STROKE- Prevention and Early Recognition

A stroke or a cerebrovascular accident (CVA) is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain. The disturbance can be due to two particular reasons:

1. Ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism)

2. Hemorrhage (leakage of blood).

Both these incidences lead to the inability of the affected area of the brain to function, which might result in an inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or an inability to see one side of the visual field

Ideally the treatment of Stroke uses a multi dimensional array of professionals and expertise.

For a stroke patient TIME = BRAIN

In a patient who has suffered a brain attack or a stroke every minute counts. Permanent neurologic damage is more likely to occur the longer a stroke goes untreated. The Golden Hour in medicine describes the magical window of time that can determine whether a patient lives or dies. For a stroke patient the first hour is most important wherein he should receive complete treatment to prevent neurological damage.

Initial treatment varies according to the cause of the stroke. An ischemic stroke is occasionally treated in a hospital with thrombolysis (also known as a "clot buster"), and some hemorrhagic strokes benefit from neurosurgery. Treatment to recover any lost function is termed stroke rehabilitation, ideally in a stroke unit and involving health professions such as speech and language therapy, physical therapy and occupational therapy.

Therapy plays an important role in helping a stroke patient recover. The sessions with a physiotherapist should start as soon as possible and should include passive and active exercises to maintain range of movement, recover strength and to attain normal gait and functions. Occupational therapists work on the functional impact of the disease and assist the patient in retaining his activities of daily living. The speech therapist works on patients that end up having speech alterations. Bringing a patient back from a stroke requires team effort and every health care provider plays a major role. The patient and his family interaction has to be motivational for quick recovery. A time frame of 6 months post stroke gives maximum result and recovery is generally seen up to 18 months.

Prevention of recurrence may involve the administration of antiplatelet drugs such as aspirin, control and reduction of hypertension, and the use of statins.

Stroke could soon be the most common cause of death worldwide. Stroke is currently the second leading cause of death in the Western world, ranking after heart disease and before cancer, and causes 10% of deaths worldwide.

The incidence of stroke increases exponentially from 30 years of age, and etiology varies by age. Advanced age is one of the most significant stroke risk factors. 95% of strokes occur in people age 45 and older, and two-thirds of strokes occur in those over the age of 65. A person's risk of dying if he or she does have a stroke also increases with age. However, stroke can occur at any age, including in childhood.

Immediate Symptoms

· The symptoms of stroke depend on what part of the brain is damaged. In some cases, a person may not know that he or she has had a stroke.

· Symptoms usually develop suddenly and without warning. Or, symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse.

· A headache may occur, especially if the stroke is caused by bleeding in the brain. The headache:

o Starts suddenly and may be severe

o Occurs when you are lying flat

o Wakes you up from sleep

o Gets worse when you change positions or when you bend, strain, or cough

o Other symptoms depend on how severe the stroke is and what part of the brain is affected.

Symptoms may include:

· Change in alertness (including sleepiness, unconsciousness, and coma)

· Changes in hearing, taste

· Changes that affect touch and the ability to feel pain, pressure, or different temperatures

· Confusion or loss of memory

· Difficulty swallowing, writing, reading

· Dizziness or abnormal feeling of movement (vertigo)

· Lack of control over the bladder or bowels

· Loss of balance and coordination

· Muscle weakness in the face, arm, or leg (usually just on one side)

· Numbness or tingling on one side of the body

· Personality, mood, or emotional changes

· Problems with eyesight, including decreased vision, double vision, or total loss of vision

· Trouble speaking or understanding others who are speaking

· Trouble walking

STROKE RISK FACTORS

· High blood pressure is the number one risk factor for strokes. The other major risk factors are:

o Atrial fibrillation

o Diabetes

o Family history of stroke

o High cholesterol

o Increasing age, especially after age 55

o Race (black people are more likely to die of a stroke)

I read this on facebook today (shared by Takuya Umeki) and she deserves a special thanks for it.

STROKE IDENTIFICATION:

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke...totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

RECOGNIZING A STROKE

Remember the '3' steps, STR . Read and Learn!

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster.

The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.

Now doctors say a bystander can recognize a stroke by asking three simple questions :

S * Ask the individual to SMILE ..

T * = TALK. Ask the person to SPEAK A SIMPLE SENTENCE (Coherently)

R * Ask him or her to RAISE BOTH ARMS .

If he or she has trouble with ANY ONE of these tasks, call the ambulance and describe the symptoms to the dispatcher.