Stroke Overview: Causes and types, signs and symptoms, diagnosis, and treatment

Stroke Overview: Causes and types, signs and symptoms, diagnosis, and treatment

Cardiovascular Diseases

A "brain attack" also known as a stroke develops when blood flow to the brain tissue is blocked. Brain hypoxia (low levels of oxygen distribution in the tissues) develops in many ways which we will discuss below. In this instance, time is of the essence as brain cells die rather quickly. The prevalence of stroke is placed as the second leading cause of death worldwide, thus making it an important topic of discussion.

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Causes and types of strokes

Two main causes of strokes occur:

  • Hemorrhagic in nature: the following develops when blood vessels either rupture or leak. It is mostly associated with high blood pressure, anticoagulant treatment complications, traumatic injury, and ischemia leading to fluid leakage.
  • Ischemic in nature: the following is the most commonly occurring type of stroke. It develops when vessels are severely narrowed or completely blocked.
  • The third type is transient in nature: transient ischemic attack (TIA) can be considered a "minor" stroke as it is temporary in nature and symptoms subside after a few minutes without residual complications.

Signs and symptoms associated with stroke

  • Pins and needle sensation (weakness/numbness) and/or paralysis of one side of the body, mostly in the arm, leg, or face.
  • A sudden very painful headache that is possibly accompanied by a loss of consciousness, gastrointestinal symptoms (nausea/vomiting), and lightheadedness.
  • Difficulty initiating movement of one side.
  • Difficulty initiating speech and/or understanding spoken words.


What to look for if someone you know may experience a stroke?

As a person that isn’t in the medical field, the F.A.S.T test can diagnose the development of a stroke and may save their life because as stated earlier, time is of the essence:

  • F (face): you may ask the person to smile and observe. Is a part of the face drooping or paralyzed?
  • A (arms): you may ask the person to raise both arms. Is one of the arms unintentionally drifting back downwards?
  • S (speech): give a short phrase and ask the person to repeat it back. Can you observe any abnormalities in speech patterns?
  • T (time): again, time is of the essence so call emergency operators as soon as possible.

Diagnostic procedures

  • First and foremost, a physical exam by the doctor is imperative.
  • Blood analysis to check for coagulation abnormalities.
  • Imaging: carotid ultrasound, MRI, CT scan, and a cerebral angiogram.


Ischemic stroke treatment options

  • An IV access will be placed in order to give medication that is used to break down the clot, it’s called Tissue plasminogen activator (TPA). If given within a 4.5-hour window, the patient might fully recover.
  • Emergent endovascular procedures involve the following: injecting TPA directly into the brain vasculature by using a catheter; clot removal also known as mechanical thrombectomy; angioplasty; and carotid endarterectomy. Endovascular procedures give physicians a longer time frame to act as compared to IV infusions.

Hemorrhagic stroke treatment options

This type of stroke measure requires timely control of the bleeding and intracranial pressure.

  • If you’re on anticoagulant therapy, you will be given medication or receive drug product transfusions to counter the effects of the anticoagulant medication.
  • Surgery may be considered if the blood pooling in the brain is causing too much pressure within the brain.
  • Endovascular embolization is focused on using a method called "coiling", the surgeon will place material that induces clotting in order to stop the bleeding.
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