A stroke occurs when the blood supply to a part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within a few minutes, brain cells begin to die.
Stroke is a medical emergency, and prompt treatment of a stroke is crucial. Early treatment can minimize damage to your brain and potential stroke complications. The good news is that strokes can be treated, and many fewer Americans now die of strokes than was the case 20 or 30 years ago. Improvement in the control of major risk factors for stroke - high blood pressure, smoking and high cholesterol - is likely responsible for the declin
The warning signs of stroke are:
- Numbness, weakness, or paralysis of the face, arm, or leg (on one or both sides of the body)
- Vision that suddenly blurs or decreases (in one or both eyes)
- Trouble speaking or understanding
- Dizziness, loss of balance, or a fall that is unexplained
- Difficulty swallowing
- Sudden, severe, unexplained headache
- Sudden confusion
About 80 percent of strokes are ischemic strokes. They occur when the arteries to your brain are narrowed or blocked, causing severely reduced blood flow (ischemia). This deprives your brain cells of oxygen and nutrients, and cells may begin to die within minutes.
The most common ischemic strokes are : -
Thrombotic stroke : - This type of stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot usually forms in areas damaged by atherosclerosis - a disease in which the arteries are clogged by fatty deposits (plaques). This process can occur within one of the two carotid (kuh-ROT-id) arteries of your neck that carry blood to your brain, as well as in other arteries of the neck or brain.
Embolic stroke : - An embolic stroke occurs when a blood clot or other particle forms in a blood vessel away from your brain - commonly in your heart - and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus. It's often caused by irregular beating in the heart's two upper chambers (atrial fibrillation). This abnormal heart rhythm can lead to poor blood flow and the formation of a blood clot.
Essential Tremor: DBS is a highly effective therapy for patients with essential tremor, often resulting in an 80% decrease in tremor that lasts for several years. Patients with a tremor secondary to stroke, traumatic brain injury or multiple sclerosis are less likely to benefit from DBS.
"Hemorrhage" is the medical word for bleeding. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Hemorrhages can result from a number of conditions that affect your blood vessels, including uncontrolled high blood pressure (hypertension) and weak spots in your blood vessel walls (aneurysms). A less common cause of hemorrhage is the rupture of an arteriovenous malformation (AVM) - an abnormal tangle of thin-walled blood vessels, present at birth.
There are two types of hemorrhagic stroke : -
Intracerebral hemorrhage : - In this type of stroke, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging cells. Brain cells beyond the leak are deprived of blood and are also damaged. High blood pressure is the most common cause of this type of hemorrhagic stroke. Over time, high blood pressure can cause small arteries inside your brain to become brittle and susceptible to cracking and rupture.
Subarachnoid hemorrhage : - In this type of stroke, bleeding starts in a large artery on or near the surface of the brain and spills into the space between the surfaces of your brain and your skull. This type of hemorrhage is often signaled by a sudden, severe "thunderclap" headache. This type of stroke is commonly caused by the rupture of an aneurysm, which can develop with age or be genetically inherited. After the hemorrhage, the blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow to parts of your brain.
Carotid endarterectomies are performed to prevent and reduce the risk of stroke. This surgery has been proven to be highly beneficial for patients who have already had a stroke or experienced the warning signs of a stroke and have a severe stenosis of 70 percent to 99 percent. During this procedure, a surgeon removes fatty deposits (plaques) from carotid arteries that run along each side of neck to brain.
Carotid angioplasty is an endovascular surgery procedure that opens clogged arteries to prevent or treat stroke.Carotid angioplasty is often combined with the placement of a small metal coil called a stent in the clogged artery and this procedure is suggested when traditional carotid surgery isn’t feasible or is too risky.
A craniotomy is surgical procedure performed in the brain itself to remove blood clots or repair bleeding in the brain. The neurosurgeon first must perform a craniotomy and then Surgical clipping by placing a tiny clamp at the base of the aneurysm, to stop blood flow to it. This can keep the aneurysm from bursting, or it can prevent re-bleeding of an aneurysm that has recently hemorrhaged.
This surgical procedure is performed by endovascular specialists, to help prevent a stroke from occurring. Smaller AVM can be removed through an opening drilled into the skull; if it is located in an accessible (peripheral) part of the brain, to eliminate the risk of rupture and lower the risk of hemorrhagic stroke. However, it’s not always possible to remove an AVM if its removal would cause too large a reduction in brain function or if it’s large or located deep within your brain, Less invasive radiosurgery works best for deep, hard-to-reach AVMs; the procedure involves directing radiation to the affected area.
A rehabilitation program is an important part of treatment for stroke survivors. It starts in the hospital as soon as patient is stable following a stroke. The program is done with an objective to help the patient relearn the skills he/she lost when stroke affected the part of brain. This program helps to regain independence and improve quality of life. A multidisciplinary team of health professionals will work out in a rehabilitation program.