stroke
What is a stroke, or a brain infarction?
A stroke, or brain infarction, is a sudden disruption in the
blood supply to the brain, affecting one or more of the blood vessels that
nourish the brain. This disruption leads to an impairment or reduction in
the brain's oxygen supply, resulting in damage or impairment of brain cells.
The sooner the blood supply to the brain returns to its normal state after a
stroke, the greater the chances of recovery and positive outcomes.
When a stroke occurs, the blood supply is insufficient to provide an adequate amount of oxygen and glucose to the brain cells, leading to the death of some brain cells.
type of Strokes
Strokes are classified into three types, including:
Hemorrhagic Stroke: This occurs when an artery ruptures or blood leaks from the blood
vessels, leading to bleeding.
Ischemic Stroke: This occurs when arteries narrow or harden due to the deposition of
substances in the arteries, and the presence of clots that block blood
vessels, resulting in reduced blood supply.
Transient Ischemic Attack: This refers to a temporary disruption in blood supply.
Signs in the heart that warn of the risk of stroke
Atrial fibrillation is one of the most common heart rhythm disorders. During
an episode of atrial fibrillation, the regular contractions of the atria are
replaced by ineffective contractions that do not effectively move blood. As
a result, blood can stagnate and form clots, which can then travel to the
brain and cause ischemic strokes.
Atrial fibrillation-related strokes carry a higher risk of permanent
brain damage or death than other types of ischemic strokes.
Stroke Causes
The causes of stroke are diverse, and based on the cause, strokes are classified into different types. The most common causes of stroke may include blood clots, aneurysms in the brain, or bleeding in the blood vessels of the brain.
Ischemic Stroke Causes:
Ischemic strokes occur due to the blockage of one of the arteries leading to the brain, either by a blood clot or fatty deposits.
Transient Ischemic Attack Cause:
Transient Ischemic Attacks happen when blood temporarily does
not reach the brain.
Hemorrhagic Stroke Causes:
Hemorrhagic strokes occur when an artery in the brain ruptures or leaks blood, causing increased pressure within the skull and damage to brain cells and tissues.
Factors that Increase the Risk of Stroke Incidence or Exposure
Factors contributing to the risk of strokes include:
- High blood pressure.
- Heart and artery diseases, congenital heart muscle and valve problems.
- Irregular heartbeats.
- High blood lipid levels.
- Diabetes.
- Genetic predispositions and family medical history.
- Structural problems in brain blood vessels, such as aneurysms.
- Unhealthy dietary habits, like foods high in cholesterol, salts, and
saturated fats.
- Obesity.
- Lack of physical activity.
- Smoking.
- Alcohol consumption.
- Brain tumors and cancer in general.
- Use of certain medications that may increase blood clotting, such as
contraceptives.
Stroke Symptoms
Signs and symptoms of a stroke manifest as follows:
- Issues with concentration and speech, which the patient may not
notice.
- Weakness on one side of the body.
- Inability to speak.
- Sudden and severe headache, particularly intensified in
hemorrhagic strokes.
-
Sudden loss of vision or blurred vision.
- Dizziness and loss of consciousness.
- Confusion.
- Difficulty understanding others.
- Problems with balance and coordination.
- Difficulty swallowing.
How is a Stroke, or Cerebrovascular Accident, Diagnosed?
The diagnosis of a stroke relies on:
- Symptoms and signs.
- Clinical examination.
- Computed Tomography (CT) Scan.
- Magnetic Resonance Imaging (MRI).
- Coagulation studies.
- Electrocardiogram (ECG).
- Carotid Doppler ultrasound.
- Echocardiogram via chest examination.
stroke treatment:
Effective treatment of stroke can prevent long-term disability and save lives. Rapid medical assessment and immediate medical intervention can positively impact the recovery process; the faster the intervention, the quicker the patient's recovery with minimal impact on their health. It is crucial to contact emergency services as soon as the person realizes they may be experiencing a stroke, or if there is suspicion of a family member suffering from a stroke.
The approach to drug therapy depends on the type of stroke (hemorrhagic or ischemic), but in both cases, the treatment aims to restore blood flow balance and improve brain perfusion. The most important treatment methods include:
Treatment of ischemic stroke with reduced perfusion or transient ischemic attack can be achieved through the following methods:
Antiplatelet and anticoagulant drugs: Anticoagulant medications or
antiplatelet drugs should be taken within 24 to 48 hours after the onset of
stroke symptoms.
