Overview
A stroke, or brain attack, happens when blood flow to your brain is impaired or is stopped. This is an emergency situation. In order for your brain to work properly, it needs a constant supply of Oxygen. Your arteries deliver oxygen-rich blood to all parts of your brain. Should something happen to block/stop the flow of blood, brain cells start to die within minutes. This is what happens during a stroke.
There are two types of strokes: Hemorrhagic and Ischemic.
Hemorrhagic: This occurs when a blood vessel in your brain bursts, spilling blood into nearby tissues. With a hemorrhagic stroke, pressure builds up in the nearby brain tissue, causing more damage and irritation.
Ischemic: This is the most common type of stroke. It happens when a blood vessel in the brain is blocked, as a result of a blood clot or by a buildup of fatty deposit and cholesterol (otherwise known as plaque) which can cause narrowing of complete blockage.
Causes/Risk Factors
Many common conditions increase your risk of having a stroke.
High Blood Pressure: This is the leading cause of Stroke. (See HTN page)
High blood cholesterol and lipids: If we take in more cholesterol than the body can use, the extra cholesterol can build up in the arteries, including those of the brain which will lead to narrowing of the arteries, stroke, and other problems.
Obesity (Excess body fat): is linked to higher “bad” cholesterol and triglyceride levels. Obesity can also lead to high blood pressure and diabetes.
Smoking:
Tobacco use can damage the heart and blood vessels, increasing your
risk for stroke. Nicotine raises blood pressure.
Carbon monoxide from cigarette smoke reduces the amount of oxygen
that your blood can carry.
Exposure to secondhand smoke can make you more likely to have a
stroke
Diabetes: Diabetes causes sugars to build up in the blood and prevent oxygen and nutrients from getting to the various parts of your body, including your brain.
History of prior strokes
Oral Contraceptives
Irregular Heart rhythm: Having an irregular heartbeat (atrial fibrillation) is the most powerful and treatable heart risk factor of stroke.
Sickle Cell Disease: SCD is a blood disorder that primarily affects blacks and is linked to ischemic strokes. A stroke can happen when sickle cells get trapped in a blood vessel in the brain and blocks the blood supply.
Excessive alcohol use: More than 2 drinks per day raises your blood pressure. Binge drinking can lead to stroke
Symptoms
Time is brain matter. Fast treatment can lessen potential damage to the brain. While stroke symptoms usually happen suddenly, each person’s symptoms can vary. Here are the most common signs and symptoms:
Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
Sudden confusion, trouble speaking, or difficulty understanding speech.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
Sudden severe headache with no known cause.
If you think someone may be having a stroke, act F.A.S.T. and do the following test:
F—Face: Ask the person to smile. Does one side of the face droop?
A—Arms: Ask the person to raise both arms. Does one arm drift downward?
S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
T—Time: If you see any of these signs, call 9-1-1 right away.
Note the time when any symptoms first appear. This information helps health care providers determine the best treatment for each person.
Do not drive to the hospital or let someone else drive you. Call 9-1-1 for an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room.
Diagnosis
A stroke diagnosis is made after a full health history is obtained and a full physical exam is performed by your healthcare provider. Imaging is also obtained to confirm diagnosis.
CT scan of the brain. This test uses X-rays to take clear, detailed images of the brain and can show bleeding in the brain or damage to brain cells caused by a stroke. It's used to find abnormalities and help find the location or type of stroke.
MRI. This test uses a combination of large magnets, radiofrequencies, and a computer to make detailed images of organs and structures in the body. An MRI uses magnetic fields to find small changes in brain tissue that help to find and diagnose stroke.
CTA (computed tomographic angiography). An X-ray image of the blood vessels. A CT angiogram uses CT technology to get images of blood vessels.
MRA (magnetic resonance angiography). This test uses MRI technology to check blood flow through the arteries.
Doppler sonography (carotid ultrasound). A test that uses sound waves to create pictures of the inside of your carotid arteries. This test can show if plaque has narrowed or blocked your carotid arteries.
Angiography. A catheter is inserted through your arteries. Dye is injected and pictures are taken.
Treatment/Prevention
Treatment depends on the type of stroke.
Ischemic stroke: if you get to the hospital within 3 hours of onset of symptoms, a medication called Tissue plasminogen activator (tPA) (a thrombolytic) may be given to break up the clots. tPA is known as a “clot-busting” drug.
Doctors may also treat ischemic stroke with other medicines, such as blood thinners, as well as surgery to remove the clot.
Hemorrhagic stroke: Medicine, surgery, or other procedures may be needed to stop the bleeding and save brain tissue.
Complication
Reference
Centers for Disease Control and Prevention. (2022, November 2). About stroke. Centers for Disease Control and Prevention. Retrieved February 6, 2023, from https://www.cdc.gov/stroke/about.htm Stroke. StayWell. (n.d.). Retrieved February 6, 2023, from https://demo.staywellhealthlibrary.com/az-search/content/diseases-and-conditions/stroke-1/