The greatest wonder of the universe and the most intricate thing man has ever discovered is human brain. Compared to this infinite storage of knowledge, the whole computer network in the world is nothing. Man, with his dreams and imaginations, hopes and thoughts, hunger and thirst, memories and heart beats, is indebted his whole life to his brain, the amazing powers  of which are still not revealed completely to science. That is why any affliction that affects the brain becomes so important. Stroke, also known as brain attack, is one of the most serious diseases that prevents blood flow to your brain and damages your brain cells in an irrecoverable manner. As per the studies made by World Health Organization, stroke is the third largest cause of death in the world, ranked just behind heart diseases and cancer.

What is Stroke?

Stroke is a serious condition of the brain by which the brain suddenly stops functioning partly or completely due to the disruption of blood circulation to the brain. Blood flow to the brain can be disrupted when there is a block in blood vessels due to blood clot, or by bursting of a blood vessel and filling blood into the surrounding brain tissues.

For proper functioning of the brain, it needs a continuous supply of oxygen and nutrients through blood circulation. Without oxygen, brain cells in the tissues will stop functioning and die in few minutes. Regeneration of these dead brain cells is an impossible task. Brain cannot function with dead brain cells and the part of the body they control will stop functioning. This will result in paralysis, inability to speak, diminished memory, loss of vision, loss of consciousness and even death.  

Symptoms of Stroke

Symptoms may vary from person to person, depending on the type of stroke. The following symptoms are most common.

  • Sudden numbness and weakness of face, hands or legs, usually on one side of the body: Stroke affects the left or right hemisphere of the brain, and numbness will be experienced in the opposite side of the body
  • Sudden confusion and difficulty in speaking as well as understanding, with distortion of face: It is mainly happened due to the attack in the left hemisphere of the brain. The patient will find it difficult to take food or drinking water.
  • Sudden loss of vision in one eye or both the eyes: It happens due to the disruption of blood flow to the brain stem that controls eye movements. Since both the eyes cannot be concentrated simultaneously on a single object, the patient will experience double vision.
  • Dizziness, loss of balance and difficulty for walking, standing and sitting: When the stroke attacks the cerebellum that controls the body balance by receiving the messages of sensory nerves from the ears, the patient will feel dizzy, lose body balance and sometimes starts vomiting. Other symptoms of stroke are also to be verified before confirming that it is stroke.
  • Severe headache without any specific reasons: Headaches can be caused due to several reasons but sudden headache of severe nature, without any particular reason, can be the symptoms of stroke. This happens in hemorrhagic stroke, by bursting blood vessels and filling blood in the brain tissues.

F.A.S.T the easy way to recognize Stroke

FAST is an abbreviation of an easy method to identify stroke, based on the three most common symptoms. It has been used internationally to ensure timely treatment of stroke patients.

F : FACE - Ask the person to smile. Is a section of the face drooping and difficult to move? 

A : ARM  - Ask the person to raise both arms. Does he find it difficult and one arm or both the arms fall?

S : SPEECH - Ask the person to speak a sentence. Does he find it difficult or produce some unclear words that you cannot understand? 

T : TIME - When any of the above signs are observed, it is time to call emergency services or to take him to the hospital immediately. Note down the time and inform the hospital authorities that you are bringing the patient so that they will make necessary arrangement for the treatment and save time. Know that time is the deciding factor!

Types of Stroke

Blood flow to the brain is disrupted basically due to two reasons, namely, a block in the blood vessels or bursting of blood vessel. Based on these two reasons, stroke can be classified into following two categories.

  • Ischemic stroke
  • Hemorrhagic stroke

Ischemic Stroke

About 87 percent of the brain attacks that happen in the world belong to this category. It happens when the blood supply to the brain is interrupted due to a block in the blood vessel. Ischemic stroke is subdivided into following two categories.

  • Embolic Stroke
  • Thrombotic Strokes

Embolic Stroke

Embolic stroke is caused by a blood clot formed somewhere else in the body which travels through the blood vessels to the brain and creates obstructions in the tiny blood vessels in the brain. These blood clots are called embolus. Embolic strokes are mostly seen in people having heart problems. Usually it occurs suddenly without any warning signals.

Thrombotic Stroke

Thrombotic stroke occurs due to the disruption of blood flow to the brain, caused by a blood clot called thrombus, formed in the arteries supplying blood to the brain. It is mainly seen on those persons with high cholesterol levels and fat build-up inside the blood vessels.

Hemorrhagic Stroke 

Hemorrhagic stroke happens when a blood vessel supplying blood to the brain blasts and bleeding occurs. Hemorrhage is the name given to the blasting and bleeding of an artery in the brain. Genetic problems and hyper tension are also the reasons for hemorrhagic stroke. This stroke is rare but serious in nature.  Almost 13% of the strokes are caused by hemorrhage.

Hemorrhagic stroke is further divided into two main categories:

  • Intracerebral hemorrhage
  • Subarachnoid hemorrhage

Intracerebral Hemorrhage

Due to high blood pressure, blood vessel in the brain bursts, bleeding happens and blood is spilled over the surrounding tissues. This stroke happens without any warning symptoms. Bleeding and swelling in the brain tissues will increase the pressure inside the skull and the situation can become critical and even cause death.

Subarachnoid Hemorrhage

Subarachnoid hemorrhage happens when an artery bursts and bleeding takes place between the brain and the membrane that covers it. It is usually caused due to the bursting of aneurysm in the brain. An aneurysm is the weakened portion of an artery, expanded like small balloons. Aneurysm is often present at the time of birth and bursts due to high blood pressure.

