What Are Causes of Brain Stroke & Its Treatment

 

Summary: Stroke, also called cerebrovascular accident or brain attack, is a sudden impairment of cerebral circulation in one or more of the blood vessels supplying the brain. Strokes interrupt the oxygen supply to the brain tissues and can cause serious damage.

For anyone who has suffered a stroke, it is vitally important to restore normal circulation as soon as possible to limit damage to the brain tissues. The number still hovers around the 30% and stroke could soon be the most common cause of death worldwide. Of those who do survive, about half remain permanently disabled and many experience a recurrence within weeks, months or years.

Causes and Incidence

A stroke results from obstruction of a blood vessel, typically outside the brain, but occasionally within the brain itself. Factors that increase the risk of stroke include a history of transient ischemic attacks, atherosclerosis, hypertension, kidney disease, arrhythmias (particularly atrial fibrillation), rheumatic heart disease, diabetes, postural hypertension, heart enlargement, high serum cholesterol, smoking, lack of exercise, long time use of contraceptives, obesity and a family history of strokes. Females have additional risk factors for stroke such as oral contraceptives that are not present in men. Cocaine induced ischemic stroke is now being reported in younger patients.

Men traditionally have had a greater risk of stroke than women but women start catching up to men five or 10 years after menopause. While stroke is most common in the elderly, people of any age and any level of physical fitness can suffer the injury. A persons risk of dying if he or she does have a stroke also increases with age.

Stroke is uncommon in children accounting for only a small percentage of stroke cases each year. Stroke in children is often secondary to congenital heart disease, abnormalities of intracranial vessels genetic disorders and blood disorders such as thrombophilia.

Types of Stroke

Strokes can be classified into two major categories: ischemic and hemorrhagic, 80% of strokes are due to ischemia, the rest are due to hemorrhage. 

The major causes of stroke are thrombosis, embolism and hemorrhage:

·                Donate to veterans with a brain injury is the most common cause in middle age and elderly people as they tend to have a higher incidence of arterial plague, diabetes or hypertension. It can occur at any age, especially in those with a history of rheumatic heart disease, endocarditis, cardiac arrhythmias, or after open heart surgery.

·         Embolism is the second most common cause of stroke. Embolisms occur when a blood vessel is blocked by a clot, a tumour, fat, bacteria or air. Embolisms usually develop within 10 to 20 seconds and without warning and when they reach the brain, will cut off circulation by lodging in a narrow part of an artery causing swelling and tissue death.

·         Hemorrhage the third most common type of stroke, which is more prevalent in women than men, like embolism can occur suddenly at any age. It results from chronic hypertension or from aneurysms that cause a sudden rupture of a cerebral artery. 

For people referred to the emergency room, early recognition of stroke is deemed important as this can expedite diagnostic tests and treatments. Strokes due to thrombosis embolism, or arterial spasm, which cause ischemia, must be distinguished from those due to hemorrhage, which are usually severe and often fatal. Stroke is diagnosed through several techniques: observation of clinical features, a neurological examination, CT scans or MRI scans, Doppler ultrasound, and arteriography. Stroke support group help to live a healthy life.

Treatment

Surgery to improve cerebral circulation, tissue plasminogen activator (tPA) for clot dissolution, anti-coagulants and anticonvulsants are commonly used to treat stroke. Treatment to break up a blood clot, the major cause of stroke, must begin within three hours of the stroke to be effective. The treatment must be administered within three hours of the stroke event. Therefore, patients who awaken with stroke symptoms are ineligible for the therapy, as the time of onset cannot be accurately determined. Patients with clot-related (thrombotic or embolic) stroke who are ineligible for treatment may be treated with heparin or other blood thinners, or with aspirin or other anti-clotting agents in some cases.

Prevention

Generally there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual’s underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Lowering blood pressure has been conclusively shown to prevent both ischemic and hemorrhagic strokes. Aspirin prevents against first stroke in patients who have suffered a myocardial infarction. Nutrition, specifically the Mediterranean-style diet, has the potential of more than halving stroke risk.

Rehabilitation

Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Survivors often have problems understanding or forming speech, they may have difficulty controlling their emotions or may express inappropriate emotions. They may also have numbness or strange sensations.