A stroke impacts millions of people every year around the world, making it a highly alarming phenomenon. In the case of a stroke, time management is absolutely critical. Patients must be treated as quickly as possible, as soon as the first symptoms of the condition appear.
A stroke immediately affects the function of the brain. It occurs when there is a sudden interruption of blood flow to this vital control centre of the human body. Early diagnosis and prompt treatment can help minimise the risk of long-term complications. So, what are the signs of a stroke?
Stroke: Definition
Commonly referred to as a “stroke,” a cerebrovascular accident (CVA) is defined as a sudden interruption of blood flow to the brain. This failure immediately leads to a lack of oxygen and nutrients in all or part of the nerve cells, which ultimately die irreversibly.
A stroke causes a sudden loss of a brain function depending on the affected area of the brain. However, the symptoms remain the same for both men and women. The key is to act quickly to minimise damage, particularly the risk of mortality.
In most cases, there are no warning signs of the condition. The consequences of a stroke are highly variable. Some individuals recover fully, while others live with long-term effects. It is crucial to manage several risk factors.
The main signs of a stroke include numbness in the face or limbs, weakness on one side of the body, confusion, double vision, or sudden dizziness.
The risk factors for stroke are as follows:
Age. The risk of stroke increases with age.
High blood pressure. High blood pressure is responsible for about half of all strokes and is the most common risk factor for cardiovascular disease (heart or blood vessels). Around two-thirds of Americans with high blood pressure do not have it under control.
High cholesterol levels (hypercholesterolemia). Hypercholesterolemia increases the risk of a stroke. If you have heart disease, your triglyceride levels should be low (less than 150 mg/dL). A triglyceride level above 200 mg/dL can increase the risk of a heart attack or stroke.
Diabetes mellitus (type 1 or type 2 diabetes). Diabetes increases the risk of a stroke as it often causes narrowing of the arteries that supply blood to the brain and other parts of the body; this condition is called atherosclerosis.
In Medicine, we encounter several cases of strokes. Different types of cerebrovascular accidents can be mentioned:
Cerebral thrombosis is the most common type, accounting for around half of all cases. It is characterised by the formation of a blood clot that causes the blockage of an artery near the brain. This obstruction occurs at the site of atherosclerosis, a lipid plaque, and can gradually lead to cerebral oedema.
Initially, symptoms include vomiting, visual disturbances, and seizures. Over time, cerebral venous thrombosis causes intracranial hypertension, cerebral ischaemia, or sometimes haemorrhagic ischaemia.
Causes of cerebral thrombosis
Cerebral thrombosis is caused by the formation of a blood clot (thrombus) in one of the arteries leading to the brain. This occurs when there is an imbalance between clot formation and clot dissolution. Clots usually form as part of the natural healing process after an injury or surgery, but they are normally dissolved by proteins called fibrinolytic enzymes. If these enzymes are not present in sufficient quantities, clots can develop and lead to complications. The most common cause of this deficiency is low levels of antithrombin III (ATIII), which is essential for fibrinolysis (the breakdown of clots). Other factors involved in blood clotting may also be abnormal, such as von Willebrand factor (vWF) and deficiencies in protein C and protein S.
Cerebral embolism affects around one-third of patients. It is also defined as the blockage of the cerebral artery caused by clots formed elsewhere.
This condition leads to a reduction in blood flow to the cerebral region, resulting in an ischemic stroke.
Various symptoms may appear, such as paralysis, speech or cognitive difficulties, and loss of sensation.
The treatment for cerebral embolism depends on the severity of your condition and its underlying cause. Treatment may include medications called anticoagulants, which help prevent the formation of new clots in the blood vessels and accelerate the breakdown of existing clots.
A cerebral haemorrhage most often leads to a haemorrhagic stroke, making this type of stroke more severe. It results from long-term hypertension, blood clotting issues, the rupture of an artery in the brain within the cortex or meninges, and other causes.
This type of stroke accounts for 5 to 20% of cases. It is characterised by the sudden onset of bleeding due to the rupture of a small blood vessel. Most commonly, a haematoma forms inside the brain.