Mini Stroke or TIA

In addition to the strokes referred above, there is “Mini stroke” called Transient Ischemic Attack (TIA). TIA produces similar symptoms of a stroke, which is caused due to temporary blockage of blood flow to some portion of the brain. It will last for few minutes to few hours and is a warning signal about an imminent stroke; just like a storm before a heavy rain. Similar to ischemic stroke, it is either embolus or thrombus that causes TIA. Only difference is that the disruption of blood flow is temporary. In some cases, the mini stroke may cover 24 hours and more, evolving to a complete stroke. So, if a TIA is identified, it is essential to get immediate medical help.

Prevention

Compared to any other diseases, prevention has more importance in case of stroke, because once the stroke has attacked, the brain cells that are irrecoverably lost may lead you through a life full of tragedy. We are responsible for what we are. With our changed life style, unhealthy food habits and lack of physical activities, we invite and nurture all sorts of risk factors, which accelerate the dangerous attack of stroke. Stroke and heart attack are closely related and hence any risk factors that lead to stroke will also increase the possibilities of heart attack. We should be conscious to identify these risk factors and eliminate them from our life by adopting a healthy life style. This is the only method we can adopt to wipe away this dangerous disease from our life.

Risk Factors

The risk factors are of two types. The first one is the controllable risk factors that can be changed or controlled by our conscious efforts. The other one is the uncontrollable risk factors that are beyond our control.

Controllable Risk Factors

  • High blood pressure: It is the most important risk factor that leads to brain attack. High blood pressure of 140/90 or above can damage the blood vessels of the brain causing bleeding and clotting. By reducing salt content in food, regular physical exercise, maintaining healthy body weight, reducing stress, and avoiding smoking and alcohol consumption will help to keep normal blood pressure even without any medication.
  • Heart Diseases:  Heard disease is another major risk factor for stroke and it is found to be the major cause of death of the people who have already survived a brain attack. The risk factors are common for stroke and heart disease.
  • High blood cholesterol: Due to high cholesterol levels, thickening of the arteries or atherosclerosis will happen by the deposits of cholesterol and fatty substances, thus reducing blood flow to the brain and causing stroke. Cholesterol should be controlled to a safer level by avoiding fatty foods and by doing physical exercises.
  • Diabetes: The risk of stroke is more on people having diabetes. Diabetes increases the chance of fatty build-up in blood vessels and also disruption of blood flow in the small blood vessels in the brain. Prevent diabetes or control it strictly to safeguard from stroke.
  • Obesity: Excess body weight is responsible for causing high blood pressure, heart diseases, and diabetes that are the risk factors for stroke. By good eating habit and regular physical exercises can reduce body weight and hence the possibility of stroke.
  • Cigarette smoking: The risk of disruption of blood flow to the brain is more in smokers than in non-smokers. It is better to quit smoking completely to save from ischemic stroke.
  • Alcohol: Excessive use of alcohol increases blood pressure and causes diabetes. Alcohol increases the homocysteine level in the blood that increases the possibility of blood clotting, thus leading to stroke.
  • Irregular heart beat: Abnormal rhythm in heart beat is a major risk factor, but can be treated and made under control, once identified in the earlier stage.

Uncontrollable Risk Factors

  • Age : Normally, people above 55 years are more susceptible for stroke. But, nowadays, due to the change in life style, the stroke does not look the age of the person before attacking.
  • Gender: Men have more risk for affecting  stroke than women.
  • Heredity: Risk of stroke is more for those people whose parents or relatives were the victims of stroke, mini stroke or heart attack.

Treatment

On identifying the stroke symptoms, the patient should be taken to the hospital immediately and ensure proper medications that may help him from occurring its serious consequences. No first aid is necessary or effective, so any effort to do first aid should be avoided and save time. For a stroke patient, time is the most critical factor. The first four hours, just after affecting the stroke, is known as ‘window period’. If treatment is available within these ‘golden hours’ the patient can be recovered. Emergency treatment should be made available to dissolve the clots, restore the blood circulation to the brain and reduce the magnitude of the damaged brain cells. Emergency treatment will help the patient to reduce the possibility of a next attack and bring him back to the normal life by handling the medical complications that would happen due to stroke. When medications are not sufficient several types of surgery may be performed depending upon the nature of the stroke. Treatments and surgery are the subjects of the specialized doctors and not discussed here in detail.

Life after Stroke

Most of the people can come back to normal life gradually, after stroke treatment. Physiotherapy helps the patient to relieve from his complex situations by careful assessment and diagnosis, health care, treatment and rehabilitation. The purposes of physiotherapy include the improvement joint movement and muscle strength, voluntary movement of muscles, attaining and maintaining the balance of the body and strengthen the body, hands and legs to perform daily routines independently. The first three months of physiotherapy is ‘golden period’, during which the patient gets maximum relief. By following the instructions of the physiotherapists strictly, the patient can come back to normal life gradually, depending on the intensity of the attack.

Conclusion

We, with our changed life style, unhealthy food habit and restless life invite a lot of unwanted guests, the messengers of death, to settle in our body. High blood pressure, diabetes and cholesterol have migrated into our body and continue to control us, questioning our freedom. Stroke attacks our brain and attacks our life and the whole life is shattered in an unexpected moment. But we can close that iron shutter of premature death and trauma. Thanks to medical science; it has already identified the major risk factors that lead to the brain attack. Just make an assessment right now to verify any of them are present in your life. If so capture them from the root, control them, change your life style and live a tension-free life.

If we are vigilant a little bit, then death cannot approach us opening the back door. And, even if it knocks on the front door, we get the signal. We know the importance of time than anything else. Time is the determinant. So, be aware; protect your brain, it is precious; and you are not too late!


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