A brain stroke is the occurrence of neurological deficits due to cerebrovascular cause (problem-related to blood vessels of the brain). There are two types of stroke one of which is called Ischaemic stroke which occurs because of partial or total blockage of the blood vessel by a blood clot resulting in the decreased or total cessation of blood supply to a part of the brain. Brain cells(neurons) die as a result of this and with each minute of lack of blood supply about 1.7million cells die. The other type of stroke is called haemorrhagic stroke in which blood vessel ruptures leading to leaking of blood into the brain tissue. Ischaemic stroke is by far more common than haemorrhagic stroke (75%versus25%).
The common risk factors for stroke include high blood pressure, diabetes mellitus, increased blood cholesterol, cigarette smoking, excessive alcohol intake and heart disease. The other risk factors include old age, male sex, sedentary lifestyle and mental stress. Though stroke mostly occurs in older individuals there is an increasing trend of its occurrence in younger people mainly to stress, change in dietary habits and hectic lifestyle. Some of these also have a family history of stroke at a young age.
Stroke commonly manifests in the form of sudden onset of weakness of one half of the body, inability to speak or comprehend properly, slurring of speech, double vision or dimness of one half of vision, unsteadiness while walking. It can also manifest as severe headache and decrease in the level of consciousness. Diagnosis is done by a brain scan most commonly CT scan and in some situations, MRI may be necessary.
The most important thing to do when somebody has a stroke is to rush to the hospital as early as possible since the only approved therapy for ischaemic stroke is intravenous administration of clost bursting drug rtPA(recombinant tissue plasminogen activator) in the first 4.5hrs after the onset of symptoms. Even in this period patients who receive earlier have a better outcome than who receive the latter. Beyond the first few hours, we can only give medication to prevent a second stroke by using blood thinners such as aspirin and clopidogrel. In some situation, anticoagulants like warfarin may be necessary. The best thing to do is to prevent stokes from happening by adopting a healthy lifestyle including a diet rich in fibre and low in cholesterol, regular exercise and medication as required for risk factors like hypertension and diabetes mellitus.
Dr.Chenna Rajesh Reddy
Apollo Health City Hyderabad