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Stroke

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The brain requires a constant supply of oxygen and nutrients to function. A stroke occurs when the blood supply to the brain either is blocked or bursts. This disruption deprives your brain of the oxygen and nutrients necessary to function. This causes the brain cells to die. A stroke can affect different parts of the brain so that area may not function as well as it did before resulting in speech problems, ambulation, as well as sensory functions such as sight and feeling.

There are several different types of strokes:

  • Ischemic
  • Hemorrhagic Stroke
  • Transient Ischemic
Ischemic Stroke:

This type of stroke is the most common. It occurs when a blood clot blocks an artery cutting off the blood to a part of the brain. Unless nearby blood vessels can deliver enough blood to the area, the brain cells will begin to die and the individual will begin to have problems using certain parts of their body or lose some ability. There are two types of Ischemic Stroke:

  • Embolic – this is where a blood clot forms somewhere in the body and moves through the blood stream into the brain. Once in the brain the clot blocks a blood vessel and causes a stroke.
  • Thrombotic – this is where a blood clot forms somewhere in the body and does not move to the brain but forms in an artery that supplies blood to the brain. If the clot interrupts the blood flow to the brain, a stroke can occur.
Hemorrhagic Stroke:

This type of stroke is caused when a blood vessel in the brain bursts or leaks and releases blood into the brain. High blood pressure and brain aneurysms can cause blood vessels to weaken and possibly cause a hemorrhagic stroke. A hemorrhagic stroke can be categorized in two ways:

  • Intracerebral hemorrhage - In this type of stroke, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the leak are deprived of blood and damaged. This type of stroke can be caused by a blood vessel in the brain bursting and blood being spilled into the surrounding brain tissue. This can be cause by a number of things like high blood pressure, trauma or a possible malformation of the brain.
  • Subarachnoid hemorrhage - In this type stroke, an artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull. This is often signaled by a sudden, severe headache. A subarachnoid hemorrhage is commonly caused by the rupture of an aneurysm.
Transient Ischemic Stroke (TIA):

This occurs when an artery leading to or inside the brain becomes blocked for a short period of time. This is considered a mini-stroke and may cause a short period of numbness, trouble with speech, balance or coordination. Even though this may only last for less than a five minute period, you should still seek medical attention as this may be a sign of future strokes.

There are different risk factors and symptoms of strokes. Many of the risk factors can be treated. Factors such as smoking, high blood pressure, high cholesterol, diabetes, obesity, heavy drinking, drug use and many other factors can contribute to the risk of a stroke. Talk to your doctor or one of our experts about these and other factors.

Symptoms

Symptoms of a stroke can vary depending on what type of stroke it is and what part of the brain is affected. The following signs or symptoms should be reported to your physician and the duration they last should be documented.

  • Paralysis in the face, arm or leg.
  • Trouble walking
  • Trouble speaking or understanding
  • Trouble with vision in one or both eyes (blurred or blackened vision)
  • Sudden severe unexplained headaches accompanied by nausea or vomiting

Diagnosis

A stroke should be diagnosed by an emergency team or an experienced physician. The type of stroke will need to be evaluated to determine the best treatment option. They will perform various tests in order to rule out other possible conditions. A complete medical history is necessary to determine whether family members have a history of stroke. A full physical examination must be performed to evaluate your symptoms, whether they are still present and the duration.

You may be required to have blood tests to check for different conditions. Other tests that may be performed are CT Scan or an MRI as well as various other diagnostic tests used to determine whether a patient has had a stroke.

Treatment

There are a variety of treatments for a stroke and they are mainly treated on an emergency basis. The emergency treatment will depend on the type of stroke you've had, cause, how much time has elapsed between the stroke and the seeking of care as well as whether it's a Ischemic Stroke where there is a blockage of a artery or a hemorrhagic stroke where it involves a blood vessel burst which involves bleeding into the brain.

An ischemic stroke must be treated by the doctors quickly to restore blood flow to the brain. Therapy with drugs that break up the clot in the artery are usually given within four hours of the onset of the stroke. If for some reason you cannot have a certain drug you may be given an antiplatelet medicine such as aspirin to stop platelets from clotting together.

A hemorrhagic stroke must be treated differently because it means an artery has burst or is leaking blood into the brain and medication may make it worse. The first steps in this treatment is to locate the cause of the bleed and control it. Surgery may also be needed if the stroke is due to an aneurysm. Aneurysm clipping or coil embolization Aneurysm clipping is done to block off the aneurysm from the blood vessels in the brain. This is done through a small incision into the brain. Your physician may also recommend Coil embolization. During this procedure a tube is inserted through an artery in the groin. The tube is slowly threaded to the site of the aneurysm. Then a tiny coil will be pushed through the tube into the aneurysm. The coil will cause a blood clot to form which will block blood flow into the aneurysm and keep it from bursting.

SCCNS uses a team approach to care for stroke patients and we believe that through this team approach every measure is taken to ensure the utmost care of the patient.

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