What is a stroke?
The brain can aptly be called the control centre of the human body. An essential internal organ, the brain is made of specialised cells known as neurons. These neurons are responsible for making the brain function properly, and this is only possible when these specialised cells or neurons get ample blood supply. The blood supply to the brain is also assisted by cerebral arteries, which help in carrying oxygenated blood and other nutrients to the brain. For a brain to function effectively, there must be an uninterrupted supply of oxygenated blood.
However, sometimes blood supply to the brain may either decrease or get interrupted due to various reasons; and hampered blood supply to the brain may sometimes lead to a stroke. A stroke is a medical emergency, which means it requires immediate medical attention. Where most instances of strokes are caused or occur due to blockage in the arteries, which take oxygen-rich blood to the brain, sometimes strokes can also occur when a blood vessel in the brain ruptures or bursts. The way a stroke can affect you not only depends on the severity of the stroke, but it also depends on the part of the brain that it affects the most.
Symptoms of stroke can be experienced differently by different people. While some suffering a stroke may complain of severe headache, in other cases, people may experience minimal or no pain at all. Since different parts of the brain are responsible for controlling different areas of the body; therefore, the body parts that are affected the most by a stroke, are the ones that are directly controlled by that area of the brain.
When a stroke occurs, the cells in the brain are deprived of oxygen. This deprivation of blood can either damage the brain cells or kill them altogether. Therefore, knowing various symptoms and signs of a stroke is one of the leading steps towards managing and treating this health condition, which may turn fatal if not cared for. When any stroke occurs, prompt medical assistance must be sought to minimise the intensity of the damage. Also, the treatment will depend on the type of stroke that affects a person. It is essential to understand that if not diagnosed and treated on time, stoke can cause irreversible or permanent damage to the brain, which may sometimes lead to fatal medical conditions and also death in some instances.
Below are the symptoms of stroke, discussed in detail for timely diagnosis and treatment.
Both men and women can experience a stroke; however, statistics say strokes usually occur more in women, who are also at a high lifetime risk of it. There are various reasons that put women at an increased risk, and some of the reasons include taking birth control pills, preeclampsia, pregnancy, hormone replacement therapy, atrial fibrillation, and migraines with aura to name a few.
However, if a person can establish the signs and symptoms of stroke, it will go a long way in controlling the damage. Prompt diagnosis and treatment would mean lesser disability and better recovery. While experiencing a stroke, an individual may find it difficult to not only understand any conversations but also experience difficulty in talking. Apart from the inability to move a body part, strained facial expressions, sudden confusion is some symptoms that are experienced by both men and women.
Specific symptoms of stroke are different in men and women, as discussed below.
Symptoms of stroke in men
Here are some symptoms that are more prominent in men than women:
- Numbness on one side of the body
- Men may experience an inability to balance their bodies properly. This inability is also known as poor coordination
- Sudden weakness on one side of the body
Symptoms of stroke in women
Women may experience certain symptoms that are usually not associated with stroke in men. Here are some of them:
- Trouble in breathing
- A general feeling of weakness
- Loss of consciousness or fainting
- Trouble in breathing
- Experiencing hiccups
- Symptoms of nausea and vomiting
- Experiencing seizures
- Sudden state of confusion
- Sudden behavioural changes
It is often seen that the symptoms experienced by women may not be directly associated with stroke. This often poses to be a problem and may sometimes lead to a delay in receiving treatment.
Here are some symptoms that are common in both men and women:
- Sudden headache with no evident reasons
- Overall confusion that may lead to trouble in communicating
- Experiencing visual disturbances in one or both eyes
- Weakness or numbness of the face and limbs; usually on one side of the body
- Difficulty in balancing, sudden dizziness and more
It has been observed that men are more likely to exhibit more pronounced symptoms, which could be easily associated with a stroke than their female counterparts who are more likely to show lesser pronounced or non-traditional symptoms. Sometimes delay in interpreting the stroke symptoms can delay the treatment or lead to more health complications.
