Cerebral Vascular Accident/Stroke

  • A Stroke can be defined as any interruption of blood supply to the brain, usually caused by a blood vessel in the brain that is either blocked or ruptured.
  • When the blood supply to the brain is compromised, the brain is deprived of oxygen.
  • In a matter of moments, oxygen-starved brain cells die.
  • Stroke can cause permanent brain damage and even death.

Causes

  • Atherosclerosis or clogged arteries can occur in the brain or blood vessels in the neck area that feed the brain.
  • These blocked vessels can lead to an Ischemic stroke.
  • Individuals with weakened blood vessels or aneurysms (bulges or weak spots in the vessel walls) may experience hemorrhagic stroke.
  • Strokes without obvious causes are called cryptogenic strokes.

Terminology

  • The medical term for a Stroke is known as a  Cerebrovascular Accidents(CVA)
  • When the blood supply is blocked, starving brain cells of oxygen, the stroke isischemic.
  • When a stroke is caused by bleeding into the brain, it is haemorrhagic.
  • Small, sometimes unnoticed strokes are called transient ischaemic attacks(TIAs).
  • Many people experience TIAs and do not notice them or notice something unusual but fail to seek medical care.
  • Strokes without symptoms are called silent strokesand may be major or minor.
  • Ischaemic strokes are often treated with clot-dissolving drugs known as a process calledthrombolysis.

Symptoms

  • The onset of a stroke is usually of an abrupt nature depending on which are of the brain is affected.
  • The larger the area affected, the bigger the stroke and the more severe the symptoms are likely to be.
  • Some patients experience symptoms for a day or more before seeking medical intervention, in particular, when they attribute their symptoms to other causes.

Typical signs and symptoms of a stroke are:

  • Sudden, severe headache that gets worse with changes in posture
  • Sleepiness, lethargy
  • Loss of consciousness, coma
  • Changes in hearing, vision, taste
  • Clumsiness
  • Loss of memory, confusion
  • Loss of balance, coordination, difficulty walking
  • Dizziness and abnormal sense of motion
  • Difficulty swallowing
  • Difficulty reading, writing
  • Loss of bladder or bowel control
  • Muscle weakness in face, arms, or legs (often just on one side)
  • Numbness or tingling on one side of the body
  • Changes in mood, emotion, personality
  • Impaired sense of temperature, touch, pain
  • Impaired speech

Treatment

A stroke must always be considered a medical emergency.

  • Prompt treatment by experts from the Stroke Centre at the Neuro Spinal Hospital, offers stroke patients the best possible outcomes.
  • Treatment for stroke requires a proper diagnosis. This can only be confirmed by medical expertise and diagnostic equipment including computed tomography (CT) scans and magnetic resonance imaging (MRI).
  • If the stroke is ischaemic and is associated with a clot, thrombolytic therapy is commenced with clot-dissolving drugs.
  • Patients are monitored closely during the treatment and radiology scans are ordered during therapy.
  • Thrombolysis is most effective if it is started as early as possible after onset of symptoms.
  • A highly skilled stroke team is essential to monitor the progress of thrombolysis.
  • If the patient investigations have been delayed and the blood vessels are blocked further investigations to detect narrowed arteries in the neck or in the head will be commenced and a further procedure is done to open the blockage.
  • In the case of a Hemorrhagic an emergency neurosurgical procedure is / maybe required to remove the blood that has built up around the brain and repair damage to the blood vessels.
  • The Neuro Spinal Hospital in Dubai offers the only Stroke Centre in the region and its specialists are trained in the latest techniques to offer the best treatment to these patients.

Prognosis

  • The Neuro Spinal Hospital’s Stroke Centre offers the best up to date Centre to treat all patients suffering from Strokes which are serious and potentially life-threatening conditions that require immediate and highly expert care.
  • The outcome depends on the extent of the stroke, the area where the stroke occurred, and how rapidly the patient received medical intervention.
  • Some stroke patients will make a complete recovery and about half of all stroke patients are able to leave hospital to live independently at home.
  • However, stroke can cause permanent brain damage, disability, and even death.

Risk Factors

  • The greatest cause of  Stroke is high blood pressure, but other conditions also increase the risk of stroke, including:
    • Atrial fibrillation
    • Diabetes
    • Heart disease
    • High cholesterol
    • Clogged/ blocked arteries
    • Advanced age
    • Smoking
    • Head injury
    • Cocaine use
    • Alcohol use
    • Certain types of bleeding disorders
  • A family history of stroke is also a risk factor, as is having a prior stroke or a TIA.
  • When a person has a stroke, he or she is at high risk for another stroke in the first few months after the initial stroke.
  • Over time, that elevated risk lessens.

Conclusion

  • Strokes are serious medical emergencies that can be treated by prompt state-of-the-art interventions.
  • Stroke are either ischaemic (caused by a blocked artery in the brain) or haemorrhagic (caused by a broken blood vessel bleeding into the brain).
  • Ischaemic strokes are treated by thrombolysis, while haemorrhagic strokes often require emergency neurosurgery to repair the broken vessel and drain off blood.
  • The Neuro Spinal Hospital offers the only Stroke Centre in Dubai and the Gulf region.