A stroke is a medical emergency because strokes can lead to death or permanent disability.
A stroke, also known as a cerebrovascular accident (CVA) or “brain attack” is when part of the brain loses its blood supply and causes the part of the body that the injured brain controls to stop working.
The loss of blood supply to the brain can be “ischemic” because of lack of blood flow, or “hemorrhagic” because of bleeding into brain tissue.
There are opportunities to treat ischemic strokes but that treatment needs to be started in the first few hours after the signs of a stroke begin.
That is from onset of symptoms, there is only a 3 to 4 1/2 hour window to use clot-busting drugs (thrombolytics) to try to restore blood supply to the affected part of the brain.
Strokes may be described based on the function of the body that is lost and by the area of the brain that is affected.
Most commonly involved in strokes is the brain, the symptoms involve either the right or left side of the body. In strokes that affect the brainstem or the spinal cord, symptoms may present on both sides of the body.
Causes of Stroke
Causes of strokes include ischemia (loss of blood supply) or hemorrhage (bleeding) in the brain.
People at risk for stroke include those who have high blood pressure, high cholesterol, diabetes, and those who smoke. People with heart rhythm disturbances, especially atrial fibrillation are also at risk.
You can prevent stroke by quitting smoking, controlling blood pressure, maintaining a healthy weight, eating a healthy diet, and exercising on a regular basis.
Stroke is diagnosed by the patient’s symptoms, history, and blood and imaging tests. The prognosis and recovery for a person that has suffered a stroke depends upon the location of the injury to the brain.
Symptoms of Stroke
Strokes may affect motor function or the ability for the body to move. Part of the body may be affected, like the face, a hand, or an arm. An entire side of the body may be affected (for example, the left part of the face, left arm, and left leg).
Weakness on one side of the body is called hemiparesis (hemi = half + paresis = weak) and paralysis is hemiplegia (hemi = half + plegia = paralysis).Similarly, sensory function — the ability to feel — can affect the face, hand, arm, trunk, or a combination of these.
Other symptoms like speech, vision, balance, and coordination help locate the part of the brain that has stopped working and helps the health care professional make the clinical diagnosis of stroke.
This is an important concept since not all loss of neurologic function is due to stroke and if the anatomy and physiology do not match the loss of body function, other diagnoses may be considered that can affect both brain and body.
What are the warning signs and symptoms of a stroke?
There may be no warning signs of a stroke until it occurs. It is why high blood pressure (hypertension), one of the risk factors for stroke, is called the silent killer.
Some patients may experience transient ischemic attack (TIA) that can be thought of as a stroke that has resolved itself. The symptoms may be mild or dramatic and can mimic a stroke with weakness, numbness, facial droop, and speech difficulties, but these symptoms may only last a few minutes.
TIAs should not be ignored since they may offer an opportunity to look for potentially reversible or controllable causes of stroke. As well, there is no guarantee that the symptoms of stroke will resolve on their own.
For that reason, a TIA should be considered an emergency and medical care should be accessed immediately. Symptoms of stroke depend upon what area of the brain has stopped working due to loss of its blood supply.
Often, the patient may present with multiple symptoms including the following: Acute change in level of consciousness or confusion, Acute onset of weakness or paralysis of half or part of the body, Numbness of one half or part of the body, Partial vision loss,Double vision, Difficulty speaking or understanding speech, Difficulty with balance and vertigo.
What is the treatment for stroke?
A stroke is a medical emergency, but prompt intervention can restore blood supply to the brain if stroke patients receive medical care early enough.
As in many emergencies, the first consideration are the CABs (Circulation, Airway, and Breathing, according to the new CPR guidelines) to make certain that the patient has blood pumping, no airway blockage and can breathe, and then has adequate blood pressure control.
In severe strokes, especially those that involve the brainstem, the brain’s ability to control breathing, blood pressure, and heart rate may be lost. Patients will have intravenous lines established, oxygen administered, appropriate blood tests, and noncontrast CT scans performed.
At the same time, the health care professional performs an assessment to make the clinical diagnosis of stroke and decides whether thrombolytic therapy (tPA, a clot busting medication) or clot retrieval (mechanically removing the clot through catheters that are threaded into the blocked artery) is an option to treat the stroke.
Culled from MedicineNet