The symptoms of a cerebral haemorrhage may include:
- Sudden headaches
- Nausea and vomiting
- Confusion, difficulty speaking or understanding speech (aphasia)
- Seizures (convulsions)
- Weakness or paralysis on one side of the body (hemiparesis)
Treatment depends on the cause and severity of the cerebral haemorrhage. If you are unconscious, immediate surgery may be needed to stop the bleeding or remove clots from the brain.
The best way to prevent a stroke is to manage the risk factors that can lead to one. If you have high blood pressure, high cholesterol, or diabetes, make sure to take your prescribed medications and see your doctor regularly.
Be sure to have your cholesterol levels and blood pressure checked annually.
If you smoke, do everything you can to quit. If you’re unable to stop on your own, ask your doctor for help to quit smoking.
Stop drinking alcohol. Alcohol increases the risk of stroke by raising blood pressure and weakening the walls of the blood vessels in the brain.
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F.A.Q
An ischaemic stroke is caused by the obstruction of a blood vessel that supplies oxygen to the brain. A clot forms in an artery and blocks the blood flow to part of the brain.
The medical treatment for an ischaemic stroke depends on its severity and the permanent brain damage it has caused. Here are some common treatments:
- Medications to dissolve blood clots, such as alteplase (tPA). This medication can be administered intravenously in the hospital. It dissolves clots and restores blood flow to the affected area of the brain within three hours of symptom onset.
Medications to treat other conditions associated with strokes, such as high blood pressure or diabetes.
Long-term anticoagulant medications to prevent the formation of another clot in the brain or elsewhere in the body. These medications are often prescribed for several months following the stroke.
Haemorrhagic stroke is a type of stroke caused by bleeding in the brain. It occurs when blood vessels break or rupture. The blood leaks into the surrounding brain tissue, damaging brain cells and causing symptoms such as weakness on one side of the body, confusion, difficulty speaking or understanding others, and vision problems.
Haemorrhagic strokes can be caused by aneurysms (widening of an artery due to plaque build-up), arteriovenous malformations (abnormal connections between arteries and veins), or head trauma.
Most people who suffer a haemorrhagic stroke experience symptoms within minutes or hours of the injury. However, some may develop symptoms over days or weeks following the injury.
A stroke is damage to the brain caused by a lack of blood supply, while a heart attack is damage to the heart muscle due to an interruption in blood flow. The symptoms are different, although some may overlap, such as chest pain.
A transient ischaemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary blood clot or blockage in an artery supplying the brain. The symptoms of a TIA can be similar to those of a stroke but typically only last a few minutes or hours, whereas a stroke can last for days, weeks, or even months.
A transient ischaemic attack (TIA) is also known by other names, including mini-stroke, cerebrovascular accident (CVA), and brain attack.
A transient ischaemic attack (TIA) is caused by a temporary blockage in one of the blood vessels supplying the brain. This blockage causes minor damage to brain tissue, which can result in weakness or numbness on one side of the body, confusion, difficulties with speech, and vision problems in one eye. These symptoms usually resolve within an hour or two as the blockage clears.
You can use the acronym FAST to remember the signs of a stroke:
F: Face drooping (one side of the face appears to droop).
A: Arm weakness (weakness in one arm).
S: Speech difficulty (trouble speaking or understanding).
T: Time to call emergency services immediately if you notice any of these signs.
The speed and extent of your recovery after a stroke depend on several factors, including the cause of the stroke and the area of the brain affected.
The most common type of stroke, known as an ischaemic stroke, occurs when a cerebral artery is blocked by a clot. These strokes are more frequent in people with high blood pressure and other vascular risk factors. When a cerebral artery is blocked, oxygen-rich blood cannot reach the brain tissue downstream of the obstruction.
As a result, the cells in these areas die, and if these brain cells do not receive blood flow quickly enough to recover, you experience a stroke. Even with immediate medical treatment, strokes usually leave lasting effects.
Stroke rehabilitation generally involves regaining strength and function through various activities and exercises. There are many types of therapies that may benefit someone who has had a stroke – for example, physiotherapy to regain strength in affected limbs or speech therapy to address communication difficulties caused by damage to specific parts of the brain.
Rehabilitation can also help stroke survivors relearn basic skills, such as walking or washing independently. There is ongoing research into how rehabilitation influences long-term outcomes.
