What is stroke?

Find out below.

General

Stroke is one of our most common diseases today. Its the third most common cause of death and the most common cause of permanent disability in industrialised countries. Because stroke is a life threatening condition the affected person need immediate treatment to reduce the risk for severe brain damages or death. Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability.

Cause

Stroke is a collection name for ischaemic stroke and haemorrhagic stroke.  

A stroke occurs either when the blood flow in an area in the brain is cut off by a blood clot in a blood vessel (ischaemic stroke) or when a blood vessel in the brain or at the brain surface breaks (haemorrhagic stroke). 

About 85% of all strokes are ischemic and the remaining part haemorrhagic. 

Two different types of stroke 

Ischaemic stroke is when the blood supply to the brain stops. This can happen in two different ways:

Embolic stroke is when a blood clot forms somewhere in the body and travel through the bloodstream to the brain. When it arrives to the brain, the clot travel to a vessel that’s too small to pass and gets stuck. Then it’s in the way for the blood and the blood stops.

Thrombotic stroke is when the blood can’t pass through the arteries because of a plaque. Plaque is a cholesterol laden that sticks to the inner wall of the artery. Over time plaques can increase in size and narrow or block the artery and stop the blood from getting through.

In both above cases the brain cells don’t receive any oxygen, (ischaemi) and can’t function normally. In this state, the cells start to die in the surrounding area and a swelling occurs which can lead to death. In the ischemic area the tissue is damaged forever but the surrounding area can be saved if the person comes immediately under hospital care. 

Hemorrhagic stroke is less common then ischemic stroke but much more deadlier and severe. Also hemorrhagic stroke can happen in two different ways:

Intracerebral haemorrhage is when the blood leaks out within the brain.

Subarachnoid haemorrhage is when the bleeding occurs at the brain surface.

When the above happens the delivery of oxygen to the brain also stops. Bleeding in the brain can have many causes. The most common is that a blood vessel is weakened because of high blood pressure or arteriosclerosis. The symptoms are headache, nausea, vomiting and reduced or even lost consciousness.

Symptoms 

The symptoms often come very sudden. The most common symptoms of stroke are:

  • Weakness or numbness of the face, arm or leg one of side of the body.

  • Loss of vision in one or both eyes.

  • Loss of speech, difficulty talking or understanding what others are saying.

  • Sudden, severe headache with no known cause.

  • Loss of balance or unstable walking.

Because its important to act fast if a person has a stroke, there are few simple questions called the F.A.S.T. test:

Face: Check their face. Has their mouth drooped?

Arms: Can they lift both arms?

Speech: Is their speech slurred? Do they understand you?

Time: Is critical! If you see any of these signs, call emergency straight away.

 

Warning signal, TIA! 

A form of stroke is called transient ischemic attack (TIA), which is a brief interruption of blood to part of the brain that causes temporary stroke-like symptoms. Usually the blood flow starts normal again and no permanent damage has been caused. But if you have received a TIA it’s a risk that you will receive a new and bigger blood clot in your body in the nearest days, which can cause a real stroke. Therefore its important to immediately seek emergency care and receive treatment to reduce the risk for a stroke.

Risk factors

Its mostly elderly people over 65 years who receive a stroke but anyone can have a stroke. 

Many risk factors for stroke can be controlled before they cause problems. These risk factors are:

  • High blood pressure

  • Atrial fibrillation

  • Uncontrolled diabetes

  • Obesity

  • High cholesterol

  • Excessive alcohol intake

Impact at life after a stroke

The impact of stroke varies from person to person and depends on; which kind of stroke, which area of the brain that is damaged, how much brain tissue that is permanently damaged, location of the blocked or burst artery, the general and level of activity before the stroke.

Some of the problems that people may have after stroke are:

  • Paralyzed or weakness on one side of the body.

  • Ignoring one side, called neglect, which means that you have difficulties to recognize one side of the body or the environment around that side.

  • Controlling or coordinating movements. Also balance issues.

  • Difficulties to speak or understand what other people say. Also to read, write or count.

  • Problem with the five senses; hearing, smell, taste, touch and sight.

  • Difficulties to eat or drink.

  • Having a change of personality and problem with the memory.

First month after a stroke big improvement usually occurs. Even several years later improvements can happen.

Because of the major impacts for a persons live after stroke, it’s of big importance to receive immediate treatment. Reduced time to treatment reduce permanent disability.

Treatments

When a person gets a stroke it's very important to know what kind of stroke it is. That decides what kind of treatment to give the patient. There is no medical treatment that will repair the brain damage from the stroke.

Intravenous thrombolysis (anticoagulants) and neuro thrombetctomy (mechanical removal of a blood clot with a device) are two treatments that have revolutionized stroke care in recent years. But more knowledge needs to be obtained and thats why SITS plays such an important role in acute treatment and secondary prevention of stroke. SITSs aim is to “save brains and lives”!