Stroke

What is a Stroke?

The term “Stroke” refers to a serious life-threatening medical condition that occurs due to the poor blood supply to the brain ¹. Stroke causes some parts of the body to stop working that the injured brain controls. Stroke causes brain cells to begin to die within a minute. A person having a stroke requires immediate emergency treatment to reduce brain damage and other complications. Scientists reported three types of stroke so far. These include ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA) ².

Ischemic stroke comprises the most common type of stroke, accounts for up to 87% of all cases. This occurs when the brain’s blood vessels become narrowed or blocked, which results in reduced blood flow (ischemia). Blood vessels mainly narrowed or blocked because of the deposition of fatty substances in the bloodstream, which prevents blood and oxygen from reaching an area of the brain. Hemorrhagic stroke occurs due to the rupture or leakage of a blood vessel. Factors related to hemorrhagic stroke may include high blood pressure, trauma or injury, overtreatment with anticoagulant, bulging of blood vessels (aneurysm), cerebral amyloid angiopathy, arteriovenous malformation, etc.

A transient ischemic attack (TIA), sometimes known as a ministroke, refers to a temporary period of symptoms similar to those developed during a stroke. This condition occurs when blood flow to a part of the brain disrupts for a certain period. Similar to ischemic stroke, a TIA occurs when a clot or debris reduces or blocks blood flow into the bloodstream. This results in a temporary decrease in blood supply to the brain. A TIA means a warning sign that a stroke may occur soon.

The symptoms of a stroke may appear without warning. Some primary symptoms include confusion, trouble speaking, headache, paralysis or numbness of the face, arm, or leg, problems seeing in one or both eyes, trouble walking, etc. Some people may also experience depression, loss of bladder control, dizziness, etc. Different types of stroke caused by different reasons. Risk factors of having a stroke may include diabetes, hypertension, smoking, alcohol consumption, high cholesterol, older age, etc.

How do Neurosurgeons Diagnose a Stroke?

A stroke occurs rapidly. Stroke accounts for the fifth leading cause of death in the USA. Almost 800,000 people suffer from a stroke in one calendar year ³. A patient needs to receive treatment at a hospital within 3 hours after symptoms appearing to get the best outcome. Physicians may use different diagnostic tools to determine the type of stroke. These include ⁴:

1. Physical examination: This includes a brief medical history and the patient’s symptoms. Physicians will check the muscle strength, blood pressure, sensation, reflexes, vision, and coordination of the patient.
2. Blood tests: Doctors may perform blood tests to determine the presence of blood clots, or any abnormal substances in the blood.

Other clinical tests like CT scan, MRI scan, echocardiogram, carotid ultrasound, cerebral angiogram, etc. may also perform to confirm the condition of the patient and determine the type of stroke in the hospital facility ⁵.

How do Neuro Specialist Physicians Treat Stroke?

Treatment of a stroke depends upon the types of stroke. Both the ischemic and hemorrhagic stroke require different treatments because they have different causes and effects on the body. Treatment of ischemic stroke focuses on restoring the normal blood flow to the brain. Physicians may administer blood thinners like aspirin or tissue plasminogen activator (TPA) to break down clots and prevent others from forming. TPA needs to take place within 4.5 hours of the stroke symptoms starting. Neurosurgeons may use another option known as angioplasty ⁵.

Angioplasty involves a surgeon inflating a small balloon inside a narrowed artery using a catheter. Then surgeon will insert a mesh tube into the opening, which prevents the artery from narrowing again. Treatment of hemorrhagic stroke focuses on bleeding control and reducing the pressure on the brain. In case of aneurysm, neurosurgeons will perform surgery to remove the blood and relieve pressure on your brain. Other rehabilitation processes include speech therapy, physical therapy, occupational therapy, etc. to treat patients for quick recovery.

References

1. Alrabghi, L. et al. Stroke types and management. Int. J. Community Med. Public Heal. 5, 3715 (2018).
2. Gadisa, D. A. et al. Clinical Characteristics, Treatment Outcomes, and its Predictors Among Hospitalized Stroke Patients in Ambo University Referral Hospital, West Ethiopia: A Retrospective Hospital-Based Study. Vasc. Health Risk Manag. 16, 591–604 (2020).
3. Gebreyohannes, E. A., Bhagavathula, A. S., Abebe, T. B., Seid, M. A. & Haile, K. T. In-Hospital Mortality among Ischemic Stroke Patients in Gondar University Hospital: A Retrospective Cohort Study. Stroke Res. Treat. 2019, (2019).
4. Kuriakose, D. & Xiao, Z. Pathophysiology and treatment of stroke: Present status and future perspectives. Int. J. Mol. Sci. 21, 1–24 (2020).
5. Gurol, M. E. & Kim, J. S. Advances in stroke prevention in 2018. J. Stroke 20, 143–144 (2018).