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Our brain is a complex body organ that controls several functions of the body. Stroke (cerebrovascular accident) is a medical emergency which develops when any part of the brain deprives from blood supply. Each brain part is responsible for performing certain function and if it lacks in blood requirement, it won’t work appropriately. For instance, if a stroke hits at the back of the brain, a person may experience disability in vision. The effects of stroke mainly depend on the area of obstruction and the degree of damage to the brain tissues.
The brain (neural structure) has three primary components: the cerebellum, the brain stem and the cerebrum (which comprises of the right and left cerebral columns or hemispheres). The cerebrum is the largest part of the neural structure. The cerebellum is attached to the brain stem and is located at its posterior part. Brain stem is located at the lower part of the brain and is linked with the spinal cord.
Effects of Stroke on Various Brain Parts
Each stroke may leave different effects, as every stroke is variant. How quick you recover from a cerebrovascular accident depends upon various aspects such as how much and which areas of your neural structure were damaged as well as your general health prior to getting the stroke. The support from the rehabilitation team, your friends and family also plays a great role in your recovery.
Cerebrovascular accident is a deadly event which causes damage and sudden interruption in the brain functioning. Since this complex organ controls everything you do, think and say, a stroke can harm it badly in many ways. See how it affects the function of each part.
Although strokes occur rarely in the cerebellum, they have very severe effects. Some of the effects involve:
- Severe headache
- Vomiting and nausea
- Difficulty in balance and coordination (called ataxia) and inability to walk
This section is responsible for controlling sensation and movement, thinking, memory, regulation of emotions, reasoning, sexual function and speech. Cerebrum is divided into two parts: the right hemisphere and the left hemisphere.
- Your activities may become cautious and slower than normal.
- Paralysis or weakness on the right side of the body.
- Difficulty in talking, reading, calculations or thinking.
- You may require frequent feedback and instructions to perform any task (it means you may experience memory issue).
- You may experience difficulty in remembering and learning any new information.
- Vision problems.
- Paralysis of weakness on the left side of the body.
- Trouble in making judgments, such as losing control on your behavior, not realizing your limits and acting impulsively.
- Trouble in distinguishing depth, distance, between back and front or between up and down. This can make it difficult to button a shirt, pick up an object and tie a shoe lace.
- Difficulty with short term memory. Some people tend to remember certain things that happened many years ago, but find trouble in recalling something that occurred a few minutes ago.
- Difficulty in understanding maps.
- Ignoring or forgetting people or objects on your left side. In some cases, victims tend to ignore their left leg or arm.
Stroke at this part of your brain occurs rarely. The brain stem is located at the end of your neural structure or we can say at the base of the brain, preceding the spinal cord. A person with stroke in this area can have difficulties with:
- Body temperature control
- Heart and breathing function
- Co-ordination and balance
- Paralysis or weakness in legs and arms of both sides
- Speaking, swallowing and chewing
Physical and Mental Effects of Stroke
Difficulty in Using Certain Languages: A person may suffer aphasia, in which he or she may have difficulty in writing and understanding speech. In some cases, they may understand but are not able to think of the appropriate words to write or speak. Some may have dysarthria in which they know and understand the right words, but find difficulty in saying them clearly.
Paralysis or Weakness: Paralysis or weakness may affect a leg or arm of a person or it may also affect the entire one side of the body. A victim with paralysis or weakness in the left side of the body indicates that the stroke has injured the right hemisphere of the brain. This leads to difficulties with coordination and balance, since the weight of the weak side of the body pulls against the potent side. It can also develop difficulty in walking, standing and sitting even if the person looks strong enough to perform these activities.
Difficulty in Swallowing :This trouble may deprive the victim from having enough food. They may sometimes breathe in food while trying to gulp it. Due to weakness or paralysis, one side of the mouth or tongue may get senseless, which makes it difficult for them to gulp the food.
Perception And Vision Problems: Usually, stroke survivors have a perception and vision problem because of which they do not tend to look towards one side of their body which is weak (either right or left). For instance, a person may eat only one side of food on the plate because he or she can’t see the other side.