Types of stroke
Not all kinds of strokes may pose life-threatening conditions or fatal complications. Therefore, it is essential to understand the difference between the various types of strokes to understand their implications in a better manner.
Following are the types of strokes that may occur due to various reasons:
This is one of the most common types of strokes that can affect people. An Ischemic Stroke can occur when plaque, also known as fatty deposits, gets collected in the arteries. This fatty deposit can lead to narrowing of the arteries- a condition which is also known as atherosclerosis. Atherosclerosis leads to obstruction of blood flow to the brain, and this obstructed blood tends to pool up to result in blood clots. These blood clots are responsible for blocking the arteries.
Apart from atherosclerosis, a person can have an Ischemic Stroke because of a heart attack, irregular heartbeat, blood clotting issues, or any injury of the blood vessels in the neck or certain problems in the heart valves.
Embolic Stroke can be classified as a part of Ischemic Stroke. This kind of stroke occurs when a blood clot gets formed anywhere in the body and gets transported to the brain through the bloodstream. The blood clot then lodges itself in the artery, thereby obstructing the blood flow to the brain, and eventually causing a stroke.
Transient Ischemic Attack (TIA)
Transient Ischemic Attack is also known as a mini-stroke. A TIA exhibits symptoms similar to other strokes; however, it may last from anywhere between a few minutes to a few hours, without causing any damage. This stroke occurs when the blood vessels become too narrow, which may be due to the presence of a clot too. This is often seen as a warning sign of a future stroke, which means if you have a TIA or a Transient Ischemic Attack, there are a fair amount of chances that you might have a significant stroke in the future. A TIA may be considered a warning as well as an opportunity to take preventive measures.
The majority of strokes are Ischemic Strokes that occur due to clots in the brain; however, some strokes occur when a blood vessel ruptures inside the brain. These strokes are known as Hemorrhagic Strokes.
These strokes are fairly uncommon and may occur a little more than in 13% of the cases. Also, known as ICH or intracerebral haemorrhage, Hemorrhagic Strokes happen when the blood vessels in the brain rupture leading to accumulation of blood around the ruptured tissue. This exerts an excess amount of pressure on the brain, which can further lead to loss of blood in the other surrounding areas too. People with high blood pressure, bleeding disorders, brain injury, abnormal blood vessels, and other related issues are more likely to get affected by Hemorrhagic Strokes.
If the bleeding occurs inside the brain, it is known as intracerebral haemorrhage, and if the bleeding happens in the area that is between the skull and brain, then it is known as subarachnoid haemorrhage.
The main reason behind a stroke is a decrease or a complete blockage of blood supply to the brain. This hampered or blocked blood supply can be caused due to a number of reasons. Following are some of the major reasons that may cause a stroke:
- Excess weight- It is essential to be fit and have a healthy weight to maintain a healthy life. However, people who are obese or are somewhat overweight are more at risk of suffering from a stroke. This is mostly because obesity causes excess fat to build up in the body. This means an increased amount of fat in the body can narrow down the arteries, disrupt the blood supply to the brain and cause a stroke.
- High blood pressure- One of the leading causes of stroke is hypertension or high blood pressure. Increased pressure may lead to rupturing of the blood vessels, causing internal bleeding that may eventually cause a stroke.
- Age- People who are more than 55 years of age are more likely to suffer a stroke than their younger counterparts because arteries and blood vessels become more fragile with age. Therefore, sometimes, age can be one of the factors that can cause a stroke.
- Heart diseases- A person suffering from a heart condition such as an irregular heartbeat, atrial fibrillation or related heart diseases, may be more prone to a stroke than others. Also, if they have fatty deposits in their arteries, it increases their chances of developing a blockage in the arteries, which may again lead to a stroke.
- Medications- Often, certain medicines may cause stroke. This usually happens in patients who are on blood-thinning medication. While blood thinners are used to lower the risk of stroke, they may often cause increased internal bleeding in some instances, which is a cause for death. Also, medicines such as birth control pills or hormone therapy drugs may also lead to a stroke.
