Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
– World Health Organization
Stroke
By Dilip Daniel
Guyana Journal, November 2009
A stroke, also known as a cerebrovascular accident (CVA), is a medical emergency similar to a heart attack. It is the cause of about 200,000 deaths per year in the United States. Strokes occur when the blood flow to the brain stops, and are sometimes called “brain attacks”. There are two types of strokes: ischemic (lack of glucose and oxygen) and hemorrhagic (bleeding). An ischemic stroke is caused by a blockage in the blood vessel leading to the brain. A hemorrhagic stroke occurs when there is bleeding in one of the blood vessels of the brain, preventing blood from going to other parts of the brain. Having a stroke can cause brain damage, paralysis or death. Stroke is one of the leading causes of disability. The incidence of stroke increases with age. The number of stroke-related deaths in the United States is expected to double by 2030.
Generally, people start to experience neurologic symptoms within seconds of losing blood flow to the brain. This is because neurons (cells in the brain) get their energy and nutrients mainly from the blood..If the brain cells are starved of energy for a few minutes then the brain tissue starts to die. However, if the blood flow is restored rapidly, before brain damage occurs, brain function will be fully restored. Ischemia or diminished blood supply, followed by quick restoration of blood flow is called a Transient Ischemic Attack (TIA).
Sudden onset of neurological symptoms does not necessarily indicate a stroke. There are conditions that mimic strokes such as intracranial (within the brain) tumors, migraines, and seizures. Patients with tumors may also have sudden bleeding within the brain, and seizures. Migraines can mimic hemorrhagic strokes because both present with severe headache. Also, migraines can occur later in life in patients that have no prior history of migraines, and this may confuse the diagnosis. Time is critical when dealing with stroke patients. It is important to seek help immediately. If you think that you or someone else is experiencing the symptoms of a stroke call 911 or go to your closest emergency room.
Q&A
How do I know if I am having a stroke?
People experiencing a stroke tend to have sudden onset of symptoms. They may have numbness or weakness in the face, arm, or leg, usually on one side of the body. This can also be accompanied by confusion, or trouble speaking or understanding speech. Some people may also experience a severe headache, dizziness, or trouble seeing in one or both eyes.
What are the risk factors for having a stroke?
Some factors that increase your stroke risk are high blood pressure, cigarette smoking, heart disease, diabetes, and transient ischemic attacks (TIA). Most of these factors are chronic (long term) conditions that can be treated with diet, exercise, and medication. If you have any of these risk factors you should consult your physician about steps you can take to lower your individual risk.
What should I do if I think I am having a stroke?
If you are experiencing the symptoms of a stroke, or someone you know is experiencing these symptoms, seek medical attention immediately. Brain cells begin dying within minutes of losing oxygen, so get medical attention immediately to limit the amount of damage done to the brain.
How is a stroke treated?
Stroke is treated depending on what type of stroke the patient is suffering from. If a patient has an ischemic stroke a drug called tPA (tissue plasminogen activator) can be given to help dissolve the clot that is causing the ischemic stroke. This drug can only be given up to 3 hours after the onset of symptoms, so it is critical to seek treatment as soon as possible.
o If the patient is suffering from a hemorrhagic stroke it is treated by blocking the site of the bleed or inserting a coil to cover the site of rupture. Clot dissolving drugs cannot be given during hemorrhagic stroke because this would make the bleeding worse. The goals of treatment for a hemorrhagic stroke include relieving symptoms, repairing the cause of bleeding, preventing complications and starting rehabilitation.
Does stroke occur more frequently in men or women?
Stroke occurs more frequently in men than in women, but more women actually die from strokes. The lower incidence of stroke in women is probably due to their increased level of estrogen.
Why does smoking increase the risk of getting a stroke?
Smoking promotes the development of insulin resistance. Insulin resistance causes a person to become less sensitive to the effects of insulin. This promotes the development of diabetes which is a risk factor for stroke. Diabetes leads to vascular (blood vessel) complications, which can increase your risk for stroke. Having high blood pressure may also increase a person's risk for developing a stroke.
For more information please visit:
The National Stroke Association
www.stroke.org
American Stroke Association
www.strokeassociation.org
Medline Plus
http://www.nlm.nih.gov/medlineplus/stroke.html
Dilip Daniel is a Doctor of Pharmacy Candidate at the University of the Sciences in Philadelphia, PA.
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