Every year, around 1.5 million Indians experience a stroke, yet the majority of the population remains unaware of it. Read more to discover what a stroke is, its symptoms, diagnosis, treatment, and more.
What is a stroke?
A stroke is a condition in which the blood supply to the brain is decreased or cut off, resulting in the death of brain cells. The brain receives oxygen and nutrients through the blood, and if the blood supply is interrupted, the cells in the brain begin to die within minutes. Different parts of the brain control different functions, so when brain cells in those parts die, the functions controlled by those parts are impaired.
What are the types of strokes?
- Ischaemic stroke: The fine blood vessels that supply the brain are blocked by fatty deposits or blood clots, thus resulting in blood flow being cut off to certain areas. This is the most frequently seen type of stroke
- Hemorrhagic stroke: Certain conditions lead to leakage or rupture of blood vessels in the brain. Though this type of stroke is less common than ischaemic stroke, these are more life-threatening
What are the causes of stroke?
- Ischaemic stroke
- Blood clots formed within the blood vessels that supply blood to the brain (thrombotic stroke)
- Blood clots formed elsewhere in the body move with the blood into the blood vessels in the brain and cause blockage (embolic stroke)
- Hemorrhagic stroke
- High blood pressure
- Bulges or weak spots in blood vessels that rupture (aneurysms)
- Head trauma
- Overuse of blood thinner medicines
What are the risk factors for stroke?
- High blood sugar
- High blood pressure
- High cholesterol levels in the blood
- Smoking
- Heavy alcoholism
- Use of cocaine, methamphetamine, etc.
- Obesity
- Lack of exercise
- Family history
- Obstructive sleep apnoea
What are the symptoms of a stroke?
- Drooping of one side of the face
- Inability to move arms, legs, face, or parts of the body (typically on one side)
- Numbness of the face, legs, arms, or body (typically on one side)
- Difficulty walking and maintaining balance
- Dizziness
- Inability to speak or slurred speech
- Severe, sudden, persistent headaches
- Sudden vision changes, including blurring, loss, or double vision in one or both eyes
What is a mini-stroke?
A mini-stroke, also called a transient ischemic attack (TIA), is a condition in which a patient experiences stroke-like symptoms that typically last for a few minutes. TIA occurs due to a transient interruption in the blood supply to the brain due to a clot or blockage in the blood vessels. It requires immediate medical attention and emergency care as it is a warning sign for future ischaemic strokes. The underlying cause of a mini-stroke should be identified and treated aggressively to prevent a stroke.
What should I do if I experience symptoms of stroke?
If you experience symptoms of a stroke, alert someone who will be able to help you. In the event that nobody is close by,
- Immediately call an ambulance and get yourself admitted. Do not drive yourself to the hospital because your condition may worsen on the way
- Do not take any tablets, such as aspirin. You may not know what type of stroke you have. Aspirin is a blood thinner that can make your condition worse if you are experiencing a hemorrhagic stroke
Time is an important factor in the medical care for stroke patients. The longer you wait, more areas of your brain may get damaged, and the more severe your damage may be. Hence, shift to the hospital as soon as possible.
How do I respond if I witness someone having a stroke?
- Immediately call an ambulance and shift the person to a hospital with facilities for managing stroke.
- Keep a mental note of the symptoms and when they began
- While the person is still conscious, try to learn about their medical history. This includes details of diseases, medicines, and allergies
- Attempt CPR if the person loses consciousness
- Do not give any medicine to the person, as it may worsen the condition
- Do not attempt to give food or water to the person
- Stay calm
How is a stroke diagnosed?
- Medical history and physical examination: The doctor will inquire about the symptoms, history of medical problems, and medicines that your loved one is taking. They will also examine them for numbness, weakness, reflexes, etc.
- Blood tests: To find out blood cholesterol and sugar levels
- Brain scans: CT or MRI scans to identify if the stroke is caused by blockage of blood vessels or bleeding into the brain, which area of the brain is affected, and how severe the condition is
- Carotid ultrasound: Ultrasound of this large artery in the brain to find out if there is any narrowing or blockage to this
- Cerebral angiogram: In this, a dye is injected into the blood vessels, which makes them clear in X-rays. This is done to assess if there is any blockage or narrowing of the blood vessels
- Echocardiogram: This is done to obtain a detailed view of your heart to find out if there are any problems that are related to your stroke
How can I prevent stroke?
- Eat a healthy, balanced diet. Avoid junk food and limit the intake of salt, sugar, and fat
- Avoid smoking
- Limit the intake of alcohol
- Adopt an active lifestyle and exercise regularly
- Avail proper treatment for diabetes, high blood pressure, and high blood cholesterol levels
What are the treatment options for stroke?
The emergency treatment depends on the type of stroke experienced by the person.
- Ischaemic stroke:
- Medicines for dissolving the clot (Thrombolytics): Alteplase, Tenecteplase, etc. should be given as injections within 4.5 hours from the beginning of symptoms
- Thrombectomy: A catheter is introduced to the artery in the groin and is guided to the region of the blood clot. The blood clot is removed using a device or suction, which is passed through a catheter
- Carotid endarterectomy: If the cause of the ischemic stroke is the narrowing of the carotid artery (a large artery on the neck) due to fatty deposits, it is unblocked surgically
- Haemorrhagic stroke:
- Medicines to reduce blood pressure
- If the person has been on blood thinners, then blood transfusion or medicines to reverse the effects of the medicine
- Surgery (craniotomy): This is done to remove the blood from the brain and to repair the ruptured blood vessels
- Supportive therapy and rehabilitation:
- Medicines for controlling underlying health conditions such as diabetes, high blood pressure, and high cholesterol levels in the blood
- Feeding tubes may be necessary if the person has difficulty swallowing
- Speech therapy: This is useful for people who have difficulty speaking clearly
- Physical therapy: This helps your loved one relearn movements and coordination
- Occupational therapy: This helps in resuming day-to-day activities including eating, bathing, reading, and writing
A very important aspect of recovering from a stroke is the support and care extended by family and peers. Be patient with those who are recovering from strokes and encourage them to be more active. Additionally, help and the encourage them to make the necessary lifestyle changes to prevent a second stroke.
