A brain stroke, or stroke, is a medical emergency that occurs when the blood supply to the brain is interrupted or reduced. Brain cells can die within minutes without oxygen-rich blood which can cause severe brain damage or death if not treated urgently.
Strokes pose a significant health risk across India, impacting all age groups. As per research, almost 1.8 million individuals in India endure strokes annually. Knowing the types of strokes, their symptoms, how they can be diagnosed, and treatment options will enable you to be proactive, which in turn could save a life.
1. Ischaemic Stroke
Ischaemic stroke is the commonest type of stroke and it constitutes around 85\% of strokes. It occurs when a blood clot blocks or constricts an artery that supplies blood to a particular region in the brain. This may result from fatty deposits (plaque) forming in the blood vessels, a condition known as atherosclerosis.
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Common Symptoms
- Numbness or weakness of the face, arm, or leg, especially one-sided
- Difficulty in speaking or listening
- Blurred vision or losing vision in one or both eyes
- Sudden intense headache
- Loss of coordination or balance
Diagnosis
In order to confirm an ischemic stroke, doctors conduct several tests:
- Using a CT scan or MRI to check for blockages or damages
- Conducting Carotid ultrasounds to assess blood flow in the neck arteries
- Examining the blood with blood tests to assess clotting and other indicators of health
- Using an ECG or Echocardiogram to assess the functioning of the heart as heart issues cause the formation of clots
Treatment
The goal of treatment is to restore blood flow to the brain by dissolving/ removing the blood clot:
- Giving clot-busting drugs (within 3 to 5 hours)
- Use of non-steroidal anti-inflammatory drugs or blood thinners like aspirin to prevent future clots
- Clot removal surgery in some cases
- Lifestyle changes and rehabilitation including using physiotherapy and speech therapy alongside changing diet
2. Haemorrhagic Stroke
A type of stroke that occurs when the blood vessels in the brain rupture due to weakness is called haemorrhagic stroke. It leads to bleeding either on, in or around the brain
This subtype of stroke is least frequent; however, it poses a higher threat to life.
The following can cause the bleeding:
- Chronic Hypertension
- Brain Aneurysm
- Trauma to the head
- Taking anticoagulant drugs
Common Symptoms
- Extreme headache (an frequently comes across the term “the worst headache ever”)
- Vomiting or nausea
- Partial paralysis or weakness in a particular region of the human body
- Convulsions
- Trouble in communicating or comprehending
- Confusion or unresponsiveness
Diagnosis
- CT scan or MRI; check for intracranial hemorrhage
- Cerebral angiography; assess the blood supply in the brain
- Lumbar puncture (spinal tap) too look for blood in the cerebrospinal fluid in exceptionally rare conditions
Treatment
The objective is to maintain control over the bleeding and minimize pressure on the brain.
- Undergoing a medication that can control high blood pressure
- Anticonvulsant or antiepileptic medicines
- Surgical procedures to assist in restoring ruptured blood vessels or evacuating the blood
- Clipping or coiling; procedures to treat aneurysms
Providing care often involve long term recovery through physiotherapy, occupation therapy, and speech rehabilitation.
3. Transient Ischaemic Attack (TIA) – Mini Stroke
A TIA, or Transient Ischemic Attack, is frequently referred to as a “mini-stroke.” It occurs when blood flow to the brain is temporarily cut off. The symptoms are similar to those of a complete stroke but “mini-strokes” only last a few minutes to hours and completely resolve within 24 hours.
Though TIAs do not cause lasting damage, they are warning signs of impending strokes. Therefore, these should always be taken seriously.
Common Symptoms
- Sudden face, arm, or leg numbness or weakness
- Difficulties with speech, either intelligibility or comprehension
- Uncontrollable undue spinning or loss of balance
- Vision loss, even if temporal
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Diagnosis
Act fast if help is sought since the symptoms often fade:
- MRI scan or CT as a check to identify full stroke
- Ultrasound of the carotid alongside scans of the heart to establish causation
- Testing blood sugar alongside cholesterol and clotting
Treatment
Preventing another episode is the primary treatment goal:
- Aspirin or other blood thinners
- antihypertensives together with diabetes and cholesterol medications
- adjustment of lifestyle habits such as cessation of smoking, healthy eating, and exercise
- Severe case of blockage in neck arteries might mandate surgery or stenting
Conclusion
If ever you feel the signs of a stroke, or know someone who does, reacting instantly can greatly improve the chances of quicker recovery.
Written by: Dr. Mahendra M
MBBS, MS – General Surgery, MCh – Neuro Surgery
NeuroSurgery