Unusual Fatigue : Abnormal fatigue and getting tired quickly may restrict the patient’s performance and participation in a rehabilitation plan.
Cognitive Problems: Cerebrovascular accident usually causes problems with attention, memory, learning, thinking and other mental functions. A victim may experience difficulty in many of these or only one. For instance, he or she may get confused if something is not in order, face difficulty in following instructions or directions or may find difficulty in keeping the track of time and date.
Sudden Explosion of Emotions : Sudden bouts of laughter, fits of crying or bursts of anger may indicate that a person needs medical help, support and understanding to get adjusted with the effects of stroke.
Bladder or Bowel Control Problems: These troubles can be helped by using bedpans, portable urinals and other devices.
Depression:This is the most common effect of stroke. A person may undergo depression soon after the cerebrovascular accident or several weeks later. Family members or friends usually notice it first. For a stroke victim, it’s completely normal to get depressed over the several troubles which result due to the stroke. However, some survivors undergo a major depressive mania, which needs to be diagnosed and treated as early as possible.
Any kind of major illness will change a person’s life at some extent. Nearly, all stroke victims recover at some level and most of them lead a meaningful and happy life. Family, friends, relatives and rehabilitation team can help the survivor to overpower the effects of stroke and recover from them as soon as possible.
Brain is considered as the most intricate body organ. It has over 100 billion neurons (specialized nerve cells) and works as a remote control for everything we do, say, sense or think. These neurons stay alive and function appropriately when they receive adequate amount of nutrients and oxygen through the blood vessels; they cannot repair or duplicate themselves. Different brain parts control various activities. When a particular area of the brain is damaged, functioning preformed by that area gets disturbed and ultimately results into stroke. If you learn to identify the symptoms of cerebrovascular accident (stroke), you will not only be able to receive immediate medical aid, but this will also help you in early diagnosis and treatment of stroke.
Cerebrovascular accident (CVA) is a sudden failure of brain function due to the interruption in blood supply to the brain, which may either a cause of hemorrhagic stroke (bleeding inside and around the brain as a result of the rupture of an artery) or ischemic stroke (clotting of blood). The insufficient blood supply to a particular area of the brain affects the neurons (brain cells) in such a way that they tend to die. The outcomes of a stroke are mainly based on the injured area of the brain and the extent of damage. In all around, 20 percent of strokes are hemorrhagic and 80 percent are ischemic. This medical condition produces various disabilities such as sensory loss, vision problems, speech problems, memory loss and paralysis. Few people may also experience depression or certain emotional conditions post stroke. Medications, modification in risk factors and sometimes surgery can work in favor to reduce the risk of getting prone to stroke.
Diagnosis of Stroke
Anyone suspected with a stroke needs a prompt medical attention. If you find any of the symptoms of this medical emergency, rush to the hospital immediately, so that the tests can be performed for appropriate stroke diagnosis and treatment can be provided quickly. Physicians are equipped with various tools for diagnosing and screening an active stroke. Here are some diagnosing procedures:
- Ultrasound: In this procedure, a wand is moved over the carotid blood vessels inside the neck, which provides a image that shows if there is any clotting, blockage or narrowing inside. Here two types of ultrasound can be performed: Transcranial Doppler Ultrasound (allows to see the blood flow in the vessels inside the brain) and Carotid Doppler Ultrasound (allows to determine whether blockages in the arteries of the neck through which blood flow towards the brain has caused stroke).
- Computerized Tomography (CT) Scan: This technique provides a 3-D picture in which abnormal vessels, bleeding or aneurysms inside the brain can be marked.
- Physical Assessment : In this type of test, blood tests and blood pressure tests are performed to check out the blood sugar, amino acid and cholesterol levels.
- Magnetic Resonance Imaging (MRI): In this process, a magnetic field is generated to develop a 3-D picture of the brain, which shows the present damages due to stroke.
- Arteriography: This involves use of a catheter, which is inserted into the blood vessel for injecting a dye. Here the presence of a clot or blockage can be seen through X-rays.