- Gender-Many times the gender can become one of the reasons for strokes. Women are at an increased risk of stroke as compared to men. While men too may suffer a stroke later in their lives, this is mostly due to old age.
- Genetics or Family History- Sometimes, a stroke can occur due to certain diseases or ailments that run in the families. This means if anyone in the family has or has had high cholesterol in the past, hypertension or diabetes or other genetic conditions may lead to blockage of arteries; there are a good amount of chances that it has been passed down genetically.
- Smoking or Tobacco- Nicotine in cigarettes and tobacco is a catalyst for a stroke. This is because nicotine can not only lead to fatty build up in your arteries, but it may also increase your blood pressure. Smoking also makes your blood thicker that may lead to clotting and thus cause a stroke. This holds not only for active smokers but this makes passive smokers susceptible too.
- Diabetes- A high amount of sugar is the blood is not good for the brain. Diabetes may not only lead to damaging the blood vessels but also lead to increased blood sugar levels, which prove to be fatal for the brain.
Risk factors of stroke
A stroke can affect the flow of blood to a particular area in the brain. It is imperative that majorly this condition occurs due to lifestyle-related factors. There is no denying that stroke can lead to immense health complications and may sometimes lead to death. While some risk factors can be controlled, other factors may not be controllable. Discussed below are both kinds of risk factors:
Factors that cannot be controlled
- Family history- When an individual’s grandparents, or parents have had a stroke at a younger age or before hitting the 65 years old mark, it puts that particular person at a higher risk. A hereditary condition like Cadasil, which can interrupt the blood flow to the brain, may also increase the risk of stroke.
- Race or ethnicity– Certain races or ethnicities are at an increased danger of a stroke when they are more likely to suffer from health conditions such as diabetes, obesity, hypertension amongst many others.
- Age- The likelihood of this condition increases with age, and it holds for both the sexes. Older people or people who are more than the age of 65 are at comparatively higher risk. In rare cases, even young individuals and kids may be affected by it.
- Gender- A stroke usually poses more threat to women than it does to men. Some reasons that put women at increased risk are use of oral contraceptive, pregnancy, gestational diabetes, history of preeclampsia, post-menopausal hormone therapy, and more.
- Previous history of a stroke- If an individual has a prior history of stroke; it places him at an increased risk of having another one when compared to the person who has never had a stroke
Factors that can be controlled
- High blood pressure- Increased blood pressure puts an individual at a considerable risk of suffering a stroke. Managing this condition and keeping the blood pressure in check can reduce the chances to a great extent.
- Physical inactivity- It is important to be physically active to keep strokes at bay. Inactivity can cause health conditions such as hypertension, diabetes, high cholesterol, obesity, and more that increase the chances of stroke.
- Diet– A diet with high amounts of cholesterol, saturated or trans-fat may lead to high amounts of cholesterol in the blood. A high-calorie intake may lead to excessive weight or obesity issues while a diet with more amount of sodium can cause hypertension. This is how certain dietary choices can put a person at a higher risk of a stroke.
- Carotid Artery Disease- These arteries are responsible for supplying blood to the brain. Any fat deposits in the carotid arteries may pose the threat of a stroke or put an individual at high risk.
- Atrial Fibrillation- This condition makes the upper chambers of the heart faulty, which causes the chambers to beat incorrectly. These abruptic heartbeats may sometimes lead to the pooling of the blood, which may result in a blood clot.
In order to figure out whether certain symptoms in a person are indicating a stroke, or the concerned person is suffering from other underlying conditions, a doctor may prescribe specific tests, a screening or scan. Also, a proper diagnosis will help the doctor to access the kind of stroke and follow the right course of treatment for the same.
Here are some diagnosis options that your doctor may recommend on the basis of symptoms observed in a person:
The doctor may advise some blood tests to assess the blood sugar levels to see whether it is too high or too low. The tests will also help examine how fast the blood clots and whether or not the patient is suffering from any infection.
