Stroke

DESCRIPTION

Definition
 
A stroke is a life-threatening medical emergency. It occurs when there is a sudden deprivation of oxygen and nutrients to the brain cells when the blood supply to the brain is interrupted or greatly reduced. Since the brain cells are starved of oxygen-rich blood there is damage to the surrounding nerves which causes the death of brain cells within minutes. The body parts controlled by the damaged brain cells lose their ability to function.
 
Signs and Symptoms
 
Following signs and symptoms are important to watch out for if you suspect someone may be having a stroke:
1. Difficulty in speaking and comprehending -- slurred speech
2. Paralysis or numbness on one side of the face, arm, or leg
3. Blurred vision or difficulty in seeing with both eyes
4. Severe headache
5. Difficulty in walking straight
 
Investigations
 
The doctor needs to assess and evaluate which type of stroke you are having and which areas of your brain are affected. Elimination of other possible causes is also important, e.g., brain tumor, or adverse drug reaction. A complete physical examination will be performed with evaluation of personal and family history, review of current medications, and neurological examination.
Diagnostic tests include:
1. Blood tests -- check your blood sugar, clotting factors, and also check whether vital blood salts are out of balance
2. CT scan -- assess whether it is a tumor, blood leak, or cut off blood supply
3. MRI -- assess the blood flow to the brain
4. Carotid ultrasound -- assess carotid arteries in your neck
5. ECG -- check functioning of your heart
 
Treatment
 
Treatment differs depending upon the type of stroke:
1. Ischemic stroke: Drugs which break down clots are used, e.g., aspirin. TPA which is tissue plasminogen activator can also be injected as it dissolves clots very fast. This can be given in an emergency via a catheter directly into the artery.
2. Hemorrhagic stroke: Drugs to reduce pressure in the brain and to prevent sudden seizures and constrictions of blood vessels are given.

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