What is a stroke?
Stroke is restricted or interrupted blood supply to the brain. Stroke can occur when blood vessels within the brain get blocked or rupture. Lack of oxygen supply to the brain kills brain cells. Strokes can be fatal and in some cases, a person may enter the state of coma immediately after a severe stroke.
What are different types of strokes?
There are three different types of strokes-
- Ischemic stroke
- Transient ischemic attack
- Hemorrhagic stroke
What is Ischemic stroke?
- Ischemic stroke occurs when blood vessel within the brain gets blocked
- Hence, blood flow to brain is obstructed
- This blockage is caused because of fat deposits in the inner lining of blood vessel walls
- Condition wherein blood vessel gets blocked because of fat deposits in it is called atherosclerosis
- These fatty deposits can cause two types of blockages- cerebral thrombosis and cerebral embolism
- In cerebral thrombosis, there is a blood clot (thrombosis) in cerebral sinus region of the brain
- Cerebral embolism is blockage (fat, air and plaque) in blood vessel of the circulatory system. This blockage obstructs blood supply to the brain.
- It is most commonly occurring type of stroke amongst the three types of strokes
What is transient Ischemic attack?
- Transient Ischemic Attack (TIA) is a temporary stroke caused because of transient (temporary ) blockage in the blood vessels
- Some of the clots dissolve on their own while some don't. Scientists don't know the precise reason behind this. Generally, clots that exist for longer period of time, do not dissolve easily.
- It is commonly referred as mini stroke
- Average time period of TIA is one minute, while some of them last for over three-five minutes
- This stroke serves as warning and one must take it very seriously
- TIA does not cause permanent injury to the brain
What is hemorrhagic stroke?
- Hemorrhagic stroke occurs when weak blood vessel ruptures
- This causes blood to leak in surrounding areas and compresses other blood vessels and tissues
- Aneurysm is a condition in which weakened part of the blood vessel is swollen or ballooned. If it is left untreated, it can get weaker and ultimately burst out causing bleeding in brain.
- Cluster of abnormally developed blood vessels leads to the condition of Arteriovenous malformation. Any of these blood vessels can burst causing bleeding in the brain.
- Hemorrhagic strokes are of two types- Intra-cerebral and sub-arachnoid hemorrhage
- Intracerebral hemorrhage (ICH) is a life-threatening type of stroke caused by bleeding of brain tissue
- Sub-arachnoid condition occurs in fetus and may cause miscarriage depending upon mother's age and fetus' gestation age
What is atherosclerosis?
- Arteries are blood vessels that supply oxygenated blood from heart to different parts of body
- Arteries further divide into capillaries that reach out to each and every cell of the bodyHere, nutrients and oxygen from the blood are supplied to the cell and waste materials from the cell are exchanged into the blood.
- Blood now becomes impure and de-oxygenated
- Capillaries join together to form vein-lets and vein-lets combine further into veins
- Veins carry de-oxygenated blood or blood that is deprived of oxygen from different parts of the body to the heart for purification
- When plaque builds up in the arteries, it interrupts blood flow to organs. This condition is called atherosclerosis. Plaque consists of cholesterol, fats, calcium and other substances found in blood.
- Atherosclerosis can result in stroke and other fatal disorders
What are the symptoms of stroke?
If any of the symptoms mentioned below are consistent for even short period of time, it is best to consult with doctor for diagnosis. Some common symptoms of stroke are enlisted here:
- Severe headache along with vomiting or altered consciousness
- Vision trouble
- Difficulty in speaking and understanding
- Trouble with activities related to co-ordination like walking, reading etc.
- Numbness in face, arms or in one side of the body
What are the symptoms of Ischemic stroke?
- Intense headache
- Numbness on one side of body
- Vision loss in one or both eyes
- Trouble in speaking and understanding
- Decrease in consciousness level
How is Ischemic stroke diagnosed?
Ischemic stroke can be diagnosed by using various techniques such as CT Scan, MRI etc.