- CT and MRI with Angiography: This is another form of scanning in which the dye is injected into the arteries, which provides more detailed and clearer images.
- Echocardiography: This follows with an ultrasound that gives view of the heart to see the embolus.
Treatment of Stroke
This medical emergency develops due blood clots and hence it can be treated by busting the clots with the use of certain drugs such as Tissue Plasminogen Activator.
Treating Ischemic Stroke
The main objective of treating ischemic stroke involves restoring the blood supply to the brain and for this, blood clot-busting drugs such as heparin, tissue plasminogen activators or aspirin are used. Along with this, surgical procedures may also be performed that helps to widen or open up arteries. Surgical techniques involve angioplasty (a tube is inserted into the cartoid artery in which a balloon is produced that widens this artery and is kept open with stent which is a metallic mesh tube). Endarterectomy (this involves broadening of the cartoid artery by removing the plaque inside).
This type of stroke is treated in a different manner. Surgical techniques used to treat hemorrhagic stroke involve arteriovenous malformation (AVM), aneurysm embolisation and aneurysm clipping removal. AVM removal involves a surgical process to take off usually smaller AMVs and AVMs that are present in the more accessible brain part. They are removed so that they do not rupture. Aneurysm embolisation or coiling involves the use of a catheter, which is inserted inside the aneurysm to locate a small coil. This coil removes off the sealing and clotting from the arteries. Aneurysm clipping involves placing a tiny clamp at the aneurysm base that insulate it from the circulation of its adjoining artery and prevents the aneurysm from re-bleeding and bursting.
There are some other medicines such as anticoagulants, which include antiplatelet agents (aspirin) and warafin that can be used to prevent and treat stroke. They interfere with the tendency of the blood to form clots and thus can help in preventing cerebrovascular accidents.
Carotid stenting is a method which involves the use of angiography for directing and inserting a stent (metal mesh tube) in a narrowed artery inside the neck and removing the blockage. Another surgical method is carotid endarterectomy, which is used to remove the fatty deposits that have clogged the carotid artery and may lead to a stroke.
Most victims of the stroke may require rehabilitation for managing their normal life or preventing recurrence of stroke. The condition of a person due to this medical emergency mainly depends on the extent and area of damage to the brain tissue. The rehabilitation process involves occupational therapy, speech therapy, family education and physical therapy. According to the US researchers, victims who had observed their symptoms around five months before the stroke were able to recover their brain functioning by using the novel robotic device, which is to be squeezed by the hands.
Some researchers stated that drugs that are used for lowering the cholesterol level can be used to prevent recurrence of stroke.
Warning signs of stroke are same as the signs of a mini stroke or a transient ischemic stroke. Learning to observe these symptoms can help a person to receive early treatment as well as recover quickly.
Stroke prevention usually depends on being healthy and making few modifications in lifestyle. This involves:
- Quit smoking
- Control blood pressure
- Adopt a healthy diet plan
- Check if you are victim of atrial fibrillation
- Avoid the use of drugs
- Moderate quantity of alcohol consumption
- Manage stress
- Lower intake of sodium, cholesterol and fat
- Workout regularly (some study has stated that aerobics can reduce the risk of stroke)
- Control and treat diabetes
- Three cups of tea a day can reduce your chances of stroke
- Use preventive medications such as anticoagulant and anti-platelet drugs to prevent clotting of blood
- Cholesterol lowering medications are helpful in preventing recurrence of stroke.
A person should know his/her risk of getting a stroke, and he/she should know how to identify the symptoms of a mini stroke or transient ischemic stroke. This will help in appropriate diagnosis and treatment of stroke with better recovery.
