Stroke: definition, types, symptoms, causes, risk factors, diagnosis, treatment



Definition 


The stroke is a “brain attack”, it's occurs when the supply of blood to the brain is reduce, and 
this happen when a blood vessel which carries oxygen and nutrients through blood to the brain is injured or blocked.

When this happens, the brain does not get enough blood as much as need, and they start to die within a few minutes.

This can cause permanent brain damage and long-term disability.

Types 



There are three main types of stroke:

Ischemic stroke:


These are the most common types of strokes, About 80 percent of strokes are ischemic strokes.

 It's occur when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia).

These are two types :

- Thrombotic stroke
- Embolic stroke

Hemorrhagic stroke:


The hemorrhagic stroke occurs when the blood vessel is ruptured (leaks) and the bleeding begins inside the brain.

Transient ischemic attacks (TIAs):


It's also called mini-stroke, TIAs happen when the blood supply to the brain is blocked for a short time.

 It does not cause permanent damage to your brain, but if you have had a TIA, you are at a much higher chances of having a stroke.

Symptoms



Symptoms of stroke often appear suddenly, They are included:

- Confusion, difficulty in speaking and understanding
- Weakness or paralysis on the face, arm or leg, Especially on one side of the body
- Blurred or blackened vision in one or both eyes
- Loss of balance or loss of coordination
- Suddenly loss of sensation (emotions)
- A sudden, severe headache and weakness.

Causes


The stroke can be caused by a blocked artery (ischemic stroke) or the  bursting of a blood vessel  (hemorrhagic stroke).

Ischemic stroke : 


This type of stroke is caused by Plaque which made of fat, cholesterol, calcium, and other substances builds up in the arteries, leaving less space for blood to flow And the result is artery starts blocking or contracting.

Blood clots often cause the blockages that lead to ischemic strokes.
 

Hemorrhagic stroke :


Hemorrhagic stroke is caused by the rupture of arteries in the brain, and its also cause by :

- High blood pressure
- Overtreatment with anticoagulants
- Weak spots in your blood vessel walls

Transient ischemic attack (TIA) : 


In this case Blood flow is temporarily impaired to part of the brain, also known as mini- stroke.

Risk factors 


Stroke is more likely to affect people if they have the following risk factors :

Long standing risk factors : 


- High blood pressure
- Diabetes
- Heart diseases
- Personal or family history of stroke
- Obesity
- High cholesterol
- Brain aneurysms 

Other risk factors, many of which of you can control :


- Physical inactivity
- Drinking and smoking
- Use illicit drugs
- Unhealthy diet
- Stress and depression

Diagnosis


When you suspect that you have a stroke, immediately consult with doctor.

There are so many different types of diagnostic tests that doctors can use to define which type of stroke you has occurred:

Physical examination :


- Doctor will ask about family history that Anyone had a stroke in history?
- Doctor will check for numbness or weakness in your face, arms, and legs
- Check blood pressure
- Check your pulse for an irregular heartbeat

Blood tests :


- Blood glucose test
- Platelet count
- PT and PTT tests
- Cholesterol test

CT scan :


CT scan can show  hemorrhages, tumors and bleeding in the brain or damage to the brain cells from a stroke.

MRI scan : 


This test can detect changes in brain tissue and damage to brain cells from a stroke.

Carotid ultrasound :


This test shows buildup of fatty deposits (plaques) and blood flow in your carotid arteries (in your neck).

Treatment 


Treatment of stroke depends on whether it is ischemic stroke or hemorrhagic stroke, because both have different causes.

Ischemic stroke treatment : 


In this case the arteries blocked or narrowed, so doctors focuses on restoring an adequate flow of blood to the brain, these are Some medicines and  surgery include:

- Intravenous injection of tissue plasminogen activator (tPA)
- Carotid endarterectomy
- Angioplasty and stents

Hemorrhagic stroke treatment : 


 In this case the blood leaking into the brain, so doctors focuses on controlling the bleeding, these are Some medicines and  surgery include:

Medicine: 


- Warfarin (Coumadin, Jantoven)
- Clopidogrel (Plavix)

Surgery : 


- Aneurysm
- Arteriovenous malformation (AVM)
- Surgical clipping
- Coiling (endovascular embolization)
- Surgical AVM removal
- Stereotactic radiosurgery

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