Things You Need To Know About Before, During And After Stroke

December 23, 2019

What is a stroke?
When there is a shortage of blood supply to the brain, it can lead to a stroke. Stroke symptoms (for example, loss of arm or leg function or slurred speech) can mean a medical emergency, because if left untreated, the ischemic brain cells can quickly become damaged or die, leading to brain damage, severe disability or death. If you see someone experiencing stroke symptoms, call 9-1-1.

Stroke symptoms
The first signs of a stroke can happen suddenly to a person. Learn about these signs of a stroke.

Difficulty speaking.
Difficulty understanding or confusion, especially with simple tasks.
Difficulty with muscle strength, especially on one side of the body
Numbness difficulties, especially on one side of the body.
Severe headaches
Vision changes (monocular or binocular)
difficulty swallowing
One side of the face sags.

Signs of a stroke
The F.A.S.T. test was designed in 1998 to help paramedics in the UK assess strokes quickly. It takes into account the most common stroke symptoms and is designed to help assess strokes quickly, with little training required.

The F.A.S.T. test
F refers to the face – if one side of the face droops, it’s a possible sign of a stroke
A is for arms – if a person can’t extend their arms, this is another possible sign of a stroke
S for Speech – Slurred speech and understanding simple sentences is another possible stroke sign.
T for time – If there are any signs of FAS, you should call 9-1-1 immediately.

Stroke and the brain
Remember the FAST test for stroke.The “T” in FAST also means that the longer the blood supply to the brain is blocked (usually by a blood clot), the greater the potential for brain damage.

For many patients, the time frame for diagnosing and treating this blood clot is usually within 3 hours (some clinicians recommend longer). In some eligible patients, clot-busting drugs may be used to dissolve the clot and restore blood flow. Not all patients are eligible for this treatment. There are also some risks associated with this treatment, such as bleeding, which can cause problems.

Stroke is a major cause of long-term disability in people.

Types of Stroke Diagnosis
There are two main types of strokes (ischemic and hemorrhagic) and they are treated differently. Urgent diagnosis is usually made with a CT scan (or MRI scan) of the head.

ischemic stroke
This slide shows a CT scan of an ischemic stroke, which accounts for about 80 to 90 percent of all strokes. Ischemic strokes are caused by a blood clot, which reduces or stops flowing to the brain. The clot may develop elsewhere in the body and circulate into blood vessels that stay in the brain, or the clot may originate in the brain.

Ischemic strokes are usually divided into two main subtypes: thrombotic and embolic.

Thrombotic strokes
Nearly half of all strokes are thrombotic strokes. Thrombotic strokes are caused by blood clots forming in the brain due to diseased or damaged arteries in the brain.

Thrombotic strokes
Blood clots can also lead to embolic strokes. However, in the case of embolic strokes, the clots form in arteries outside the brain. Typically, these clots start in the heart and continue until they become lodged in the arteries of the brain. The damage to the body and nervous system from an embolic stroke is almost immediate.

hemorrhagic stroke
This illustration shows a hemorrhagic stroke using MRI images. The circle illustration outlines the makeup of a hemorrhagic stroke. A blood vessel in the brain ruptures and blood escapes under pressure into the brain, compressing other blood vessels and brain cells causing damage and death. This bleeding into the brain is difficult to stop and is more likely to lead to death. There are two types of hemorrhagic strokes: intracerebral strokes and subarachnoid strokes.

Intracerebral strokes
“Intracerebral” means “inside the brain” and it refers to strokes caused by bursting of diseased blood vessels in the brain. Intracerebral strokes are usually caused by high blood pressure.

Subarachnoid strokes
Subarachnoid hemorrhage refers to bleeding immediately around the brain, in an area of the head called the subarachnoid space. The main symptom of a subarachnoid stroke is a sudden, severe headache that may be felt as a bouncing or popping sensation. A number of factors can cause a subarachnoid stroke, including head injury, blood thinners, bleeding disorders, and tangled bleeding from blood vessels known as arteriovenous malformations.

Mini Stroker (TIA)
“Small strokes” (also known as transient ischemic attacks or TIAs) are temporary blockages of blood vessels in the brain.TIAs can produce mild stroke symptoms that can be relieved.TIAs usually occur before a stroke occurs, so they are a warning sign that a patient may need stroke prevention treatment.

Symptoms of a mini-stroke
weak point
sagging of the face
vision loss

Mini Stroke Treatment
Treatment for mini-strokes may include medication, lifestyle changes, and possibly surgery to reduce the chance of another stroke.

What are the causes of strokes?
A common cause of stroke comes from the blood vessels inside and outside the brain. Atherosclerosis (hardening of the arteries) occurs when plaque (deposits of cholesterol, calcium, fat, and other substances) builds up and narrows the blood vessels, making them susceptible to forming blood clots and further blocking them. These blood clots can only break free and occlude the small blood vessels inside the brain. The blood vessels inside the brain themselves can also accumulate this plaque. Occasionally, the weakened blood vessels can burst and bleed into the brain.