Thrombolytic drugs: Thrombolytic medications can help dissolve blood
clots in the brain arteries, thereby reducing damage to the brain.
Thrombus Removal via Catheterization: During catheterization, thrombi
are mechanically removed; the physician inserts a catheter tube into a large
blood vessel inside the patient's head, then uses a device to extract the
clot from the vessel. This procedure is most successful when performed 6 to
24 hours after the onset of a stroke.
Stents: Physicians may place stents to widen narrow arteries and
support weakened artery walls.
Surgery: Doctors may resort to surgery if other methods fail, especially if the clots are too large to be removed via catheterization.
Treatment Methods for Hemorrhagic Stroke
Hemorrhagic strokes can be treated through the following methods:
Medications: In the case of a hemorrhagic stroke, medications that help with blood clotting, or those that counteract the effects of blood thinners to stop bleeding, can be used. Medications to control blood pressure, reduce brain blood pressure, and protect the patient from seizures can also be employed.
Clipping and Coiling: Physicians use clipping or coiling as mechanical methods to stop bleeding in patients with hemorrhagic strokes.
Surgery: Surgeons may resort to surgery to stop bleeding if the
arteries are torn, and the patient may require a craniotomy to relieve
pressure inside the patient's brain.
Stroke Rehabilitation with Physical Therapy
A comprehensive medical program for physical therapy and
rehabilitation should be implemented, involving neurologists, physical
medicine and rehabilitation specialists, physical therapists, nurses, and
family members. This collaboration between the medical team and family
members is essential for the success of the rehabilitation process.
Physical therapy in this case should commence in the early days following the injury, as tolerated, and typically involves the following steps:
The physical therapist begins by mobilizing the patient's upper and
lower extremities in the absence of active movement, ensuring that the
motions encompass both small and large joints.
Once movement is initiated in the patient, the therapist works on increasing
and enhancing it through assistance and later resistance.
The patient should be encouraged to sit on the bed or a chair gradually,
aiming for up to two hours daily even if balance has not yet been
achieved.
Weight-bearing on the patient's legs is crucial to stimulate balance and the
sensation in the affected limb.
Turning the patient in bed from side to side is essential to reduce the risk
of pressure sores, particularly on the lower back and heels, with the use of
an air mattress being preferable for this purpose.
Foot drop can be prevented by using a foot support or pillow.
In the initial period post-injury, the patient may require a shoulder
sling.
Encouraging self-care in terms of eating and drinking, as well as training
the affected limb using the healthy limb, is important.
Around three weeks to a month after the injury, the dormant period ends, and
joint stiffness may set in, prompting the therapist to capitalize on this
phase to achieve improved mobility.
The therapist begins by teaching the patient how to transfer from the bed to
the chair and vice versa.
Once standing is feasible, the patient progresses to walking, which is a
fundamental aspect of the rehabilitation process.
It is noteworthy that movement improvement typically starts in the lower
extremities before progressing to the upper extremities; movement in the
thigh, knee, and foot appears first, followed by movement in the shoulder,
elbow, and finally the hand.
alternative medicine Treatment:
Garlic:
Garlic is one of the best anti-coagulant herbs and contains several compounds with anti-coagulant properties. It protects against strokes due to its preventive effect. It is possible to add garlic to food and increase the intake of its cloves.
Ginkgo:
Ginkgo, a two-lobed herb, is used in the treatment of stroke-related brain disorders such as memory, balance, and dizziness. It also increases blood flow in the brain and strengthens blood vessels in the body, helping to prevent both temporal and ischemic strokes.
Pigweed:
This herb contains a large amount of calcium, thereby protecting against clotting, whether in the brain or the heart. Fresh leaves can be used, or the leaves can be steamed or the dried herb can be used.
Carrot:
Consuming carrots prevents and treats strokes, significantly reducing their risks. Carrots are rich in beta-carotene, acting as an antioxidant, and are also rich in carotenoids and vitamins A and C, all of which assist in stroke protection.
Willow:
Willow bark is an herbal aspirin, reducing the risk of stroke by acting as
an anti-coagulant and promoting clot fluidity. Willow bark can be boiled,
strained, and consumed in the amount of three cups daily.
Evening Primrose:
Evening primrose oil is rich in gamma-linolenic acid, which has
anti-coagulant and blood pressure-lowering effects, making it very
beneficial in preventing strokes.