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What is stroke

The term stroke encompasses all cerebrovascular diseases due to interruption, temporary or permanent, of the blood supply to any part of the brain that appear suddenly.
The brain, like any other organ, receives blood for its operation through the arteries. They feed it with oxygen and glucose, which are the main food of the brain. When blood flow ceases to reach any area of the brain, they can alter the functions in that area, temporarily if the irrigation has recovered instantly; or permanently, if the flow is stopped during an important time and brain cells have been damaged.
The stroke has come to be considered one of the leading causes of death in developed countries. In fact, in women is the first cause; and men second, behind myocardial infarction. Are considered health priority; and they are the most common reason for admission to any service of Neurology.
Stroke is also the first permanent, physical and intellectual disability. and the second cause of dementia after Alzheimer's disease.

Types of stroke

Types of stroke they can be classified according to the vascular phenomenon that has caused them. Mainly, distinguished two main types of stroke: ischemic stroke and hemorrhagic stroke.

Ischemic stroke: stroke and TIA

This type of stroke is the most common. Occurs when the stuffiness of the artery, preventing blood to reach an area of the brain. When this occurs, or oxygen or nutrients arrive and cells suffer an injury. It is what is known as cerebral ischemia; and if the lack of blood supply is prolonged, cerebral infarction occurs. In this case, the tissue is already dead. Occlusion may be due to thrombus, the presence of a tumor that compress the artery, or a clot (usually sent from the heart).
When the flow is not blocked during an important time period, this type of attack are known as transient ischemic accident (TIA). It usually takes a few minutes; as a result, are usually valued by the doctor when they have gone. The symptoms are varied, depending on the area of the brain that has been exempt from watering (see stroke symptoms), and the risk factors are the same as in cerebral infarction. This type of attack, although they revert spontaneously, should be evaluated by a neurologist, it is important to know if the brain tissue has been damaged, and since people that have undergone AIT are more likely to end up suffering a longer ischaemic stroke in time, cerebral infarction and death in a part of the brain.

Hemorrhagic stroke

In this case, less often, the problem is the rupture of an artery, which can be intracerebral (from within the brain) or the surface of the brain (about layers that surround it, the meninges). In the first case, the cause is often associated with high blood pressure in the artery (which breaks and produces the intracerebral hemorrhage) and, less frequently, by malformations in vessels; in the second, it is more common that the cause is a head injury (a blow or fall), or an expansion of the artery (aneurysm), which makes the artery wall may not expand more and break, releasing the blood into the space between the brain and the meninges (subarachnoid hemorrhage). This blood, as well as not nourish brain cells, can create pressure on it, causing damage. These damages are usually more severe than those produced by the ischemic stroke. Some infections of the brain, certain tumors, and the consumption of certain drugs, can also cause bleeding.

Risk factors for a stroke

They are mainly associated to age, sex, race, and family history. Obviously, these stroke risk factors cannot be avoided; Although people who are in these groups, they can benefit from more rigorous controls of the modifiable risk factors described in the section on prevention.
  • Age: according to numerous studies, the age of 55, the occurrence of stroke is more common. Since that age, for every 10 years, the risk is multiplied by two. and after 75 years of age, is already the leading cause of deaths vascular age and decade Strip (source: clinical practice guidelines on primary and secondary prevention of stroke, Ministry of health, 2009).
  • Sex: in women, death from cerebrovascular disease is more frequent. This is explained because older, more likely to suffer an attack; and on the fringes of advanced ages dominated by women, by their longer life expectancy.
  • Race: seems to be that people of black and Hispanic race are more likely to suffer a stroke. Although it is believed that it might be the black people are more prone to high blood pressure and diabetes, it seems clear that these factors explain the high incidence of stroke in certain breeds.
  • Family history: if someone in your family of stroke and cerebrovascular disease patients, has increased risk of any type of stroke, in part by the genetic heritage of some of the risk factors.

Symptoms of a stroke

The symptoms of a stroke can vary considerably depending on the region of the brain that has been free of blood. This largely hampers the acknowledgment of the attack. However, in general, almost all strokes are studying with, at least, some of these symptoms, sudden appearance:
  • Abrupt disorder of sensation in the face, arm or leg on one side of the body.
  • Sudden muscle weakness on one side of the body.
  • Difficulty speaking or understanding what is being said.
  • Disorders of vision.
  • Loss of balance.
  • Headache of sudden appearance and a high, unlike the usual intensity; that can be accompanied by nausea and vomiting, loss of consciousness or coma, if it is a very serious attack. Most important thing in strokes by hemorrhage.
If there is one (or more) of these symptoms, should immediately call emergency medical phone, trying to keep calm, and indicating to staff the symptoms the person in the most accurate manner possible.
Diagnosis of a stroke
Largely, the symptoms the patient will indicate the possibility of stroke to the neurologist. Physical examination may be useful for the doctor suspected of what area of the brain is affected (although alarm symptoms very similar, there are very specific symptoms depending on the different areas of the brain that may be damaged).
Advances in diagnostic imaging will allow to confirm the suspicion of stroke and type; as well as know the severity of it and the area of the brain affected. If the neurologist suspected cardiac cause (clot), you may request a consultation to cardiology to treat the problem jointly.

Treatment of a stroke

In general, establishes that the stroke should be treated in less than three hours by the team of neurologists for a good prognosis. To do this, doctors can try to inject medications that dissolve the clot or thrombus and retrieve blood flow, in case of an ischemic stroke (by plugging).
In the case of hemorrhages, it may be more complicated; and it is possible that the patient required surgery or catheterization to repair the damaged artery, if there is no suspicion that can repair itself; or to remove the hematoma that presses the brain. Not all bleeding require surgical treatment. Some can benefit from drug treatment to prevent bleeding to continue.
Rehabilitate a stroke
It is common, after some major stroke, the patient should go to rehabilitation, especially if it has come to cause infarction (death) of any region of the brain, since there is to get as far as possible to another area of the brain pass to control the functions that formerly controlled the area.
Usually, the rehabilitation should begin as soon as the patient is stable. Doctors, nurses and physiotherapists are the multidisciplinary team that will try to help the patient recover altered functions.
Prognosis of stroke
It is very difficult to establish a prognosis for stroke. As you have seen, will depend greatly on type stroke in question and the time that has been brain tissue without receiving blood; in the affected area; of age, sex, and race of the patient; and their own ability to recovery.
Advances in diagnosis and treatment have been fundamental; and the control of risk factors is vital to prevent the emergence of a first stroke (primary prevention) or a relapse (secondary prevention).

Stroke prevention

Stroke prevention, in many cases, is trying to eliminate certain modifiable risk factors of daily life. The most important, traditionally, are:
  • Smoking.
  • Excessive consumption of alcohol.
  • Uncontrolled arterial hypertension.
  • Diabetes.
  • High cholesterol.
  • Obesity.
  • Sedentary lifestyle.
  • Diets rich in salt and fats.
  • Some pathologies of heart arrhythmias or myocardial infarctions, which can send clots of blood to the arteries of the brain, by dabbing them (ischemic stroke by stroke).
  • Atherosclerosis (fatty deposits in the vessels which, to let go, can act as a plug in the artery).
How many more listed risk factors a person, the greater the risk of suffering from a stroke; for this reason, many more risk factors can suppress or control (in the case of diseases), the lower the likelihood of attack.
Published for educational purposes
Health and Wellness

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