BRIAN STROKE

What is stroke?

A stroke is a "brain attack". It can happen to anyone at any time. It occurs when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells die during a stroke, abilities controlled by that area of the brain such as memory and muscle control are lost.

How a person is affected by their stroke depends on where the stroke occurs in the brain and how much the brain is damaged. For example, someone who had a small stroke may only have minor problems such as temporary weakness of an arm or leg. People who have larger strokes may be permanently paralyzed on one side of their body or lose their ability to speak. Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability.

Stroke by The Numbers

Each year nearly 800,000 people experience a new or recurrent stroke. A stroke happens every 40 seconds. Stroke is the fifth leading cause of death in the U.S. Every 4 minutes someone dies from stroke. Up to 80 percent of strokes can be prevented. Stroke is the leading cause of adult disability in the U.S

TYPES OF STROKE:

Hemorrhagic stroke

There are two types of stroke, hemorrhagic and ischemic. Hemorrhagic strokes are less common, in fact only 15 percent of all strokes are hemorrhagic, but they are responsible for about 40 percent of all stroke deaths.

A hemorrhagic stroke is either a brain aneurism burst or a weakened blood vessel leak. Blood spills into or around the brain and creates swelling and pressure, damaging cells and tissue in the brain. There are two types of hemorrhagic stroke called intracerebral and subarachnoid.

INTRACEREBRAL HEMORRHAGE

The most common hemorrhagic stroke happens when a blood vessel inside the brain bursts and leaks blood into surrounding brain tissue (intracerebral hemorrhage). The bleeding causes brain cells to die and the affected part of the brain stops working correctly. High blood pressure and aging blood vessels are the most common causes of this type of stroke.

Sometimes intracerebral hemorrhagic stroke can be caused by an arteriovenous malformation (AVM). AVM is a genetic condition of abnormal connection between arteries and veins and most often occurs in the brain or spine. If AVM occurs in the brain, vessels can break and bleed into the brain. The cause of AVM is unclear but once diagnosed it can be treated successfully.

SUBARACHNOID HEMORRHAGE:

This type of stroke involves bleeding in the area between the brain and the tissue covering the brain, known as the subarachnoid space. This type of stroke is most often caused by a burst aneurism. Other causes include:

AVMBleeding disordersHead injuryBlood thinner

Three Major Players1. ischemic stroke (caused by blood clots)2. hemorrhagic stroke (caused by ruptured blood vessels that

cause brain bleeding)3. transient ischemic attack (TIA) (a “mini-stroke,” caused by a

temporary blood clot)Stroke Symptoms

No matter which type of stroke you have, many of the symptoms are the same. If you notice someone experiencing any of these symptoms,

1. numbness or weakness that starts suddenly, most commonly on either the left or right side of the body (face, arms, or legs are often affected)

2. confusion, difficulty comprehending language, or trouble talking that begins without warning

3. sudden vision problems (in one eye or both)4. severe, piercing headache, with no clear cause, that starts

suddenly5. difficulty walking because of sudden loss of balance or

dizziness6. Trouble with speaking and understanding7. Paralysis or numbness of the face, arm or leg.8.

Warning Stroke

While the three main types of stroke share the same symptoms, they differ in the duration of time the symptoms occur.

In a TIA, symptoms generally last only about one minute, according to the American Stroke Association (ASA). Some can last up to five minutes.

The difference between the other types of strokes and a TIA is the temporary nature of the blood clot that caused it. While ischemic and hemorrhagic strokes can cause permanent brain damage, TIAs usually don’t.

Risk factors

Many factors can increase your risk of a stroke. Some factors can also increase your chances of having a heart attack. Potentially treatable stroke risk factors include:

Lifestyle risk factors

1. Being overweight or obese2. Physical inactivity3. Heavy or binge drinking4. Use of illicit drugs such as cocaine and methamphetamines\

Medical risk factors

1. High blood pressure — the risk of stroke begins to increase at blood pressure readings higher than 120/80 millimeters of mercury (mm Hg). Your doctor will help you decide on a target blood pressure based on your age, whether you have diabetes and other factors.