Changes in lifestyles
People can also reduce their risk of stroke by changing certain aspects of their lifestyle. For example, people who stop smoking, start sticking to an exercise program, and limit their alcohol intake (two drinks a day for men and one drink a day for women) can reduce their risk.

Stroke Prevention. Diet
One of the best ways to reduce your risk of stroke is to eat a diet low in fat and cholesterol to reduce the chance of plaque forming in your blood vessels. Foods that are high in salt may increase blood pressure. Cutting calories helps reduce obesity. Eating more vegetables, fruits, and whole grains, more fish, and less meat (especially red meat) is recommended to reduce the risk of stroke.

Uncontrollable Stroke Risk Factors
Unfortunately, there are risk factors that people cannot control, such as family history of stroke, gender (men are more likely to have a stroke), and race (African-Americans, Native Americans, and Alaska Natives all have an increased risk of stroke). In addition, women who have a stroke are more likely to die from stroke than men.

Emergency treatment for strokes
Emergency treatment for a stroke depends on the type of stroke and the underlying health of the patient. Ischemic strokes are treated by removing (dissolving) or bypassing blood clots in the brain, while hemorrhagic strokes are treated by trying to stop the bleeding in the brain, control high blood pressure, and reduce brain swelling. Hemorrhagic strokes are more difficult to treat.

Aspirin is part of a group of drugs called antiplatelet agents. Antiplatelet agents like aspirin help prevent fragments of blood cells from sticking together and forming clots, thus helping to prevent some forms of stroke. The American Heart Association recommends taking aspirin within two days of an ischemic stroke to reduce the severity of the stroke. For those who have already had a minor stroke, doctors may recommend daily aspirin therapy.

TPA is used to treat ischemic strokes. It is given as an intravenous injection through the arm to help dissolve blood clots and improve blood flow to the area of the brain that is blocked by the clot. TPA may be helpful if it is used within three hours of a stroke.

Stroke rehabilitation
Strokes that cause long-term damage are usually severe and/or go untreated or untreated after extensive brain damage or death. The type of damage depends on the area of the brain where the stroke occurred (for example, the motor cortex where motor problems occur or the area of the brain that controls speech). While some problems will be permanent, many people who do rehabilitation therapy can regain some or many of the abilities lost in a stroke.

speech therapy
If a stroke has impaired a person’s ability to use speech, speak, or swallow, rehabilitation through a speech therapist can help a person regain some or most of the abilities that were initially lost due to the stroke. In cases of severe impairment, rehabilitation can provide methods and skills to help a person adapt and compensate for the severe impairment.

The goal of physical therapy is to improve a person’s strength, gross coordination, and balance. This rehabilitation helps people regain the ability to walk and do other things after a stroke, such as using stairs or getting out of a chair. Regaining fine motor skills, such as buttoning a shirt or using a knife and fork or writing a letter, are activities that occupational therapy aims to help with.

Stroke Recovery. Talk Therapy
Some people have difficulty coping with their new disability after a stroke. It is common to have an emotional reaction after a stroke. A psychologist or other mental health professional can help people adjust to new challenges and situations. These professionals use talk therapy and other methods to help people cope with reactions such as depression, fear, worry, sadness, and anger.

A good diet for stroke prevention includes vegetables, fish and whole grains.
Preventing Another Stroke. Lifestyle
The methods discussed earlier that can prevent or reduce a person’s risk of stroke are essentially the same for people who have already had a stroke (or TIA) and want to prevent or reduce the chances of having another stroke. In short, quit smoking, exercise, and if obese, lose weight. Limit your intake of alcohol, salt, and fat, get into the habit of eating more vegetables, fruits, and whole grains, and eat more fish and less meat.

Prescription drugs and side effects
Medications are often prescribed for people at high risk for stroke, and these are designed to reduce risk by inhibiting thrombosis (aspirin, warfarin, and/or other antiplatelet medications). These medications are designed to reduce risk by inhibiting thrombosis (aspirin, warfarin, and/or other antiplatelet medications). In addition, antihypertensive medications can also help by lowering high blood pressure. Medications have side effects, so it is important to discuss these with your doctor.

Preventing another stroke. Surgery
There are some surgical procedures to prevent strokes. Some patients have plaque stenosis in their carotid arteries. The plaque can be involved in the formation of blood clots in the artery and can even dislodge the clot to other parts of the cerebral blood vessels. Carotid endarterectomy is a surgical procedure in which the surgeon removes the plaque from the artery to reduce the chance of future strokes.

Preventing Another Stroke. Balloons and Stents
Some clinicians also use a balloon at the end of a stenotic catheter to treat a plaque that has narrowed the carotid artery (and occasionally other brain arteries). Inflating the balloon pushes the plaque aside, increasing the lumen of the vessel (opening the vessel). This opened artery is then reinforced (kept open) by an expandable stent that becomes rigid when dilated.

Life after a stroke
About two-thirds of stroke victims (over 700,000) survive each year and usually require some degree of rehabilitation. Some people may make a full recovery with clotting medication, others will not. Many people who are disabled after a stroke can work independently with treatment and rehabilitation methods. While the risk of a second stroke after a first stroke is higher, individuals can take the steps outlined in the previous slides to reduce this risk.