- CT scan: X-ray pictures of skull and brain are taken using Computed Tomography (CT) Scan machine. Patient is made to lie on a table that slides down into a tunnel-like device. The inside of this machine rotates and takes several X-ray pictures of brain from different angles. This enables the doctor to detect the presence blockages or clot inside the brain.
- MRI Scan: Unlike CT Scan, MRI (Magnetic Resonance Imaging) technique does not use X-rays for imaging purposes. It makes use of radio waves and magnetic field to get accurate pictures of brain anatomy. It is highly effective in taking soft issue images and can show minute differences between similar areas. Patient is made to lie on a table and slided into the opening of MRI machine. The images assist doctors in identifying clots, blockages and tumors.
- Cerebral Angiogram: A thin, flexible tube called as catheter is inserted into groin through a small incision. It is further glided up to vertebral artery. A dye is injected into blood vessels for better view of arteries under X-ray imaging.
- Carotid Ultrasound: Carotid ultrasound test helps in identifying plaque build up and flow of blood in carotid arteries. It uses sound waves.
Doctors may ask to do either single test or combination of tests for better analysis and interpretation.
What are the symptoms of Transient Ischemic Attack?
Transient Ischemic Attack lasts for a very short duration and symptoms generally vanish within an hour. Symptoms of Transient Ischemic Attack are enlisted here:
- Facial paralysis or feeling of numbness in one side of body
- Double vision or loss of vision in either of the eyes
- Loss of concentration and co-ordination
- Difficulty in speaking
How is Transient Ischemic Attack diagnosed?
Since Transient Ischemic Attack (TIA) is a short-lived stroke, doctors generally diagnose it by asking more about the event, family history, rather than neurological examination. However, some doctors may recommend you to undergo certain tests like CT Scan, MRI Scan etc. (Refer Question 9)
What are the symptoms of Hemorrhagic stroke?
Hemorrhagic stroke is a type of stroke in which blood vessel ruptures. This causes blood to leak in the organ, thereby compressing other blood vessels and affecting blood pressure. Since it can be a fatal kind of stroke, symptoms or early signs should be taken seriously and must not be ignored. Few symptoms of hemorrhagic stroke are enlisted here:
- Sudden and severe headache
- Loss of consciousness
- Numb feeling on one side of body
What are the diagnostic tests for hemorrhagic stroke?
Hemorrhagic stroke is caused due to rupture of blood vessel in brain. It also includes some common tests like MRI Scan, CT Scan etc. However, doctors may suggest some other diagnostic tests to detect hemorrhagic stroke. (Refer question number 9)
Is stroke genetic?
Many studies have revealed that people with family history of stroke, are at higher chances of suffering from brain stroke. This applies not only to stroke, but also to other diseases such as diabetes, high blood pressure, cancer etc. So if you suffer from any of symptoms of stroke, you must not delay your appointment with doctor. It is always better to get diagnosed by doctor early, than to regret later.
What are the causes of stroke?
Stroke occurs when supply of blood (oxygen supply) is restricted or when a weak blood vessel tears out.
- Lifestyle, genetics and other factors have influence on our overall well-being and health. Alterations in healthy lifestyle may increase chances of stroke.
- People who live sedentary lifestyle may also suffer stroke
- Alcohol and smoking are two demons that gradually kill you. Over consumption of alcohol has hazardous effect on bloodstream. People have reportedly been told to quit smoking as it poses serious threat to health. It not only sows a seed of stroke, but also a bunch of other diseases.
- High blood pressure is another cause of stroke. As the name suggests, more pressure is build up against walls of blood vessels that make weak blood vessel to rupture. This causes hemorrhage.
- Obesity leads to accumulation of fat deposits in blood stream that can block passages of blood vessels.
- Genes too can be blamed for stroke. If any of your family member or close relative has had history of stroke, then you might as well suffer from stroke. So take precautions from beginning.
Who are most likely to have stroke?
There are certain factors attributed to risk of stroke. The more risk factors you develop or are living with, more are the chances of stroke. Let us study what factors make you prone to stroke.
- Genetics: If any of your family member or close relative has suffered from stroke, then your chances of developing stroke are also increased.
