical treatment for Ischaemic strokes
A Tissue Plasminogen Activator, administered intravenously within three hours after a stroke, helps dissolve the clot and save life as well as reduce the long term effects of a stroke.
Mechanical clot removal
The clot can be removed physically through an endovascular procedure or mechanical thrombectomy. Similar to a heart angiogram and angioplasty, endovascular specialists thread a catheter through the groin upto the brain, and insert a wire cage or stent, catch hold of the clot and remove it gently back through the blood vessel. Special suction tubes are also used to remove the clot.
Treatment for Haemorrhagic strokes
In an endovascular procedure, a catheter is threaded through the groin all the way into the brain through a major artery, with many times a camera being used to identify the exact location of bleed. A mechanical agent or coil is placed in the bleed spot to plug it and prevent further rupture and bleed.
Surgery for Aneurysm or AV Malformations
In case of a massive bleed, especially from an aneurysm or AV malformation, surgical intervention will be needed to tie off the blood vessels causing the rupture and is a very specialised and critical procedure.
Post Treatment recovery
Since strokes can leave a patient with residual disability, post treatment rehabilitation in the form of effective physiotherapy, speech therapy and occupational therapy is a mandatory part of the overall treatment planning.
To prevent the chances of suffering another stroke, the key risk factors should be controlled viz. healthy living and eating, medicines to control high blood pressure and heart arrhythmias, quitting smoking, medicines to prevent formation of new clots (anticoagulants), and many times, procedures to open up the blockages.
When a stroke occurs, the blood supply to part of the brain is suddenly interrupted. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain.
Symptoms include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble with walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause.
An easy was to remember the symptoms is F.A.S.T
High blood pressure increases your risk of stroke four to six times. Heart disease, especially a condition known as atrial fibrillation, can double your risk of stroke. Your risk also increases if you smoke, have diabetes, sickle cell disease, high cholesterol, or a family history of stroke.
Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or forming speech. A stroke can lead to emotional problems; patients may have difficulty controlling their emotions or may express inappropriate emotions, and many stroke patients experience depression. Stroke survivors may also have numbness or strange sensations, including pain which is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures.
It’s assumed by many that a serious condition such as a stroke comes with a tremendous amount of pain, but this is mostly inaccurate. In fact, 85% people who suffer a stroke tend to ignore the symptoms due to not experiencing any sort of pain.
To avoid the dangers that may arise by failing to identify the symptoms, it’s important to understand and recognize them:
Technological advancements in procedures used to treat aneurysms, such as microsurgical clipping and endovascular coiling, can have you up and out of the hospital in as little as two days. Additionally, with these minimally invasive treatments, you can potentially experience less pain and scarring.
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