Stroke

Stroke refers to any interruption in blood supply to the brain, usually because a blood vessel in the brain is blocked or bursts open. 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

Atheroslerosis or clogged arteries can occur in the brain or in the blood vessels in the neck area that feed the brain. Such 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

Physicians sometimes call strokes cerebrovascular accidents (CVAs). When blood supply is blocked, starving brain cells of oxygen, the stroke is ischaemic. 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 strokes and may be major or minor. Ischaemic strokes are often treated with clot-busting drugs known in a process called thrombolysis.

Symptoms

Symptoms of a stroke depend on where and how much of an area of the brain is affected. The larger the area affected, the more massive the stroke and the more severe the symptoms are likely to be. Typical of nearly all stroke symptoms is an abrupt onset. Some patients experience symptoms for a day or more before seeking medical intervention, in particular, when they attribute their symptoms to other causes. Typical stroke symptoms may include:

  • 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 be considered a medical emergency. Prompt treatment by experts, such as from the Stroke Centre at the Neuro Spinal Hospital, offers stroke patients the best possible outcomes. Treatment for stroke requires a proper diagnosis, and this requires medical expertise and the latest 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 begins with clot-busting drugs. Patients are monitored and imaged during therapy. Thrombolysis is most effective if it is started as early as possible after onset of symptoms. Other drugs may be required. A highly skilled stroke team is essential to monitor the progress of thrombolysis. If the patient come later investigations to detect narrowed arteries in the neck or in the head which can be treated catherization to open the narrowing and to put  a stent or to use various anti-platelets or anti-coagulant.

If the stroke is haemorrhagic, emergency neurosurgery may be 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 treat stroke.

Prognosis

Strokes are serious and potentially life-threatening conditions that require immediate and highly expert care, such as that available at the Neuro Spinal Hospital’s stroke centre. 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

By far the greatest risk factor for stroke is high blood pressure, but other conditions also increase the risk of stroke, including:

  • Atrial fibrillation
  • Diabetes
  • Heart disease
  • High cholesterol
  • Clogged 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 entire Gulf region.