Health In one stroke

Stroke occurs when blood flows to part of the brain which is impaired. This causes brain cells in that part of the brain to die. As a result, oxygen and glucose cannot be delivered to the brain which ceases to function properly.

What causes a stroke? Thrombosis or blockage of an artery is the most common cause of a stroke. Brain cells which were being supplied with oxygen by the clogged artery die because of oxygen shortage. People with high blood pressure, high cholestrol, diabetes and smoking run a high risk of developing a narrowed artery. A cerebral hemorrhage can bring about a stroke by cutting off blood and oxygen supply to parts of the brain. A cerebral hemorrhage takes place when a blood vessel in the brain fissures and the blood seeps out into the surrounding brain tissue.

When blood comes out of the vessels; it exerts a pressure on the brain and damages it further as the brain presses against the skull bone. Embolic stroke is another example. It happens when a blood clot or an atherosclerotic plaque (cholesterol and calcium deposits on the wall of the inside of the heart or artery), ruptures out through the artery wall, passes all the way through arteries to the brain and embeds in an artery of the brain. This again disrupts the flow of oxygenated blood to the brain. At times, migraine headaches can also end in a stroke.

What are the signs and symptoms? By and large, the signs are unilateral, that is, it affects only one side of the body (unilateral). The defect in the brain is mostly on the opposite side of the body (depending on which part of the brain is affected). Loss of consciousness, headache and vomiting usually occur because of the increased intracranial pressure from the leaking blood compressing on the brain.

 The Face Arm Speech Test (FAST) can help to diagnose a stroke before the patient is actually taken to the hospital.

1. Face - look to see if there is any drooping or loss of muscle tone on the face

2. Arm - ask the patient to close their eyes and hold both arms out straight for 30 seconds - in a patient with a stroke, you might see one arm tends to slowly move down

3. Speech - listen to see if you can hear any slurring of the speech not otherwise explained (e.g. alcohol) and see if they can answer simple questions (for example, Where are you? What's your name? What day of the week is it?
Hypertension accounts for 35 to 50 per cent of stroke risk. Studies propose that even a small blood pressure reduction (five to six mmHg systolic, two to three mmHg diastolic) would result in 40 per cent fewer strokes. nticoagulating drugs also prevent a stroke from occuring. Aspirin or other antiplatelet drugs are highly effective in secondary prevention after a stroke.

Low doses of aspirin (for example 75 to150 mg) are as effective as high doses but have fewer side-effects. Surgical procedures such as carotid endarterectomy or carotid angioplasty can be used to remove significant atherosclerotic narrowing of the carotid artery, which supplies blood to the brain.