Stroke: Diagnostic, Cause and Treatment

A stroke, or cerebrovascular accident, happens when the blood flowing to the brain is disrupted by a blockage or bleeding, preventing the brain from getting oxygen and nutrients from the blood. As a result, brain cells begin to deteriorate which leads to permanent brain damage.

Stroke can be specified into two types

• Ischemic Stroke is a stroke caused by a sudden blockage of an artery, which is a result of atherosclerosis, a plaque buildup within the blood vessels, or blood clots that break loose and travel to the brain. If this blockage breaks up before making any damage, it is called a Transient ischemic attack (TIA) or “Mini-Stroke”. 

Also, chronic inflammation contributes to ischemic stroke, and ischemic stroke itself could lead to further inflammation, which also damages brain cells.

• Hemorrhagic Stroke is a stroke caused by bleeding within the brain, as a result of an aneurysm, Arteriovenous malformations (AVMs), or high blood pressure which all leads to sudden damage to vertebral arteries.

Why is Stroke dangerous for all ages?

Although the majority of people who suffer from stroke are the elderly, research shows strokes are on the rise among younger people under the age of 45. A stroke can happen to anyone, and it will permanently damage your brain cells which leads to many complications related to brain functions including

• Swelling in the brain due to fluid build-up
• Seizure
• Risk of Dementia
• Problems with speaking, language, thinking, and memory
• Loss of vision, hearing, or touch
• Problems with swallowing and risk of pneumonia
• Loss of bladder or bowel control
• Loss of bone density or strength
• Muscle weakness or inability to move
• Dangerous blood clots

The severity of these complications is based on the deterioration of the brain cells, which means the after-effects of stroke can range from a loss of memory to long-term disability, or even death.

What causes a stroke? and Who is at risk? 

The cause of stroke is mainly related to cardiovascular problems, including high blood pressure, diabetes, high cholesterol levels, and other diseases related to blood clots or blockages in the arteries. Patients with brain aneurysms or arteriovenous malformations (AVMs) likewise suffer a higher risk of hemorrhagic stroke.

About 10 percent of strokes occur in children and adults under age 45. Men are more likely to have a stroke than women, except for women who take birth control pills or hormone replacement therapy, and women during pregnancy or weeks after giving birth are also at higher risk.

Genetics also determine the risk of stroke, as certain genes including those that determine your blood type is related to the risk of having a stroke. If a parent or other family member has had a stroke, particularly at a younger age, the greater chance of yourself suffering from a stroke too.

Other factors affecting the risk of stroke including 

• unhealthy habits, including drugs and alcohol
• overweight and obesity
• anxiety, depression, and high stress
• blood thinners or medicines that led to bleeding
• other medical conditions such as sleep apnea, migraine headache, bleeding disorder, and sickle-cell disease

If you are having many of these factors, these are the signs of a stroke or TIA 

• Sudden numbness or weakness, especially on one side of the body
• Sudden confusion or trouble speaking or understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, or loss of balance or coordination
• Sudden severe headache with no known cause

Most of them often develop quickly, but some can develop over hours or even days

If some of these happen to you, quickly self-assess using the F-A-S-T test

F – Face: Does one side of the face droop after a smile?

A – Arms: Does either arm drift downward after raising them both?

S – Speech: Is there slurred speech or unable to say or repeat a simple phrase?

T – Time: If one of these occurs, call an ambulance as soon as possible. 

During a stroke, every minute counts. Early treatment is essential to save your life and minimize brain damage. 

Treatment and Recovery from Stroke

The doctor would diagnose a stroke based on your symptoms, your medical history, and diagnostic test – mostly by using Computed Tomography (CT) and Magnetic resonance imaging (MRI) to allocate bleeding, change in brain tissue, or damage to the brain cells.

As a result, treatment will be based on the severity of the stroke, using both medicine and or medical procedures. For ischemic stroke, a tissue plasminogen activator (tPA) or anticoagulant will be used to break up the blood clots. If the medicine is ineffective, thrombectomy using angioplasty and stent placement is needed to be done to open up blocked arteries and resume circulation. Surgery to cure carotid artery disease or congenital heart defect may need to minimize the risk of blood clots and plaque buildup.

For hemorrhagic stroke, blood pressure medicine is needed to relieve the pressure and strain on the blood vessels, and vitamin K also needs to stop bleeding. Most hemorrhagic strokes need an operation for aneurysm clipping to block off the aneurysm from the blood vessels in the brain, or coil embolization to block blood flow to or seal an aneurysm. Some would need drainage of excess fluid, or surgery to remove an arteriovenous malformation (AVM).

After the treatment, it can take weeks, months, or even years to fully recover from a stroke. Lifestyle change is essentially needed for recovery and prevention from another stroke. Routine medical care is also important, taking all prescribed medicine regularly is a must. Some would need rehabilitation and mental health support to recover from brain damage.

However, the threat of brain damage and its side effects can be minimized by acting fast. That’s why our Mobile Stroke Unit, only available at Phyathai 1 International Hospital, plays a major role in our treatment of a stroke patient, as we can diagnose the severity of stroke during transport to the hospital, making our team at Neurology Center respond and give immediate and appropriate treatment.

If your face is drooping, your arms are drifting down, or your speech is slurred, you’re at a high risk of having a stroke. Call Phyathai Hotline at 1772 press 7 for Stroke Ambulance or 02-201-4600 Ext 2148 for International Relations Center or your local ambulance number as soon as possible.