2. Cigarette smoking or exposure to secondhand smoke.3. High cholesterol.4. Diabetes.5. Obstructive sleep apnea — a sleep disorder in which the

oxygen level intermittently drops during the night.6. Cardiovascular disease, including heart failure, heart defects,

heart infection or abnormal heart rhythm.7. Other factors associated with a higher risk of stroke include:

8. Personal or family history of stroke, heart attack or transient ischemic attack.

9. Being age 55 or older.10. Race — African-Americans have a higher risk of stroke

than do people of other races.11-Gender — Men have a higher risk of stroke than women. Women are usually older when they have strokes, and they're more likely to die of strokes than are men. Also, they may have some risk from some birth control pills or hormone therapies that include estrogen, as well as from pregnancy and childbirth.

Complications

11. A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part was affected. Complications may include:

12. Paralysis or loss of muscle movement. You may become paralyzed on one side of your body, or lose control of certain muscles, such as those on one side of your face or one arm. Physical therapy may help you return to activities hampered by paralysis, such as walking, eating and dressing.

13. Difficulty talking or swallowing. A stroke may cause you to have less control over the way the muscles in your mouth

and throat move, making it difficult for you to talk clearly (dysarthria), swallow or eat (dysphagia). You also may have difficulty with language (aphasia), including speaking or understanding speech, reading or writing. Therapy with a speech and language pathologist may help.

14. Memory loss or thinking difficulties. Many people who have had strokes experience some memory loss. Others may have difficulty thinking, making judgments, reasoning and understanding concepts.

15. Emotional problems. People who have had strokes may have more difficulty controlling their emotions, or they may develop depression.

16. Pain. People who have had strokes may have pain, numbness or other strange sensations in parts of their bodies affected by stroke. For example, if a stroke causes you to lose feeling in your left arm, you may develop an uncomfortable tingling sensation in that arm.

17. People also may be sensitive to temperature changes, especially extreme cold after a stroke. This complication is known as central stroke pain or central pain syndrome. This condition generally develops several weeks after a stroke, and it may improve over time. But because the pain is caused by a problem in your brain, rather than a physical injury, there are few treatments.

18. Changes in behavior and self-care ability. People who have had strokes may become more withdrawn and less social or more impulsive. They may need help with grooming and daily chores.

Practice Prevention

1. Strokes are often deadly—but they can be prevented. The NSA states that around 80 percent of all strokes can be avoided by taking some steps:

2. check your blood pressure and cholesterol levels regularly3. don’t smoke, and drink alcohol only in moderation4. exercise regularly5. eat a low-fat, low-salt diet6. Managing your risk for stroke with simple but important

lifestyle changes can go a long way towards prevention.

MedicationsYour doctor will probably prescribe several medicines after you have had a stroke. Medicines to prevent blood clots are typically used, because blood clots can cause TIAs and strokes.

The types of medicines that prevent clotting are:

Anticoagulant medicines.Antiplatelet medicines.Cholesterol-lowering and blood-pressure–lowering medicines are also used to prevent TIAs and strokes.

Anticoagulant medicinesAnticoagulants such as warfarin (for example, Coumadin) prevent blood clots from forming and keep existing blood clots from getting bigger.You may need to take this type of medicine after a stroke if you have atrial fibrillation or another condition that makes you more likely to have another stroke. For more information, see the topic Atrial Fibrillation.

Antiplatelet medicines

Antiplatelet medicines keep platelets in the blood from sticking together.Aspirin (for example, Bayer) is most often used to prevent TIAs and strokes.Aspirin combined with dipyridamole (Aggrenox) is a safe and effective alternative to aspirin.Clopidogrel (Plavix) may be used for people who cannot take aspirin.StatinsStatins lower cholesterol and your risk for another stroke.

Blood pressure medicinesIf you have high blood pressure, your doctor may want you to take medicines to lower it. Blood pressure medicines include:

Angiotensin II receptor blockers (ARBs).Angiotensin-converting enzyme (ACE) inhibitors.Beta-blockers.Calcium channel blockers.Diuretics.