MRI and CT scan
For a more detailed and comprehensive examination, the doctor may advise an MRI and CT scan. Magnetic resonance imaging or MRI can help in detecting whether or not there is any damage to the brain tissue by an ischemic stroke or any kind of brain haemorrhages. The damage can be assessed using radio waves and magnets that help in creating a detailed image of the brain. Sometimes the doctor may also like to determine the blood flow by adopting magnetic resonance angiography or magnetic resonance venography, which involves injecting a dye in the blood vessels.
Another way of having a detailed view of the brain is through a Computerised Tomography or CT scan, which involves a series of X-ray images that help in forming a comprehensive and accurate image of the brain. This test helps in establishing any internal bleeding, tumour or other such conditions. A dye is injected in the blood vessels to get a better view of the blood vessels of the neck and brain.
Echocardiogram ECG or EKG
Electrocardiogram or EKG is a test that uses sound waves in creating detailed images of the heart. This test helps in identifying the source and reason of clots in the heart, which may have travelled all the way up to the patient’s brain and may have resulted in a stroke.
This is an invasive diagnostic technique which is not used very commonly unless the doctor feels the need for a cerebral angiogram. This test helps to establish if any of the arteries have narrowed down to a considerable extent or detect other kinds of abnormalities in the arteries. During a cerebral angiogram, a small incision is usually made around the groin area to insert a catheter, which a very thin and flexible tube. A dye is injected through the tube that makes its way through the arteries. This injected dye can thus be viewed through X-ray imaging to get a detailed view of neck and brain blood vessels.
In this kind of test, an ultrasound scan is conducted, that uses sound waves for creating detailed images of carotid arteries in the neck. This test is helpful in establishing any kind of plaque or fatty deposits that usually build up in the arteries and could result in a stroke.
It is important to understand that a stroke is a condition that requires immediate medical help to avoid any fatal complications; therefore, as soon as symptoms of a stroke are suspected in a person, medical assistance should be brought in. After a thorough diagnosis, the doctor will help establish the apt course of treatment as per the patient’s condition.
Treatment of a stroke can begin as soon as the doctor is able to establish the type of stroke. Also, treatment options always primarily depend on the cause, location of the stroke, severity and type. Once the type of stroke is known, a doctor may prescribe any of the following treatment options based on the diagnosis:
Ischemic stroke and TIA
As soon as the doctor establishes a TIA or an Ischemic Attack, the patient may be advised any of the following treatment options that can not only help in correcting the abnormality, but it can also help in preventing the likelihood of future strokes. After carefully analysing the cause of a stroke, he may either prescribe medicines to prevent blood from clotting, or in some cases invasive treatment options may be suggested.
- Antiplatelets and anticoagulants: The doctor can prescribe antiplatelet medicines to prevent the blood from clotting. When the blood vessels are injured, they can tend to stick together due to the protein in the blood plasma, which is how the process of forming a clot takes place. Antiplatelet medicines such as Aspirin are one of the most widely used drugs that have fewer side-effects. Clopidogrel, another antiplatelet medicine, can be given solo or combined with Aspirin to reduce the future occurrence of strokes.
Heparin and warfarin are anticoagulants that prevent the blood from forming clots without affecting the platelets.
- Clot-breaking drugs: Sometimes, doctors use thrombolytic therapy to dissolve the blood clots, which may be blocking blood flow to the brain. These thrombolytic drugs or more commonly known as clot-breaking drugs are used under circumstances when neurotic findings and symptoms last longer than a few minutes and do not improve.
- Mechanical thrombectomy: This is an invasive method which involves removing a clot from the arteries. An incision is made either on the abdominal region or wrist, and a catheter is inserted to remove the clot that is blocking the blood flow.
