In the United States, an estimated 800,000 new and recurrent cases of stroke are recorded annually. In other words, there is a confirmed stroke diagnosis every 40 seconds. Sadly, not all make it through treatment. According to statistics, a person dies from a stroke every 4 minutes. Stroke is rated the 4th leading cause of death after heart, cancer, and chronic lower respiratory diseases. In addition, it is the leading cause of disability in seniors.
Europe statistics are even more alarming. Stroke ranks second in the causes of death and makes up for 33 % and 25 % of cardiovascular deaths in women and men respectively. This places women at a higher risk of stroke compared to their male counterparts. However, stroke symptoms in women are usually the same as those in their male counterparts.
Good news is that stroke prevention and treatment are possible.
A stroke occurs when the supply of oxygenated blood to the brain is cut off. This is because the brain needs oxygen to function properly and lack of oxygen will cause the death of brain cells in a matter of minutes. The death of specific brain cells will be reflected by a dysfunction in the parts of the body that they control. This explains why internal bleeding in the head as a result of an impact may cause a stroke. First, there could be a stop to the supply of oxygenated blood to brain cells. Secondly, brain cells could have been damaged. The occurrence of stroke is critical and should be treated as an emergency.
Types of Stroke
There are two major stroke types
This is the most common type of stroke. An ischemic stroke is caused by a cut-off in the supply of oxygenated blood to the brain. This typically happens when the artery that supplies blood to the brain develops a blood clot which prevents blood from flowing to the brain.
There are two types of ischemic stroke
- Thrombotic stroke. This is caused by a blood clot, also known as a thrombus, inside the artery, which prevents the flow of oxygenated blood to the brain cells.
- Embolic stroke. Barriers to blood flowing to the brain can be a blood clot or plaque (known as embolus) which forms in a different part of the body, is transported through the flow of blood and then gets stuck in the artery.
Another form of stroke which falls under the Ischemic stroke category is known as a transient ischemic attack (TIA) or mini-stroke. It resembles ischemic stroke in that it is caused by blood clots but will last a short time at most 15 minutes. TIA damages the brain cells but not permanently as compared to an ischemic stroke which usually leaves lasting or permanent damage on the patient’s brain cells. It is important to note that a TIA occurrence is a stroke risk factor.
Causes of ischemic stroke
- Atherosclerosis forming lesions which block the artery.
Previous instances of transient ischemic attacks
- Carotid artery disease caused by plaque forming on the two arteries located on either side of the neck, which supply blood to the head, face, and the brain.
- Atrial fibrillation, cardiomyopathy, and heart failure. These can cause blood clots which can in turn cause stroke.
Unlike in Ischemic stroke, in hemorrhagic stroke, the blood supply to the brain is affected by the rupturing of the artery and leaking of blood. In this case, stroke is caused not only by the shortage of supply of oxygenated blood but also by the pressure of the blood leaking from the ruptured artery which can potentially damage the delicate brain cells. The latter causes the brain to swell which exerts pressure on the skull. This causes damage to the brain’s tissues and cells.
There are two types of hemorrhagic stroke
- Intracerebral stroke. This type of stroke is caused by a blood vessel in the brain rupturing and leaking blood.
- Subarachnoid stroke. While in intracerebral stroke the ruptured vessel is inside the brain, in the subarachnoid stroke the ruptured blood vessel is on the surface of the brain.
Risk factors of hemorrhagic stroke
- High blood pressure. High blood pressure tops the list of risk factors. A pressure maintained at 140/90 mmHg is certainly high and deserves medical attention.
- Aneurysms. Swellings on the walls of the artery which can expand and burst.
- Arteriovenous malformation.
Other general stroke risk factors
Other risk factors of stroke include
- Being obese and overweight.
- Sickle cell disease.
- Bleeding and blood clot disorders.
- Vasculitis which refers to inflammation of the blood vessels.
- Metabolic syndrome.
- High cholesterol.
- Smoking thins the arteries and thickens blood placing it at a high risk of developing clots.
- Overindulgence in alcohol and use of drugs.
- Gender and age. As we have already seen, women are at a higher risk of suffering from stroke compared to men. This is due to the use of contraceptives, pregnancy, use of hormone replacement therapy, as well as migraines and headaches. However, at a younger age, men are more likely to suffer from a stroke. As mentioned earlier, however, stroke symptoms in men remain the same as those in women.
