Recognizing The Signs Of A Stroke

Cerebro-vascular Stroke is a deadly medical emergency that often afflicts people in the older age, and presents as sudden loss of consciousness, alone or with other symptoms, such as headache, vomiting or seizures. Immediate recognition of stroke and urgently shifting the patient to a well equipped hospital can save life and minimize the neurological deficit.
Recognizing the Signs of a Stroke
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Stroke is one of the most dreaded health events faced by human beings. Apart from being one of the important causes of immediate death, it can also lead to deadly paralysis of a large part of the body. Since it is a condition that can afflict anyone, it is important that one be aware of it. Being able to recognize a case of stroke and taking urgent measures to ensure immediate expert medical care can often be the greatest help we can offer a fellow human being.....


Recognizing a 'stroke' early enough can be the difference between life and death!

What Is

a ‘Stroke’ ?

Stroke is a sudden damage of a part of brain which happens because of interference in the blood supply to a part of the brain because of obstruction or damage to the blood vessels.

Brain consists of neuron cells which need glucose for energy, and oxygen for survival, both of which are supplied by blood. Unlike other parts of the body, most parts of brain are supplied by only one blood vessel carrying blood to that part. These are called 'end arteries', and if there is any obstruction or damage to them, there is no other source of blood supply to that part of brain.

Neurons of brain cannot survive long without blood supply. Irreversible damage may take place if the supply is interrupted for more than five minutes. Even when the damaged part is very small, the damaged brain can lead to lot of distress signals which can be very severe and usually lead to unconsciousness and sometimes even seizures (fits).

Strokes : Two Major Types

The strokes can be classified into two major categories, INFARCTION and HEMORRHAGE.

INFARCTION, or more accurately, CEREBRO VASCULAR INFARCTION refers to the death of brain cells from obstruction in the blood vessel. This happens commonly because of some blood clot or 'thrombus' that is formed in the large arteries, usually on their walls, which then gets dissociated from those walls and flows with blood to smaller 'end-arteries'. These end arteries are the final smaller branches with small diameter. Any particle flowing with blood is called 'embolus' and when it passes through these smaller arteries, it can block the whole artery and stop further flow of blood, leading to disruption of blood supply and consequent infarction.

BRAIN HEMORRHAGE, or CEREBRAL HEMORRHAGE refers to a sudden bursting of the blood vessel inside the brain. It has two consequences, first the blood which is pumped by heart into arteries under pressure, oozes out of the vessel, accumulates and later clots there, putting pressure on the delicate brain tissue and damaging it. Second, the burst artery is unable to carry on the blood supply leading to death of parts of brain supplied by it. Common causes of hemorrhage are defects in arterial wall, or some other diseases like high blood pressure which weakens the walls of the blood vessels.

Infarction Vs. Hemorrhage

Stroke is always a dangerous event, irrespective of whether it is infarction or hemorrhage. However, hemorrhages are more dangerous, and the injury caused by them is often irreversible. This is because while infarctions are limited to smaller areas in brain, and even when damaged, can partly recover to some extent, in case of hemorrhage, a larger area is involved, and it is damaged in a way that there is relatively lesser chance of recovery.

Signs & Symptoms of Stroke

A stroke typically occurs in the form

of a very sudden event marked by severe headache, vomiting, changes in the consciousness level that vary from a transient fainting to a deep coma that may last for many weeks, and sometimes seizures (fits, or sudden involuntary movements of parts of body associated with frothing).

Stroke is more common in older age, and is rare in age below 40 unless there is some underlying disease like brain tumor or a genetic disorder.

Action to be taken in a Suspected Stroke

Thus, a Stroke typically presents as an elderly person who is otherwise fine one moment, suddenly losing his consciousness. This may or may not be associated with any features like vomiting, headache or seizures, and should invariably lead to the suspicion of Stroke. In every case, the first reaction should be to seek an ambulance and shift the patient to a well equipped hospital with emergency and intensive care facilities. Once the ambulance has been called, the next step, wherever possible, should be to notify the family physician or any other physician that may be aware of the patient’s health, so that if necessary, he can inform the attending medical experts in the emergency. It is also useful to carry medical records of the patient, in particular, any CT scan or MRI Scan that may have been done earlier, even if it is normal. A comparison with it will help attending medical experts to make a quick diagnosis.

Precursors of Stroke & Underlying Conditions

It is important to remember that stroke is primarily a disease of vascular system and not brain, and so its precursors are high blood pressure, and cholesterol deposition on the walls of blood vessels. Consequently preventing stroke requires controlling of blood pressure and reducing the cholesterol levels.

There can of course be several other conditions, which predispose to blood clotting and thrombus formation that can lead to infarction. Any heart disease, including those of the heart valves, or the arteries carrying blood can create such risk. Arrhythmias of the heart can also lead to the increased predisposition to formation of blood clot embolus and stroke.

Significance of Recognizing Stroke Immediately

When a stroke happens the pressure within the brain rises. The sudden unconsciousness can sometimes interfere in normal breathing and it can lead to death also. Hence, if a stroke can be timely identified, appropriate medical and emergency care can save life. Thus it is important to keep the possibility of a stroke in mind in all cases of persons of older age group having sudden loss of consciousness or seizures. All such cases require immediate and urgent expert medical care and should be urgently transferred to a hospital with emergency care facilities.

All such cases of unconsciousness in an old person may not eventually turn out to be stroke, but following this policy will ensure that timely treatment is able to save life in many cases!

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