- Stents: Sometimes, the doctor may opt for stenting or carotid angioplasty for treating TIA. The clogged artery is opened up with a balloon-like device. Then a small tube or stent is placed in the artery, which will help in keeping the artery open and aid in uninterrupted blood supply to the brain. This invasive treatment option is usually adopted where medicines or lesser invasive treatment options may not work well.
- Surgery: In some cases, the doctor may suggest carotid endarterectomy, which is useful in cases where the carotid artery is moderately or severely blocked. This treatment option involves making an incision in the artery to remove fatty deposits or plaque.
The treatment options of Hemorrhagic Strokes involve methods that help in not only controlling the internal bleeding but also reducing the excess pressure on the brain because of extensive fluid accumulation. Following are some treatment options available in this case:
Medications: The doctor may administer medicines that will help in reducing the pressure, prevent seizures and spasms of the blood vessels and keep the blood pressure lower.
Coiling: Coiling, also known as endovascular embolisation, is a lesser invasive technique of blocking the blood flow to the brain. This involves making an incision in the groin region and inserting a flexible tube (catheter) through it. This catheter carries tiny detachable coils, which are used to clot the blood and blocks the blood flow into the aneurysm.
Clamping: Also, known as surgical clipping, clamping is also one of the effective ways of stopping the flow of blood. A tiny clamp like device is fixed at the base of the aneurysm, which helps in stopping the excess blood from getting into the brain. This clipping is not only useful in keeping the aneurysm from bursting, but it also helps in saving the aneurysm that has been haemorrhaged recently, from bleeding all over again.
Surgery: Sometimes, the area where the bleeding has occurred may be large, where lesser invasive techniques and medicines may not be of much help. Under such circumstances, the doctor or medical practitioner may advise the patient to go in for surgery. Surgery is performed to remove the excess blood from the area and to relieve excess pressure from the brain. Surgical AVM removal, Stereotactic radiosurgery and various other surgical options can be suggested depending on the condition of the patient.
If a person has already had an episode of stroke, there are chances of having it again. This is why a doctor may prescribe medicines that may lessen the chances of having another stroke. The medicines will depend on the type of stroke you experienced. However, the following are some medicines that may be administered:
- Blood pressure medicines- These medicines may include ACE Inhibitors, Diuretics, Beta blockers, Angiotensin II receptor blockers, Calcium channel blockers, and more that can help in managing the blood pressure.
- Anti-clotting medicines- These may include antiplatelet medicines and Anticoagulants, which may help in preventing the blood from forming clots.
- Atrial-fibrillation drugs- These drugs are recommended in case the patient has irregular heartbeats. Anti-fibrillation drugs may include heart rhythm drugs and heart rate drugs.
- Diabetes medicines- These medicines will help manage diabetes and thus reducing the chances of stroke.
- Cholesterol medicines– A doctor may administer these medicines in case there are chances of the arteries being blocked due to excess cholesterol in the body.
Recovering from stroke
Once a person has received emergency medical care after a stroke, the doctor will closely monitor their progress. This will help the doctor to access the impact of stroke on the body. In case the stroke has affected the right side of the brain, the patient may experience changes in sensations and movements on the left side of his body and vice a versa. The damage on the left side of the brain may also hamper one’s speech and language skills.
In most cases, the patients are offered rehabilitation programs to recover better and lead healthy lives again. These recovery and rehabilitation programs can begin in the hospital, as an outpatient department, home, and other skilled nursing facilities too. Here are some specialists who may help a person in recovering from a stroke:
- Physical therapist
- Recreational therapist
- Occupational therapist
- Speech pathologist
- Rehabilitation nurse
How to prevent a stroke
The phrase ‘Prevention is better than cure’ applies in this case of a stroke as well. Here are a couple of tips that can help one prevent this life-threatening medical condition:
Getting rid of excess weight
Being overweight or obese can not only put a person at a high risk of developing multiple health complications but also increases the chances of having a stroke. It is advisable to keep the BMI under the prescribed healthy limits, which can be achieved by keeping a check on the daily calorie intake and also participating in some kind of physical exercise and activity every day.