- High Blood Pressure: People suffering from high blood pressure are at risk of developing stroke. High blood pressure can cause rupture of weak blood vessels that results in condition of hemorrhage. High blood pressure when left untreated may also lead to paralysis. Hence, high blood pressure patients must never ever miss any medication prescribed by their doctor.
- Smoking: Smoking is one of the leading causes of brain stroke. This habit damages blood vessels and increases blood pressure. Smoking also prohibits oxygen delivery to cells. Lungs of people who smoke are blackish-brown in color due to accumulation of toxic chemicals in it. As a result, lungs are not able to carry out their function with ease.
- Gender: Women, especially who take birth control pills, are more likely to suffer from stroke. At younger ages, men are more prone to suffer from stroke.
- Age: Older one gets, higher are chances of brain stroke.
- Ethnicity and race: African-American, native Alaskan people and American-Indian people are more likely to be diagnosed for stroke.
- Alcohol and drug use is another major cause of brain stroke
- Obese individuals
What are the treatments for stroke?
Treatment for stroke depends on what kind of stroke you suffered from.
- Aspirin: Aspirin is given as immediate treatment right after stroke to prevent occurrence of another stroke. It also prevents formation of blood clots and helps in thinning of blood.
- TPA: Tissue Plasminogen Activator (TPA), also called as alteplase, is administered into body in the form of injection via vein in the arm. It must be injected within four and half hours of stroke symptoms. TPA dissolves clot formations, thereby regulating blood flow. It also helps the patient to recover completely post stroke.
- Mechanical clot removal: A tiny mechanical device such as catheter (long, thin tube) is used to break up or remove the clot from brain. It is inserted through a small incision made across an artery in groin region to deliver Tissue Plasminogen Activator (TPA) directly into the area where stroke had occurred. TPA then melts the clot to clear blockage allowing blood to flow easily.
- Carotid endarterectomy: Carotid endarterectomy procedure is effective in reducing Ischemic stroke. Plaque from carotid arteries (arteries that are found on both side of the neck that connect with brain) is removed through this surgical procedure. A small incision is made on front of neck that gives access to carotid arteries. A surgeon then opens up these arteries and removes plaque from it. Artery is then repaired by stitches comprised of a vein section or graft (artificial material). Carotid endarterectomy procedure may not suit people suffering from heart disease or other medical conditions.
- Surgical blood vessel repair: Ruptured blood vessels as in case of hemorrhage are treated by surgical blood vessel repair procedure. Various surgical procedures such as surgical clipping, intracranial bypass, stereotactic radiosurgery, coiling etc. are implemented to treat ruptured blood vessels.
- Surgical clipping: A small clamp is placed at the base of aneurysm. Aneurysm is excessive enlargement of artery caused because of weakness in arterial walls. This small clamp prevents flow of blood to aneurysm, thereby preventing it from bursting. It also prevents re-bleeding of aneurysm that has previously been operated upon.
- Intracranial bypass: Surgical bypass of intracranial blood vessels (blood vessels of brain) is an option to treat poor blood flow to certain region of brain or complex vascular lesions.
- Stereotactic radiosurgery: Stereotactic radiosurgery is a minimally invasive treatment that implements use of highly focused radiation to treat vascular malformations.
What are stroke recovery solutions?
Post stroke treatment, doctor will advise you to go for rehabilitation program. You will be required to stay in the hospital for few days to recover and heal. Rehabilitation treatment counts upon the type of stroke and its intensity. Different types of strokes have different type of rehabilitation procedures. If the stroke has occurred in right side of the brain, your left side gets affected causing speech and language problems. If stroke has harmed left side of brain tissues, movement and sensation on right side of body might get affected.
What precautions should I take to avoid stroke?
Practicing healthy habits right from early age can go a long way to avoid stroke. Some of the precautionary measures that you can follow to reduce the risk of stroke are as follows:
- Eat healthy foods. Incorporate thermogenic or fat burning foods in your diet. Thermogenic foods such as egg whites, chicken, turkey, legumes and beans etc., harness more energy to effectively digest it. As a result, more calories are burned.
- Exercise should be on your priority list. It will help burn fat and maintain your body-mass index.
