Stroke, which is also known as cerebrovascular accident (CVA) is a medical emergency that requires prompt intervention to prevent death or severe complications. There are medical treatments available for the treatment of stroke and several measures you can take to prevent stroke from occurring. The earlier the medical intervention, the better the outcome of the treatment. Be sure to seek immediate medical help for anyone who has had a stroke.
This brief article, which responds to one of our reader’s question, will highlight the management of stroke and what you can do to prevent the occurrence of the stroke in the first place.
What Causes Stroke?
Stroke occurs when blood supply to your brain tissues is interrupted. Sometimes, the blood vessels that supply blood in the brain can become blocked by blood clots or atherosclerotic plaques (a type of fat deposit that blocks a blood vessel). At other times, the blood vessels may rupture and cause blood to spill out into the brain. When any of these happens, the brain tissues no longer receive oxygen and nutrients which leads to the death of brain cells in a matter of minutes that results in the symptoms of stroke.
Some common risk factors for developing stroke include;
- Those with uncontrolled blood pressure (hypertension)
- Presence of underlying heart disease
- A family history or previous history of stroke
- High blood cholesterol levels
- Cigarette smoking and substance abuse
- Age > 55 years
- Being a male (stroke affects more males than females)
- Being of black or African descent
The symptomatic manifestation of stroke depends on which part of the brain is affected. When the right side of the brain is affected, your symptoms will appear on the left side of your body and when the left side of the brain is affected, the symptoms appear on the right side of the body, including difficulty with speech and language.
The common symptoms of stroke include :
- Numbness or tingling sensation in hands and legs.
- Inability to raise arms or lift legs.
- A drop on one side of the face, especially when asked to smile.
- Difficulty in walking.
- Difficulty in speech or understanding language.
- Sudden and severe headache.
- Difficulty seeing in one or both eyes.
Consult a doctor if you or someone you know is experiencing any of these symptoms for proper diagnosis of an impending stroke and appropriate management.
Stroke has been broadly classified into two main groups namely Ischemic strokes and hemorrhagic strokes. Ischemic strokes are more common than hemorrhagic strokes. About 80% of all strokes are ischemic.
Ischemic strokes are caused by the blockage of the blood vessels in the brain that supplies the brain tissues with oxygen and nutrients. The blockage can be as a result of a blood clot (thrombus) or atherosclerotic plaque. When the blood clot which blocks the blood vessel is formed right in brain, it is known as a thrombotic ischemic stroke.
However, sometimes the blood clot does not form in the brain blood vessels but rather from blood vessels away from the brain (commonly in the heart) and travels from where they are formed to the brain to block the thinner vessels in the brain that supply the brain tissues. Such strokes are called embolic ischemic strokes.
A transient ischemic attack (TIA), also called mini stroke, refers to a temporary experience of stroke symptoms lasting for about 5 minutes or more. It occurs due to a temporary blockage of the blood vessels in the brain just like it has been described above. People who experience TIAs are more likely to get a full blown stroke if preventive measures are not properly taken.
An hemorrhagic stroke occurs when the blood vessels in the brain rupture and cause blood to spill into the brain, interrupting the supply of oxygen and nutrients to the distal brain tissues. The bleeding also increases pressure inside the brain. When the bleeding occurs on the brain, it is referred to as intracranial hemorrhagic stroke. When the bleeding is in the space between the brain and the skull, it is referred to as subarachnoid hemorrhagic stroke.
The management of stroke is largely dependent on the type of the stroke the doctors are dealing with. The doctors will conduct several tests, examinations and imaging studies, including CT-scan and MRI to determine the exact type of stroke and then commence on the appropriate management plan.
Management of Strokes
The goal of the managements of stroke is to restore or improve the supply of blood (oxygen and nutrients) to the affected brain areas. This is done by removing the blood clots blocking the blood vessels (ischemic strokes) and stopping the bleeding and reducing intracranial pressure (hemorrhagic strokes).
Emergency treatment, which is usually given less than 24 hours of the occurrence of the stroke, gives the patient a better survival chance and prevent complications. In emergency treatment of strokes, doctors can use certain medications or mini surgical procedures to dissolve or remove the blood clot or widen the blood vessels in the brain, and also to stop any active bleeding in the brain or reduce intracranial pressure by removing accumulated blood in the brain.
Statins are drugs that reduce cholesterol levels. They are given to correct and prevent atherosclerotic plaques. Thrombolytics or blood thinners are also given to correct or prevent blood clots from forming in the brain. However, if the stroke has been confirmed to be hemorrhagic, these drugs are avoided because they will cause more bleeding.
Depending on the clinical presentation of the stroke, the doctors will most likely stop any antihypertensive medications to allow for better brain perfusion, except in the cases of a hemorrhagic stroke, in which case the blood pressure may need to be reduced.
Other supportive treatment like drinking enough fluids, nutrient supplementation, psychotherapy and physiotherapy will be implemented by the doctors to complete the management process of strokes.
How You Can Prevent Stroke From Occurring
You can successfully prevent stroke from occurring or recurring again by adopting a healthier lifestyle style and doing the following :
- Control your blood pressure by following your doctors recommendations. This is the most important preventive measure.
- Keep cholesterol levels in check by avoiding saturated fatty foods.
- Manage your diabetes properly.
- Quit smoking cigarettes.
- Quit drinking alcohol.
- Avoid hard drugs.
- Exercise regularly and manage stress properly.
- Eat healthy diets of fruits and vegetables.
- Maintain a healthy body weight.
- Treat any underlying heart condition properly through your doctors recommendations.
The complete management of strokes goes beyond the medical staff or health team. It will involve support from your family and friends, and most importantly, your personal cooperation and determination not to give up or be depressed about the occurrence. There are several stoke patients who have been successfully managed and now are back on their feet, enjoying their lives with family and friends.
- American Stroke Association / About Stroke
- National Stroke Association / What is stroke
- MayoClinic / Stroke Symptoms and Causes
- MedicineNet / Stroke Symptoms and Treatment
- Internat Stroke Centre / What is a Stroke
- NHS / Stroke Overview and Prevention