Diseases & Medicine

Stroke; causes,riskfactors and prevention

Overview

When the blood flow to a portion of the brain is blocked or diminished, brain tissue is deprived of oxygen and nutrients, resulting in an ischemic stroke. Within minutes, brain cells begin to die.

A stroke is a medical emergency that requires immediate attention. Brain injury and other consequences can be avoided if intervention is taken early.

The good news is that stroke deaths  have decreased dramatically in recent years. Treatments that are effective can also help to avoid stroke impairment.

Symptoms

If you suspect you or someone you’re with is experiencing a stroke, pay close attention to when the symptoms started. When administered immediately after a stroke begins, some therapy options are most helpful.

The following are signs and symptoms of a stroke:

  • It’s difficult to communicate and understand what people are saying. You might be perplexed, slur words, or have trouble understanding communication.
  • Numbness or paralysis of the face, arm, or leg. In the face, arm, or leg, you may experience abrupt numbness, weakness, or paralysis. This usually only affects one side of the body. At the same moment, try to raise both arms above your head. You may be having a stroke if one arm begins to fall. When you try to smile, one side of your mouth may droop.
  • One or both eyes have vision problems. You may experience double vision or have blurred or darkened vision in one or both eyes.
  • Headache. A sudden, intense headache that is accompanied by vomiting, dizziness, or altered awareness could be a sign of a stroke.
  • Walking difficulties It’s possible that you’ll trip or lose your balance. You may have dizziness or a loss of coordination as well.

When should you see a doctor?

If you observe any signs or symptoms of a stroke, seek medical help right once, even if they seem to come and go or disappear completely. Do the following: Think “FAST” and do the following:

  • Face. Solicit a smile from the person. Is there a droop on one side of your face?
  • Arms. Request that the person raise both arms. Is one of your arms drooping? Is it possible that one arm is unable to raise?
  • Speech. Request that the other individual repeat a simple phrase. Is he or she speaking in a slurred or weird manner?
  • Time. If you notice any of these symptoms, dial 911 or seek emergency medical assistance right away.

Don’t wait for the symptoms to go away. Every second is crucial. The longer a stroke continues untreated, the more brain damage and disability are likely to occur.

If you’re with someone who you think is having a stroke, keep a close eye on them while you wait for help.

Causes

There are two main causes of stroke: a blocked artery (ischemic stroke) or leaking or bursting of a blood vessel (hemorrhagic stroke).
A transient ischemic attack (TIA) is a momentary disruption of blood flow to the brain that does not cause permanent symptoms in some persons.

Ischemic stroke

The most common sort of stroke is this one. It occurs when the blood arteries in the brain narrow or block, resulting in substantially restricted blood flow (ischemia). Fatty deposits that build up in blood vessels or blood clots or other debris that move through the bloodstream, most typically from the heart, and lodge in the blood vessels in the brain produce blocked or restricted blood arteries.

COVID-19 infection appears to raise the incidence of ischemic stroke in several studies, but further research is needed.

Hemorrhagic stroke

When a blood vessel in the brain leaks or ruptures, a hemorrhagic stroke develops. Many disorders that alter the blood arteries can cause brain hemorrhages. Hemorrhagic stroke is caused by a number of factors, including:

  • High blood pressure that is uncontrolled
  • Excessive use of blood thinners (anticoagulants)
  • Bulges at weak places in the walls of your blood vessels (aneurysms)
  • a traumatic event (such as a car accident)
  • Protein deposits in the walls of blood vessels cause vessel wall weakening (cerebral amyloid angiopathy)
  • Hemorrhage as a result of an ischemic stroke
  • The rupture of an irregular tangle of thin-walled blood arteries is a less prevalent cause of brain bleeding (arteriovenous malformation).

Transient ischemic attack (TIA)

A transient ischemic attack (TIA), often called a ministroke, is a brief period of symptoms that resemble those of a stroke. A transient ischemic attack (TIA) has no long-term consequences. A TIA is caused by a brief interruption in blood supply to a portion of the brain that can last as little as five minutes.

A TIA occurs when a clot or debris restricts or prevents blood flow to a region of the nervous system, similar to an ischemic stroke.

Even if you suspect you’ve had a TIA and your symptoms have improved, seek emergency medical attention. You can’t tell if you’re suffering a stroke or a TIA just by looking at your symptoms. You may have a partially blocked or restricted artery leading to the brain if you’ve experienced a TIA. If you have a TIA, you’re more likely to have a full-blown stroke later.