Stroke is a result of deficiency of blood supply to the brain. It occurs when the blood flow towards the brain gets reduced or interrupted due to a rupture or leakage in the artery (hemorrhagic stroke) or clogging of the blood vessel (ischemic stroke) that supplies blood to the brain. This deprives the brain from receiving nutrients and oxygen, which ultimately causes the brain tissues to die. A temporary interruption in blood supply to the brain can be termed as transient ischemic stroke; this can also be called a minor stroke, which causes temporary or minor damage to the brain cells. If any of these medical emergencies remain unnoticed and untreated for a long time, it may worsen the condition of the patient and may lead to death. Hence, it is essential to learn the causes and symptoms of stroke, so that you can consult your doctor immediately and get an appropriate diagnosis and treatment punctually.
Causes of Various Types of Stroke
Each type of stroke has a typical cause.
This type of stroke causes when a blood clot builds up in the artery and narrows it or completely blocks it and deprives the brain from blood supply. This is the most common form of stroke. The formation of blood clot affects the normal blood flow as well. Clot in the blood may develop due to certain reasons, such as:
- Atrial fibrillation or abnormal heart rhythms
- Blood clotting disorder and endocarditis (heart valves infection)
- Atherosclerosis (hardening of blood vessels). This may caused due to smoking, high cholesterol, diabetes and high blood pressure.
- Certain problems of heart valve, including a repaired heart valve, artificial heart valve, or diseases of heart valve such as stenosis (heart valve narrowing), or mitral valve prolapse
- Heart failure, heart attack and vasculitis (blood vessel inflammation)
- A type of congenital heart disorder (patent foramen ovale)
- Hypotension (low blood pressure) may also be a cause of ischemic stroke although in rare cases. Low blood pressure causes insufficient blood supply to the brain and may be result of a heart attack, diseased or narrowed arteries, a severe infection or heavy blood loss.
- Some surgeries such as carotid artery stenting or endarterectomy that are used to remove the blood clot from the narrowed carotid arteries may also cause stroke.
The most common form of stroke involves:
- Embolic Stroke: This occurs when other debris or a blood clot builds up away from the brain, often in the heart and moves through the bloodstream and gets stuck into a narrower artery of the brain. This kind of blood clot is referred as embolus.
- Thrombotic Stroke: This type of stroke strikes when a clot of blood (thrombus) develops in one of the blood vessels that supply blood to the brain. Plaque or fatty deposits that build up in the arteries often develop a clot which reduces the blood flow and causes atherosclerosis.
This form of stroke occurs due to bleeding in the surrounding space of the brain (subarachnoid hemorrhage) or internal bleeding in the brain (intra-cerebral hemorrhage). Bleeding in the brain’s surrounding space is a result of uncontrolled pressure of the blood or ruptured aneurysm. A rare cause of hemorrhage is ruptured arteriovenous malformation (AVM) – a unusual knot in the thin walled arteries since birth. Other causes of this medical emergency are rare, but include:
- Blood clotting diseases, for example, hemophilia
- Blood vessel inflammation, which may be a result of certain medical conditions such as tuberculosis, Lyme disease, assyphilis or vasculitis
- Radio therapy for treating cancer in the brain or neck
- Neck and head injuries that causes damage to the blood vessels in neck or head
- Cerebral amyloid angiopathy (a type of blood vessel disorder)
The common types of hemorrhagic stroke involve:
- Subarachnoid Hemorrhage: This form of stroke strikes when a blood vessel near or on the brain surface bursts and spills into the gap between the skull and surface of the brain. This bleeding is often followed with a severe headache, which works as an indication. A subarachnoid hemorrhage is usually caused when the aneurysm bursts, a small berry shaped or sack shaped out pouching on the blood vessel in the brain. As the hemorrhage occurs, your brain arteries may narrow and widen unevenly (vasospasm), resulting into damage to the brain cell and thus further limiting blood supply to the brain parts.
- Intracerebral Hemorrhage: In this type of medical emergency, arteries in the brain rupture and spill into the surrounding tissues and cells of brain, thus damaging them. Brain tissues beyond the leak get damaged and are deprived of blood. Intracerebral hemorrhage may also develop due to vascular malformations, high blood pressure, use of medications for blood thinning and few other conditions.
