A stroke, also known as a cerebrovascular accident (CVA), occurs when the blood supply to part of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients.
Brain cells begin to die within minutes, making it a medical emergency.
Types of Strokes
1) Ischemic Stroke
Caused by a blockage in an artery supplying blood to the brain.
Thrombotic Stroke: Blood clot forms in an artery supplying the brain.
Embolic Stroke: Blood clot or debris forms elsewhere in the body and travels to the brain.
2) Hemorrhagic Stroke
Caused by bleeding in the brain.
Intracerebral Hemorrhage: Bleeding within the brain tissue.
Subarachnoid Hemorrhage: Bleeding in the space between the brain and the surrounding membrane.
3) Transient Ischemic Attack (TIA)
Often called a mini-stroke, it's a temporary period of symptoms similar to those of a stroke.
Causes
Ischemic Stroke: Atherosclerosis, heart disease, atrial fibrillation, high blood pressure, high cholesterol.
Hemorrhagic Stroke: Hypertension, aneurysms, arteriovenous malformations (AVMs), head injury, blood-thinning medications.
Symptoms
Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body.
Sudden confusion, trouble speaking, or understanding speech.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, loss of balance or coordination.
Sudden severe headache with no known cause.
Diagnosis
Physical Examination: Neurological examination to assess symptoms.
Imaging Tests:
CT Scan: Quickly identifies bleeding in the brain.
MRI: Provides detailed images of brain tissue and blood vessels.
Carotid Ultrasound: Shows narrowing or blockage in the carotid arteries.
Blood Tests: To determine clotting factors, blood sugar, and other relevant parameters.
Cerebral Angiography: Visualizes the brain's blood vessels.
Pathophysiology of Stroke
Ischemic Stroke: Blockage of a blood vessel supplying the brain, usually due to a blood clot, leading to tissue ischemia and infarction.
Hemorrhagic Stroke: Rupture of a blood vessel causing bleeding in or around the brain, leading to increased intracranial pressure and tissue damage.
Neuronal Injury: Lack of oxygen and nutrients results in neuronal death and brain damage.
Treatment
1) Ischemic Stroke
Clot-Busting Medications: Intravenous tissue plasminogen activator (tPA) within a few hours of symptom onset.
Endovascular Procedures: Mechanical thrombectomy to remove the clot.
Antiplatelet Agents: Aspirin or clopidogrel to prevent further clots.
Anticoagulants: For patients with atrial fibrillation or other risk factors.
2) Hemorrhagic Stroke
Emergency Measures: Controlling bleeding, reducing intracranial pressure.
Surgical Interventions: Repairing blood vessel anomalies or removing the blood clot.
Medications: To control blood pressure, prevent seizures, and manage symptoms.
3) Rehabilitation
Physical Therapy: To improve motor skills and mobility.
Occupational Therapy: To regain skills for daily activities.
Speech Therapy: To improve communication and swallowing.
Supportive Care: Psychological support and counseling for patients and families.