Risk factors

Stroke risk can be increased by a variety of causes. The following are some of the potentially treated stroke risk factors:

Risk risks associated with one’s way of life

  • Obesity or being overweight
  • Physical inactivity
  • Binge or heavy drinking
  • Use of illegal drugs such as cocaine and methamphetamine

Medical risk factors

  • High blood pressure
  • Cigarette smoking or secondhand smoke exposure
  • High cholesterol
  • Diabetes
  • Obstructive sleep apnea
  • Cardiovascular disease, including heart failure, heart defects, heart infection or
  • irregular heart rhythm, such as atrial fibrillation
  • Personal or family history of stroke, heart attack or transient ischemic attack
  • COVID-19 infection

Other factors linked to an increased risk of stroke include:

  • Age – People above the age of 55 have a higher risk of stroke than those under the age of 55.
  • African Americans and Hispanics have a higher stroke risk than those of other races or ethnicities.
  • Men are more likely than women to have a stroke. When women get strokes, they are frequently older, and they are more likely than males to die from them.
  • Hormones – Using estrogen-containing birth control pills or hormone therapy raises your risk.

Prevention

The best efforts you can take to prevent a stroke are to understand your stroke risk factors, follow your health care provider’s recommendations, and live a healthy lifestyle. These actions may help avoid another stroke if you’ve had a stroke or a transient ischemic attack (TIA). The post-operative and post-hospital care you receive may also have an impact.

Many stroke preventive measures are similar to heart disease preventative strategies. The following are some general tips for a healthy lifestyle:

  • Controlling high blood pressure (hypertension).
    One of the most significant things you can do to lower your stroke risk is to do this. Lowering your blood pressure after a stroke can help you avoid another TIA or stroke. High blood pressure is commonly treated with a combination of healthy lifestyle changes and medicines.
  • Lowering your cholesterol and saturated fat intake. Reduced cholesterol and fat intake, particularly saturated and trans fats, may help to prevent plaque development in the arteries. If dietary modifications alone aren’t enough to lower your cholesterol, your doctor may prescribe a cholesterol-lowering drug.
  • Tobacco use cessation. For smokers and nonsmokers exposed to secondhand smoke, smoking increases the risk of stroke. Smoking cessation lowers the risk of stroke.
  • Taking care of diabetes. Diet, exercise, and weight loss can all help you maintain a healthy blood sugar level. If lifestyle changes aren’t enough to keep your diabetes under control, your doctor may prescribe diabetes medication.
  • Keeping a healthy body weight. Other stroke risk factors, such as high blood pressure, cardiovascular disease, and diabetes, are exacerbated by being overweight.
  • Consuming a fruit and vegetable-rich diet. A diet rich in fruits and vegetables, with five or more servings per day, may lower the risk of stroke. A Mediterranean diet rich in olive oil, fruit, nuts, vegetables, and whole grains may be beneficial.
  • Exercising on a regular basis. In a variety of methods, aerobic activity lowers the risk of stroke. Exercise can help to lower blood pressure, raise good cholesterol levels, and improve the general health of blood vessels and the heart. It also aids in weight loss, diabetes management, and stress reduction. Work up to at least 30 minutes of moderate physical exercise on most, if not all, days of the week, such as walking, running, swimming, or bicycling.
  • Drinking alcohol in moderation, if at all. High blood pressure, ischemic strokes, and hemorrhagic strokes are all linked to excessive alcohol intake. Other medicines you’re taking may interact with alcohol. However, consuming small to moderate amounts of alcohol, such as one drink per day, may assist to avoid ischemic stroke and reduce the tendency of blood to clot. Consult your doctor about what’s best for you.
  • Treating obstructive sleep apnea (OSA). If you experience signs of OSA, a sleep disorder in which you stop breathing for short periods of time periodically while sleeping, your doctor may recommend a sleep study. A device that generates positive airway pressure using a mask to keep the airway open while you sleep is used to treat OSA.
  • Avoiding the use of unlawful drugs. Certain illegal drugs, such as cocaine and methamphetamine, have been linked to TIAs and strokes.

Medications for prevention

If you’ve had an ischemic stroke or a transient ischemic attack (TIA), your doctor may prescribe drugs to help lower your risk of another stroke. These are some of them:

Antiplatelet medications. Platelets are clotting cells in the blood. Antiplatelet medications reduce the stickiness of these cells, making them less likely to clot. Aspirin is the most regularly used anti-platelet drug. Your doctor can assist you in determining the appropriate aspirin dosage for you. Your doctor may prescribe aspirin and an anti-platelet medicine such as clopidogrel for a period of time after a TIA or mild stroke to lower the chance of another stroke. Your doctor may prescribe clopidogrel alone if you can’t take aspirin.

Anticoagulants. These medications help to prevent blood clots. Heparin is a fast-acting anticoagulant that can be taken in the hospital for a short period of time.

Warfarin with a longer half-life can be used for a longer period of time. Because warfarin is a potent blood thinner, you must take it exactly as prescribed and monitor for side effects. You’ll also need to take blood tests on a regular basis to monitor the effects of warfarin.

Several modern blood-thinning drugs (anticoagulants) are now available to help those who are at high risk of stroke. Dabigatran, rivaroxaban, apixaban, and edoxaban are some of the drugs available. They have a shorter half-life than warfarin and don’t usually necessitate blood testing or doctor monitoring. In comparison to warfarin, these medications are linked to a lower risk of bleeding problems.

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