- Family history. Women with a history of transient ischemic attacks are three times more likely to suffer a stroke compared to their male counterparts. Secondly, if you have suffered from TIA before, you are at a higher risk of suffering a stroke.
- More African Americans, Alaskans, and American Indians suffer a stroke than Asian Americans, Whites, and Hispanics.
- Stress and depression.
The link between stress and the risk of stroke
Quite surprisingly, stress and depression have been linked to the high likelihood of stroke. Stress has been linked with a number of stroke risk factors including High blood pressure, obesity and high cholesterol levels, heart disease, smoking, and heavy alcohol indulgence. The more serious the risk factors of stroke the higher the risk of suffering from a stroke.
Stress hormone known as cortisol is known to worsen blood pressure when not dealt with over a long period. These same hormones contribute to diabetes, atherosclerosis, and heart disease. Managing stress can reduce your chances of stroke significantly. Statistically, those with long-term or chronic stress have four times higher chances of stroke attacks.
Here is how to identify stroke F.A.S.T?
Stroke, like any other disease, comes with warning signs. Stroke signs fast detection and early medical intervention can save a life.
However, it’s never easy particularly for the elderly, to remember common stroke symptoms. The National Stroke Association came up with the acronym F.A.S.T, a quick way of how to identify stroke symptoms easily and act early enough by calling 911 for assistance.
F for FACE. if when smiling, one side of the face droops, this could be a sign of stroke.
A for ARMS. Lift both arms, if one tends to lose energy and shift back to your side, this could be a sign of stroke.
S for SPEECH. If when trying to speak the speech is slurred and unclear, this could be a sign of stroke.
T for TIME. Time means immediate action. Call 911 immediately you notice these signs in you or someone else. Getting help in 3 hours or less could save a life, the long term damage of stroke, and allow for fast recovery after treatment.
However, watch out for these stroke warning signs in addition to the ones listed above. These include:
- Numbness in certain parts of the body including weakness in an entire side.
- Blurred or loss of vision.
- Abnormal disorientation and difficulty in speaking.
- Dizziness and loss of balance.
- Unusual intense headache.
Treatment of stroke
Stroke treatment is in two parts. Treating stroke itself and treating the risk factors.
A number of treatment options have been advanced in treating stroke. This is determined by the type of stroke one has suffered and its cause.
Treating ischemic stroke and transient ischemic attack
An ischemic stroke or transient ischemic attack, as we have seen, is as a result of a blockage in the artery that supplies oxygenated blood to the brain. Usually, a doctor will give medication or perform a procedure to remove the clot.
Medication may include drugs that will dissolve the blood clot to give way to blood flow to the brain. This medication is known as tissue plasminogen activator (tPA) which is given via injection into the vein in the arms within 4 hours of detecting the signs of a stroke.
The other alternative to the tPA injection is an antiplatelet drug whose function is to stop further coagulation of platelets to form or enlarge the already existing clot. This is where a doctor may recommend clopidogrel or aspirin drugs.
These medications have also been used for stroke prevention purposes.
Treating hemorrhagic stroke
Because hemorrhagic stroke involves blood leaking into the brain, the first and most crucial step is to identify the point and cause of bleeding and manage it. Secondly, a doctor may perform surgery to repair the ruptured artery. Note however that blood thinners and medicines that stop the coagulation of platelets are not recommended when treating hemorrhagic stroke as they only aggravate the situation.
Treating the risk factors of stroke
Risk factors are treated to prevent complications during treatment and the occurrence of future stroke cases wherever possible. These risk factors include:
- Transient ischemic attack. TIA is treated with aspirin or clopidogrel medication which works well to keep the arteries free to allow for the free flow of blood in addition to preventing blood from clotting. Secondly, finding the cause of the attack will be helpful in preventing strokes in the future.
- Atrial fibrillation is treated with anticoagulant medications like warfarin and dabigatran because of an irregular heartbeat.
- Atherosclerosis is treated through carotid surgery to correct the narrowing of the carotid artery which is a common stroke risk factor.
- High blood pressure is treated with medication intended to lower the blood pressure.
- An aneurysm is addressed through aneurysm clipping and coil embolization processes to stop blood from leaking into the brain and prevent it from rupturing again.
- Arteriovenous Malformation (AVM) repair through surgery, radiation, or injection.
