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Stroke – Causes, Symptoms, Diagnosis and Prevention

Posted by : Dr. P. P. Ashok, 22 May 2019 04:59 PM
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Did you know that stroke is one of the leading causes of death and disability in India? Let's take a look at the types of strokes, its signs and diagnosis.

What is a stroke? When an individual suffers from a stroke, the brain does not receive the blood it needs to function and the brain cells begin to die. If such a situation arises, one needs to seek immediate treatment from a doctor since it can lower the chances of brain damage, disability or in certain cases, even death.
 
Types of Stroke

There are two types of strokes, namely, Ischemic and Haemorrhagic.

Ischemic stroke: It is similar to a heart attack, except it occurs in the blood vessels of the brain. Clots may form in the brain's blood vessels, in blood vessels leading to the brain, or even in blood vessels elsewhere in the body and then go to the brain. These clots block the flow of blood to the brain's cells. Note that about 80% of all strokes are ischemic.

Haemorrhagic stroke: It occurs when a blood vessel in the brain ruptures or breaks. This leads to blood seeping into the brain tissue, causing damage to brain cells. Haemorrhagic stroke is usually caused by high blood pressure or brain aneurysms/ arteriovenous malformation. These are defects in the blood vessels on a developmental basis.

Identifying the Signs of Stroke:

Face: the face may drop on one side and the person may not be able to smile. Their mouth or eye may have drooped as well.

Arms: the person with the suspected stroke may not be able to lift one or both arms and might also experience weakness or numbness in the arms.

Speech: the speech may get slurred or garbled. The person may not be able to talk at all in spite of looking awake.

Diagnosis of Stroke

Stroke occurs rapidly and in most cases, before an individual can be seen by a doctor for a proper diagnosis. If you are able to identify someone who might be experiencing a stroke, take the individual to a hospital immediately. The person should be treated within three hours of onset of symptoms.

There are various types of diagnostic tests that doctors use to determine which type of stroke has occurred:

• Physical examination: A doctor will ask about symptoms and medical history of the patient. The blood pressure will be checked. The carotid arteries in the neck along with the blood vessels at the back of the eyes will be examined for any signs of occlusion.

• Blood tests: The doctor may perform blood tests to find out how quickly the clots occur and the levels of particular substances in the blood. It would be necessary to know the factors of clotting and whether or not an infection is present.

• CT scan: A series of X-rays detects strokes, haemorrhages, tumours and other conditions within the brain.

• MRI scan: Radio waves and magnets create an image of the brain to detect damaged brain tissue.

• Carotid ultrasound: An ultrasound scan checks the blood flow in the carotid arteries to see if there is any plaque present.

• Cerebral angiogram: Dye is injected into the brain's blood vessels, making them visible under X-ray for a detailed view of the brain and the blood vessels in the neck.

• Echocardiogram: This creates a detailed image of the heart that helps in checking for any sources of clots that could have travelled to the brain to cause a stroke.

Prevention of Stroke

Up to 50% of all strokes are preventable. You can reduce the risk of a stroke by taking a proactive approach towards your health:

• Avoid smoking because it constricts arteries and reduces its elasticity.

• Keep a check on your cholesterol levels. High levels of cholesterol can choke arteries. When combined with the thickening of arterial walls from uncontrolled blood pressure or smoking, high cholesterol can cause the narrowing of your arteries from both sides.

• Do not consume drugs. Methamphetamine, cocaine and other drugs lead to constriction of blood vessels.

• Eat healthy, exercise regularly and maintain a healthy BMI (Body Mass Index). Remember that moderation is key.

• If you notice irregular heartbeats, discuss it with your doctor and a cardiologist if recommended.

• Control your blood pressure. High blood pressure thickens arteries and makes it less elastic. People are mostly not aware that they have high blood pressure, which is why it is important to go for routine health check-ups.

Dr. P. P. Ashok from P. D. Hinduja National Hospital and Medical Research Centre says "Time is brain." It means that the more time passes before a stroke patient receives treatment, worse the consequences will be. It also means that if the stroke is treated immediately, brain damage can be minimised.

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Dr. Charulata Sankhla, MBBS, MD (Internal Medicine), Diplomate in Neurology
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Dr. P. P. Ashok, M.B.B.S, M.D (Medicine), DM (Neurology)