Understanding stroke
“It’s a cold winter morning. A middle-aged man residing with his family, gets up and walks to the bathroom. While on his way he develops a sudden headache and falls down on the floor. He has vomiting and becomes unconscious. He is transferred to the nearby hospital. The doctor examines him and says that he has developed paralysis due to brain hemorrhage. This is a common scenario seen at the emergency department in any neurosurgical unit. The disease, which has affected the person, is called stroke”
It is a sudden interruption of continuous blood flow to the brain and a medical emergency, when a blood vessel in the brain becomes blocked or narrowed, or when a blood vessel bursts and spills blood into the brain. Just like a heart attack, a stroke requires immediate medical attention.
Worldwide, strokes rank second among the top causes of death.
Strokes aren’t contagious and you can’t pass them to or get them from other people.
Stroke is not an accident, it is preventable, treatable and beatable
Warning signs and symptoms
F = Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
A = Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S = Speech Difficulty – Is speech slurred?
T = Time to Call immediately – Stroke is an emergency. Every minute counts. Note the time when any of the symptoms first appear.
Look for
● Sudden confusion or trouble understanding
● Sudden trouble seeing in one or both eyes
● Sudden trouble walking, dizziness, loss of balance or coordination
● Sudden severe headache with no known cause
TIME IS BRAIN - Act fast
For every minute that passes while someone is having a stroke, 1.9 million brain cells are lost. The longer that someone is suffering from a stroke, the greater their chance of disability or death.
The phrase “time is brain” emphasizes that human nervous tissue is rapidly and irretrievably lost as stroke progresses and that therapeutic interventions should be emergently pursued.
Types of stroke
Ischemic stroke
Ischemia is when cells don’t get enough blood flow to supply them with oxygen, because something blocks blood vessels in brain, cutting off blood flow and developing a clot
Hemorrhagic stroke
Hemorrhagic strokes cause bleeding in or around your brain, leading to rupture of a blood vessel
Transient Ischemic attack (TIA)
also referred to as a "mini-stroke." Reversible and occurs when the blood flow to part of the brain is cut off for a short period of time, usually less than 15 minutes and a warning sign. An important type of TIA due to narrowing of the carotid artery is an occasional loss of vision in one eye.
Cryptogenic strokes
Originating from Unknown source
Having Genetic and environmental exposures
Risk factors
Stroke in women is different
Have Milder symptoms like Headache and Feeling of unwell
Women often Underestimate and under report their symptoms
Stroke in young adults
● Drug abuse
● Infections like Covid
● High blood pressure, Diabetes
● Smoking and alcohol
● High cholesterol levels
● Exposure to over-the-counter health supplements and energy drinks
Diagnosis
Computerized tomography (CT) scan, Magnetic resonance imaging (MRI) scans.
Lab blood tests (looking for signs of infections or heart damage, checking clotting ability and blood sugar levels, testing how well kidneys and liver function, etc.)
Electrocardiogram (abbreviated ECG or EKG) to make sure that a heart issue isn’t the source of the problem.
MOBILE BRAIN STROKE UNITS contains a CT scanner, along with specialized EMS personnel who have been trained in stroke management
Treatment
The clot-dissolving medicine tPA (tissue plasminogen activator), the first treatment for acute ischemic stroke, known by the generic name alteplase,tPA is given to patients through an IV in the arm, and it works by dissolving blood clots that block blood flow to the brain. When administered quickly after stroke onset within three hours, tPA helps to restore blood flow to brain regions affected by a stroke, thereby limiting the risk of damage and functional impairment.
Prevention
Following the simple 7 rules can help us minimise the risk of strokes.
Life’s simple seven
Reference
Writer- Dr. Sameena Tabassum
Editor- Dr Zeba, Dr. Priyali Singh
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