The don’ts if someone is having a stroke attack
- A stroke should be treated as an emergency by calling 911 or getting an ambulance to transport you to the hospital. This is because in an ambulance you will receive professional emergency stroke treatment on your way to the hospital. Never drive to the hospital yourself or get someone else to drive you there.
- Do not attempt to give stroke victims food or drink. Let treatment be the very first priority.
- While aspirin helps in some cases, it may not be the best remedy. Hold off giving aspirin until you get a recommendation from the doctor.
6 Tips to help you deal with controllable stroke risk factors
Controllable risk factors like obesity and smoking have much to do with a lifestyle change. Here are some things that are within your power to control in addressing the risk factors linked to stroke. They will help you recover from stroke and prevent or delay future attacks.
Smoking makes your blood thicker making your blood highly likely to clot. Quitting smoking may not be a one-step process but a progressive one. All the same, make sure you are making every effort to do so.
Consider joining support groups, programs, or having counseling sessions to facilitate the process. In addition, aids like nicotine pills, patches, or gums, Zyban, and Champix which will help you quit smoking gradually and consistently.
Watch your weight
If you are overweight, consider shedding off some weight to a BMI between 18.5 and 25. Alternatively, work out a weight loss plan that will help you trim some weight. This is because obesity and its effects including diabetes and high blood pressure are all top stroke causes. Engage in exercises like walking, jogging, swimming, cycling, or others on a regular basis.
Apart from losing weight, working out helps you to build and strengthen your bones and muscles while reducing your chances of suffering stroke and other chronic diseases. By boosting your energy levels, exercise also helps your entire system function optimally. Simple walking or jogging routine will do the trick. Try and exercise regularly at least three to five days a week.
Oversalted, fat-loaded high-cholesterol and sugary foods all put you at risk of high blood pressure. Check that your diet includes fruits, vegetables, plant proteins, low-fat dairy and ensure that your blood pressure is maintained at 135 / 85 or less.
Make it a habit to eat foods like fish, chia seeds, and eggs which are rich in omega 3; blueberries, tomatoes, nuts, seeds, avocados, and beans for a balanced diet; as well as whole grains, poultry, olive oil, vegetables, and a little wine for the health of your mind.
Use relaxation techniques and others to lower your stress levels. If you notice things getting out of hand, engage a counselor.
A little alcohol may be good for your health. Too much of it and you put yourself at a higher risk of stroke. If you are struggling to stick to one glass a day, try and avoid alcohol altogether.
The aftermath of stroke treatment and their remedies
It may take a while before you fully recover from stroke and the effects of its treatment. You may notice the following effects but don’t panic. With the right attitude and remedy, you will soon be out of it while also preventing a recurrence. Note that grave stroke attacks may leave some people with permanent disabilities. However, your doctor should be able to advise you accordingly.
- Language and speech. Just as speech is affected by stroke, it may take some time before you can speak and communicate well again. With the help of a speech therapist, you should be able to talk, communicate, and enhance your memory with time. A speech therapist will also recommend a good diet if you experience feeding and swallowing challenges.
- Bladder and bowel function. For affected muscles and nerves around the bladder and bowel area, the medication should be the better option.
- Muscle and nerve health. If the stroke will have affected an entire side of your body, it may weaken your muscles. Consider physical or occupational therapy to help reconstruct and strengthen your muscles in order to resume performing normal day-to-day activities.
- Emotional health. There is much frustration that goes with not being able to do things like you used to and the fact that you will have to be dependent on others to help. Secondly, if the process of recovery is slower than you expected, you may end up being stressed. Seek emotional support from counselors, patient support groups, family, or friends to prevent stress as it is also associated with stroke.
Stroke can be treated especially if detected and treated early enough. But stroke prevention and delaying of its occurrence by living a healthy lifestyle are far better than going through treatment. The usual healthy principles apply, eat well, exercise, be active, manage stress, stop smoking, and drink moderately. This way, you will not only be preventing stroke but also other diseases.
While some risk factors like age, family history, and gender that may be beyond your control, it helps to inform your doctor about them. This will put him in a better position to recommend ways through which you can lower these risk factors while at the same time preventing a stroke. Secondly, take note of transient ischemic attacks since they are also risk factors for stroke. Finally, know yourself and what is affecting you most and deal with it.