STROKE

What is stroke?

A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes.

A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications.

 

Most strokes are caused by an abrupt blockage of arteries leading to the brain (ischemic stroke).  Other strokes are caused by bleeding into brain tissue when a blood vessel bursts (hemorrhagic stroke).

 

Because stroke occurs rapidly and requires immediate treatment, stroke is also called a brain attack. When the symptoms of a stroke last only a short time (less than an hour), this is called a transient ischemic attack (TIA) or mini-stroke.

What are the symptoms of stroke?

The effects of a stroke depend on which part of the brain is injured, and how severely it is injured. Since different parts of the brain control different areas and functions, it is usually the area immediately surrounding the stroke that is affected.

Strokes may cause

  • Sudden weakness in limbs,

  • Loss of sensation,

  • Difficulty with speaking, seeing, or walking.

 

Sometimes people with stroke have a headache, but stroke can also be completely painless. It is very important to recognize the warning signs of stroke and to get immediate medical attention if they occur.

How to recognise stroke?
BE FAST

Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to come and go or they disappear completely.

 

Think "FAST" and do the following:

Face. Ask the person to smile. Does one side of the face droop?
Arms. Ask the person to raise both arms. Does one arm drift downward? Or is one arm unable to rise?
Speech. Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?
Time. If you observe any of these signs, call for emergency medical help immediately.
Call your local emergency number right away. Don't wait to see if symptoms stop. Every minute counts. The longer a stroke goes untreated, the greater the potential for brain damage and disability.

If you're with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance.

What are risk factors for Stroke?

 

Lifestyle risk factors

  • Being overweight or obese

  • Physical inactivity

  • Heavy or binge drinking

  • Use of illegal drugs such as cocaine and methamphetamine

 

Medical risk factors

  • High blood pressure

  • Cigarette smoking or secondhand smoke exposure

  • High cholesterol

  • Diabetes

  • Obstructive sleep apnea

  • Cardiovascular disease, including heart failure, heart defects, heart infection or abnormal heart rhythm, such as atrial fibrillation

  • Personal or family history of stroke, heart attack or transient ischemic attack

What are treatment options?

  • Lifestyle modifications- Diet and exercises

  • Medical management- Blood thinners(Antiplatetlets Drugs),Drugs to control BP,  blood sugar and lipids .

  • Intravenous thrombolysis- In case of Large veesel occlusion upto 4.5hours

  • Endovascular treatment of stroke- In case of Large vessel occlusion upto 6 hours and in some cases can be treated upto 24 hours.

 

What is an endovascular treatment of stroke?

 

Endovascular treatment of stroke is the non-surgical treatment for the sudden loss of brain function due to blood clots. The treatment uses microcatheters (thin tubes visible under X-rays) which are inserted into the blood clot from the groin or the arm. The blood clot is removed from the blood vessel – this procedure is called a thrombectomy. If the blood clot cannot be removed, it is liquefied using drugs delivered through the catheter, in a procedure known as thrombolysis.


How does the procedure work?


The interventional radiologist will insert a catheter into an artery in your arm or groin and move it towards the blood clot under X-ray guidance. The blood clot is removed in a procedure called a thrombectomy. The blood clot may be removed by trapping it in a stent which is then pulled out with the clot, or the interventional radiologist may suck the clot out through the catheter.

If the clot cannot be removed, a medication may be applied through the catheter to liquefy it. If the blood vessel is too narrow, a balloon catheter can be used to restore its original size, in a procedure called an angioplasty. Afterwards, a stent is inserted to hold the blood vessel open.

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