Transient Ischemic Attack (TIA)
This is also called a mini stroke. Transient ischemic attack can be a brief alarming episode of warning signs of stroke that are allied with stroke as well. TIA occurs due to the temporary interruption in blood supply to a portion of brain. Mini stroke often continues for a few minutes. Alike ischemic stroke, a mini stroke occurs when a clot or debris clogs the flow of blood to a part of brain. Since this blockage is temporary, it doesn’t have long lasting symptoms.
Seek immediate medical aid even if your warning signs seem to settle. If you have had experienced mini stroke, it means possibly there is a narrowed or partially blocked blood vessel moving towards the brain, leading you at greater prospects of a full-blown stroke that may harm your brain badly on permanent basis. In most cases, it’s not possible to identify whether you are having a TIA or stroke just on the basis of your symptoms. Almost fifty percent of people whose symptoms seem to clear up actually experience a stroke which causes huge damage to the brain.
Symptoms of Stroke
The signs of a stroke mainly depend on the area and the level of brain tissue damage:
Usually, the symptoms of stroke are not associated with pain.
These symptoms often develop suddenly and last of a few minutes to an hour.
Some strokes arise during sleep, so the victim notices the warning signs when they wake up.
The indications may appear and go, resolve completely, or become worse within several hours.
If the warning signs go away entirely in less than 24 hours, the episode is known as a mini stroke.
- Weakness in the Facial Muscles: Your face may look lopsided or droop. Since it makes you unable to control the movement of the tongue or lips, you may sound a little slurred.
- Weakness in the Leg or Arm or Both of Same Side: A person may experience very mild weakness or complete paralysis. A sensation of pins-and-needles or complete numbness may develop on either side of your body.
- Coordination Problems: You may stumble or feel uncoordinated or have difficulty in picking up objects and walking.
- Difficulty in Speaking: You may find it difficult to move your tongue and lips to speak. Your speech may get very slurred or when you talk, your words may sound ok, but it will be something random which has no sense at all.
- Vision Related Problems: You may experience intricacy with vision, such as loss of side (peripheral) vision, double vision, or blindness. Blurred vision cannot always be a symptom of stroke.
- Loss of Consciousness: A victim may feel unconscious, hard or stupor to arouse and may die.
- Dizziness: You may feel dizzy or drunk and could have difficulty in swallowing.
- Sudden Headache: A severe, sudden headache may develop.
Understand the causes and symptoms of stroke, so that if you observe any of the indication, you can immediately call your doctor for medical assistance.
Brain cells require constant supply of glucose and oxygen rich blood through the bloodstream for functioning. When this supply gets interrupted due to the rupture or blockage in the artery that supplies blood to the brain, a person tends to have stroke. In medical terms. a stroke is called cerebrovascular accident (CVA). In this condition, the patient may experience memory problems or may abruptly become unable to speak. In other words, it can be said that stroke is a medical condition which develops due to brain damage caused by internal bleeding in the brain and blocked blood vessel. Stroke may also paralyze one side of the body. The symptoms of stroke include confusion, numbness, blurred vision, slurred speech and weakness.
Types of Stroke
Hemorrhagic Stroke: This condition tends to develop when a defective blood vessel in the brain gets ruptured and the blood gets filled in the surrounding brain tissues (cerebral hemorrhage) or when the artery running through the surface of the brain gets burst and the space between the skull and brain gets filled with blood (subarachnoid hemorrhage).
Ischemic stroke: This type of stroke is severe and occurs when a thrombus or a blood clot develops and clogs the blood supply to a section of the brain. If a blood clot developed in any part of the body breaks off to move through the bloodstream, it can be termed as embolus. This free floating clot may reach the brain with the blood flow and cause ischemic stroke.
Transient Ischemic Attack (TIA): This is a mini stroke, which increases a person’s prospects of getting a deadly stroke. It occurs when the blood flow to the brain gets restricted for short time due to the formation of a blood clot. The warning signs of TIA are almost similar to the signs of a stroke; however, these signs go within a few hours or minutes. TIA is an initial indication that you may be at higher risk of confronting cerebrovascular accident.
