An Overview Of Stroke And What Causes It

Medically reviewed by Ajidahun Olusina, MD
September 7, 2021

An Overview Of Stroke And What Causes It

Stroke is said to occur when there is an interruption or reduction in blood supply to some parts of the brain, (the eye or spinal cord) – thus, preventing brain tissues from getting oxygen and nutrients.

This can cause the brain cells to die in minutes leading to serious symptoms, lasting disability of the affected organ, or even death.

During a stroke, both rupturing and bleeding of a blood vessel in the brain or a blockage in the blood supply to the brain occurs.

This rupture or blockage prevents oxygenated blood from reaching the brain’s tissues. Without oxygen, brain cells and tissue become damaged and begin to die within minutes.

 

Types of Strokes

  • Haemorrhagic stroke
  • Ischemic stroke
  • Transient ischemic attack (TIA)

 

Signs and Symptoms of Strokes 

  • Difficulty in speaking and understanding what is spoken, also known as aphasia[1].
  • Paralysis or numbness of the face, arm, or leg.
  • Difficulty seeing in one or both eyes
  • Headache

It is important to note that signs or symptoms of a stroke may seem to come and go or disappear completely over time.

However, helping the patient go through these activities as quickly as possible can be an effective first aid measure for a patient going through a stroke. It is recommended by healthcare professionals to think fast and:

  • Ask the person to smile to see if one side of the face droops
  • Ask the person to raise both arms. It should be observed if one arm drifts downwards or if one arm unable to rise
  • Ask the person to repeat a simple phrase. It should be observed if the patient’s speech is slurred or strange

If any of the above signs is observed, emergency medical help should be sought immediately.

 

Causes and Detection of Stroke

There are two main causes of stroke: a blocked artery (ischemic stroke) or leaking or bursting of a blood vessel (haemorrhagic stroke).

The first step in the diagnosis of stroke is the determination of the type of stroke. Doctors will need to rule out other possible causes of the symptoms, such as a brain tumour or a drug reaction by carrying out processes such as history taking and physical examination.[2]

  • A physical exam. Involves listening to the heartbeat and checking the blood pressure. Neurological examination may be taken to ascertain how a potential stroke affects the nervous system.
  • Blood tests. 
  •  Computerized tomography (CT) scan. 
  •  Magnetic resonance imaging (MRI). 
  •  Carotid ultrasound. 
  •  Cerebral angiogram

 

Risk Factors of Stroke

  • Lifestyle risk factors such as: being overweight or obese, drugs and alcohol abuse - including the use of illegal drugs such as cocaine and methamphetamine
  • Medical risk factors such as: high blood pressure, diabetes, obstructive sleep apnea, cardiovascular diseases etc. and use of birth control pills or hormone therapies that include estrogen
  • Genetics factors (hereditary conditions)
  • Age, race, and sex.

                               

Temporary or permanent disabilities can occur as a result of stroke depending on how long the brain lacks blood flow and which part gets affected.  Some of these complications may include:

  • Paralysis
  • Speech or swallowing difficulty. 
  •  Memory loss or thinking difficulties. 
  •  Emotional challenges. 
  •  Pain
  • Changes in behaviour and self-care ability. 

 

Prevention of Stroke

Many stroke prevention strategies are the same as strategies to prevent heart disease. Activities involving the effective prevention of stroke includes:

  • Determining the patient’s stroke risk factors
  • Following the doctor's recommendations
  • Adopting a healthy lifestyle.
  • Treating obstructive sleep apnea

These measures might help to prevent another stroke if an individual already had a stroke or a transient ischemic attack (TIA). A follow-up care from a hospital should help too.

 

Treatment of Strokes

Treatment for stroke depends on whether an individual has an ischemic stroke or a haemorrhagic stroke

Ischemic stroke

To treat an ischemic stroke, doctors must quickly restore blood flow to the brain. This may be done with:

  • Emergency IV medication.
  • Emergency endovascular procedures.
  • Carotid endarterectomy.
  • Angioplasty and stents.

Haemorrhagic stroke    

Treatment of haemorrhagic stroke focuses on controlling the bleeding and reducing pressure in the brain caused by the excess fluid. Treatment options are:

  • Surgery. 
  •  Surgical clipping. 
  •  Coiling (endovascular embolization). 
  •  Surgical arteriovenous malformation (AVM) removal. 
  •  Stereotactic radiosurgery. 

 

Management of Stroke

  • After emergency treatment, the patient will be closely monitored. Followed by activities that will aid their recovery and a return to independent living commences.
  • The impact of a stroke depends on the area of the brain involved and the amount of tissue damage experienced.
  • Most stroke survivors will have to go through a rehabilitation program in which doctor will take into consideration the lifestyle, interests, priorities of the patient and the availability of family members or other caregivers.
  • Stroke recovery differs for various individuals. Depending on the patient’s condition, the treatment and rehabilitation team may include:
  • A neurologist
  • Rehabilitation doctor
  • Rehabilitation nurse
  • Dietician
  • Physical therapist
  • Occupational therapist
  • Recreational therapist
  • Speech pathologist
  • Psychologist or psychiatrist

 

 

References

https://my.clevelandclinic.org/aphasia[1]

 https://www.mayoclinic.org/stroke/symptoms-causes/[2]

 https://www.cdc.gov/stroke/prevention

https://www.stroke.org/about-stroke

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