- Get regular health check-ups done
- Check medical history of your family
- Quit smoking and keep a check on alcohol consumption
- Do mental exercises. Mental health is as important as physical health. Try some memory games and keep yourself active. Learning a new language or musical instrument will help as well.
- If in depression, do not hesitate or feel uncomfortable to consult a psychologist. Talk to your family and friends.
What lifestyle changes can I make to avoid brain stroke?
Adopting a healthy lifestyle not only decreases your chances of stroke, but also increases your longevity by keeping you fit and healthy. Here are some lifestyle changes recommendations that will help in keeping stroke at bay:
- Quit smoking. Yes, you need to quit smoking as it increases stroke chances by two folds. Smoking is anyway not good for your health. It is one of the leading causes of liver cancer. Even passive smoking is hazardous for health.
- Being physically active decreases fat percentage in body, thereby restricting cholesterol deposits in lining of blood vessels. Exercise improves blood circulation and ensures proper blood flow to organs of body.
- Seek emotional support whenever necessary. Consult a physiologist to reduce burden of emotional pain. Give attention to your mental health.
- Reduce stress levels. Life is too beautiful to succumb to pressure and stress levels. Have a feeling of gratitude. Positivity heals stress and releases feel-good hormones.
- Limit intake of trans fatty acids found in fast foods such as burger, pizza, refined flour or maida, bakery items, fried items etc. Trans fatty acids are hazardous to our health as they increase cholesterol amount in body.
- Restrict use of salt. Over-consumption of salt can cause high blood pressure, thereby increasing chances of stroke.
- Take medicines as directed by your physician. If you miss on them, it becomes more complicated to treat stroke.
- Maintain healthy weight. Your weight should be in proportion to your height.
- Regular medical check-ups are advised. Early detection will reduce further complications.
- Blood pressure should be checked on regular basis
- Eat healthy diet comprising of green leafy vegetables and fruits. Limit intake of red meats.
Which exercises should I do to avoid stroke?
Studies have shown that exercises are your best mate to avoid stroke.
- Cardio and aerobic exercises that make you breathe heavy and sweat profoundly are especially more effective to prevent occurrence of stroke. Exercise cuts down fat deposits in body, thereby avoiding atherosclerosis disorder.
- Doing yoga on regular basis not only reduces stress, but also chances of stroke. Asanas (yoga positions) like halasana (shoulder stand), shirshasan (head stand) etc., increase the supply of blood to brain by giving brain tissues a good exercise. Please note that it is always better to perform these asanas under guidance of a yoga teacher or practitioner.
Which exercises to practice post stroke?
Importance of exercise post stroke should not be under-estimated. Of-course you are not expected to put on your running shoes and start high cardio activity immediately after stroke. It is better to start slowly and eventually increase cardio strength.
You can try any cardio activities such as walking, jogging, running, cycling, swimming etc. Walking slowly for at least half an hour everyday in the initial period is more than enough. Please do consult your doctor before you start any cardio exercises.
What diet plan should I follow to reduce risk of stroke?
Diet plays an indispensable role in maintaining overall health. It is recommended to consume balanced diet of whole grains, dals and legumes, fish, low-fat dairy products, fruits and vegetables. Eat at least four to five servings of fruits everyday.
What diet plan should I follow post stroke?
Diet goes a long way in keeping body fit and healthy. Here are some tips for stroke patients to follow. Ask your doctor about diet consultation for enhanced benefits.
- Some stroke patients may experience loss of appetite. For such patients, it is recommended to add more flavors and spices in order to increase palatability quotient of food.
- Choose colorful foods such as carrots, bell peppers, mushrooms, green leafy vegetables, salmon etc. to make food appear visually appealing
- Choose foods that are easy and soft to chew
- Consume diet rich in fruits and vegetables
- Increase protein rich foods in your diet. Post surgery, there is loss of muscle and tissue. To replenish this loss, it is important to consume protein rich foods like eggs etc.
- Limit intake of alcohol
- Eat fiber-rich Foods
What are the costs of stroke treatment procedures in India?
Since treatment for stroke depends on its type and intensity, cost differs procedure wise.