Paediatric Stroke (stroke in children): Cerebrovascular accident may occur at any age or any point of an individual’s life span. Not only the adults undergo this medical condition, but even the children and infants may also get prone to it. This condition develops when the blood supply to the brain gets interrupted, either due to rupture or blockage on the arteries. Normal functioning of the brain may get disturbed when the brain cells begin to die due to insufficient supply of essential nutrients, blood and oxygen to any of its part.
The diagnosis and treatment pattern adopted by the doctor depends on the age of the child during the occurrence of stroke. It may occur in three various age groups:
- When the baby is in the womb or prenatal phase
- A newborn baby or the immediate 28 days after the birth
- From childhood up to the age of 18 years
In all conditions, the brain lacks in blood supply and accumulation of blood that develops severe pressure on the brain. The resulting condition of the patient after a stroke depends on how much of the brain tissues got affected and where the stroke strikes.
Strokes at large extent may cause death or paralysis. Smaller strokes may lead to minor health issues such as weakness in the leg or arms. Many patients with stroke may undergo incontinence, difficulty in speaking, bladder problems weakness in any side of the body.
Causes of Strokes
Hemorrhage strokes may occur due to high blood pressure, aneurysms or a head injury. Cerebral hemorrhage is also a result of high blood pressure because it causes the small blood vessels in the brain to rupture. This condition deprives the cells of brain from blood and insidiously elevates the pressure on the brain.
Ischemic strokes are the ultimate result of embolus or thrombus that clogs the blood supply to the brain. Thrombus clots or blood clots usually develop at those areas of the blood vessels that have been damaged due to the deposition of plaque (atherosclerosis). Embolus form of blood clots develop due to the atrial fibrillation (a random heart beat pattern that leads to poor blood supply and formation of blood clot).
Aneurysms refers to the condition in which the aberrant blood filled sacs are formed and inflate from the weak spots in the artery wall. This is one of the usual conditions for sub-arachnoid hemorrhage. In case an aneurysm bursts, the space between the skull and the brain is filled with blood, which causes spasm in the arteries of the brain. Aneurysms usually develops and becomes worse due to high blood pressure.
According to some studies, it is observed that a defect in a single gene can cause stroke and fatal disorders of the coronary arteries and aorta. Migraines may increase one’s risk of stroke during pregnancy.
Arteriovenous malformation (AVM) is unusual tousle in thin-walled arteries that is present during birth, when it ruptures a rare type of hemorrhage stroke may occur.
Risk Factors of Stroke
This medical condition may strike anyone. Although most of the risk factors of stroke cannot be controlled, some of them can be kept in line through appropriate medical care and nutrition. Risk factors of cerebrovascular accident may involve the following:
- Gender (male)
- Age above 55 years
- High cholesterol
- Family history
- Being overweight or obesity
- Hispanic, African American or Pacific/Asian Islander
- High level of a type of amino acids in blood (homocysteine)
- A transient ischemic attack (TIA) or a history of previous attack
- Use of cocaine
- Use of birth control pills or other hormonal therapy
- Excessive intake of alcohol – some studies reported that people with excessive consumption of alcohol are at a greater risk of stroke as compared to others.
What are the Warning Signs of Stroke?
This is a deadly medical condition which needs to be treated immediately after its occurrence. Within a couple of minutes after a stroke, cells of the brain begin to break down, resulting into symptoms of a stroke. It is significant to identify the warning signs, as prompt medical aid is crucial for recovery. Few common signs of stroke are as follows:
- Speech problems
- Trouble in walking, dizziness, loss of coordination and balance
- Double, blackened or blurred vision
- Weakness, paralysis, numbness on either sides of the body
- Sudden severe headache
A person with silent strokes (smaller stroke) may not always undergo any signs, but their brain tissue gets damaged.
A transient ischemic attack can be a possible indication that a stroke is about to strike. Though signs of TIA and stroke are similar, TIA symptoms last for a few minutes and causes minor damage, which is temporary. A study discovered that women have higher prospects of experiencing non-traditional or unusual alarming signs of stroke.