Keeping the blood pressure under check
High blood pressure is one of the leading causes of stroke, and for the ones who’ve hypertension, it is important that it is kept under control. This can be achieved by reducing the salt intake in one’s diet, skipping foods that have high cholesterol content, including more green vegetable and fruits in the diet and making relevant lifestyle changes.
Keeping smoking at bay
Smoking can put any person at a higher risk of stroke because the nicotine can lead to an increase in the blood pressure, while the carbon monoxide can hamper the amount of oxygen that can be carried by the blood. Even passive smoking can put a person at risk. Patients are advised to go for counselling sessions, wear nicotine patches, or seek medical help when required.
Getting diabetes treated
High amounts of blood sugar can lead to the formation of clots in the blood, thus increasing the chances of a stroke. In case someone is suffering from diabetes, it is important that measures be taken to keep it in check. Dietary changes, exercising, and medicines that have recommended by the doctor can help anybody in managing their diabetes and keeping it bay.
Reducing the alcohol intake
Enjoying a drink or two may not put someone at risk of stroke, however, for all those people who take more than two alcoholic beverages a day may put themselves at an elevated risk. It is advisable to keep a tab on the size and frequency of drinks.
One of the best ways of being in the pink of health comes from indulging in some moderate intensity exercises at least three to four times a week. One can start with 30 minutes of moderate exercising sessions and increase the time and intensity along the way.
Get treated for atrial fibrillation
Atrial fibrillation is a condition that is characterised by irregular heartbeats, which may sometimes lead to clotting of the blood. This tendency of the blood forming clots may sometimes cause strokes too. Therefore, if you have this condition, you should get it treated. Proper medications such as anticoagulant drugs are a great way of managing this condition.
A stroke is not only physically and emotionally draining for the person suffering from it but can take a toll on the family members as well. It is a devastating and disheartening experience for everyone associated with it. A stroke can not only affect the health of the person involved but may also affect the confidence, independence and other abilities of that person. Therefore, it is important to understand that stroke can be managed and treated effectively if prompt and proper medical care is sought at the earliest.
The treatment and recovery from a stroke usually depend on its severity. The recovery can be a slow and long process and may sometimes lead to several doubts in the mind of the patient. However, it is also essential to understand that there a wide range of specialists that can help the patient to heal, which can range from emergency care to moving to home care options when the patient reaches a more stable state.
There are no doubts that strokes are a fatal health condition. However, knowledge, education and timely medical assistance may help in better recovery and chances of survival.
Here are some frequently asked questions on stroke that may help you understand this condition better:
- Who are at a high risk of stroke?
Although genetics play a significant role in increasing the chances of stroke, however, if one suffers from high cholesterol, diabetes, hypertension, or is obese, smokes or drinks alcohol excessively is at an increased risk of suffering a stroke. Lifestyle changes can go a long way in reducing the chances of stroke.
- What am I supposed to do if someone is having a stroke?
Brain attack or stroke is a condition that requires immediate medical attention to reduce further complications. As soon as you suspect that someone is having a stroke, you should call an emergency helpline or take the person to the nearest hospital. A delay can not only deteriorate the condition but sometimes also lead to life-threatening conditions.
- How long does it usually take to recover from a stroke?
Strokes can affect different people differently. The recovery usually depends on the severity of the stroke. In most cases, a patient usually recovers within six months to one year. However, in some cases, patients may take longer to heal and lead healthy lives.
- Will a stroke patient go back to his earlier health condition after a stroke?
Well, this mostly depends on the intensity and severity of damage that is caused to the brain, because a stroke damages the brain cells. Also, younger people are more likely to have a better recovery than elderly people.
- Is it true that stroke is more likely to kill women than men?
This is true because women have a better life expectancy rate than men, which means that as they grow old, they may develop health conditions that may also put them at an increased risk of having a stroke. The recovery may also become difficult at an old age, which puts women suffering from a stroke at a higher risk of dying.