Stroke

A stroke is a ‘brain attack’. Here are some of the stroke attack factors and treatments available to help individuals who have this disease.

Stroke attack occurs when blood flow to an area of the brain is cut off.  When this happens, brain cells are deprived of oxygen and start to die.  When brain cells die during a stroke attack, abilities commanded by that area of the brain such as memory and muscle control become lost.

What is a stroke and its symptoms

A stroke is a medical emergency.  A stroke attack happens when our blood supply to the part of your brain is discontinued or severely decreased, depriving brain tissue of nutrients and oxygen.  After a few minute, brain cells begin to die.

A stroke may be created by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke).  Some of you may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA).

Look out for these signs and symptoms as below, if you think you or someone else may be having a stroke.

• Trouble with speaking and understanding.  You may experience confusion.  You may slur your words or have difficulty understanding speech.
• Paralysis or numbness of the face, arm or leg.  You may develop sudden numbness, weakness or paralysis in your face, arm or leg, especially on one side of your body.  Try to put both your arms over your head at the same time.  If one of the arms starts to fall, you might have a stroke.  Similarly, one side of your lips may droop when you attempt to move it or grin.
• Trouble with seeing in one or both of the eyes.  You may suddenly have blurred or blackened vision in one or both eyes, or you may see double.
• Headache.  A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate you’re having a stroke.
• Trouble with walking.  You may stumble or experience sudden dizziness, loss of balance or loss of coordination.

Other potential causes of aphasia include:

• Head trauma
• A brain tumour
• Cognitive degenerative conditions, such as Alzheimer’s disease

Why a stroke happens

Many factors can increase your risk of a stroke.  Some factors can also increase your chances of having a heart attack. Potentially treatable stroke risk factors include:A

Lifestyle risk factors

• Being overweight or obese
• Physical inactivity
• Heavy or binge drinking
• Cigarette smoking or exposure to secondhand smoke
• Use of illicit drugs such as cocaine

Medical risk factors

• High blood pressure — the danger and risk of stroke attack begins to increase at blood pressure readings higher than 120/80 millimetres of mercury (mm Hg).  A doctor will help you decide on a target blood pressure. The target will be based on your age, whether you have diabetes and other factors.
• Diabetes.
• High cholesterol.
• Obstructive sleep apnea — a sleep disorder in which the oxygen level intermittently drops during the night.
• Cardiovascular disease, like heart failure, heart defects, heart infection or irregular heartbeat.

When does a stroke happen

Having an ischemic stroke means, the oxygen-rich blood supply to some portion of your brain is reduced. Meanwhile, with a hemorrhagic stroke, it means that there is bleeding in our brain.

After about a few minutes without blood and oxygen, brain cells end up harmed and may die. The body tries to reestablish blood and oxygen to the cells by enlarging other veins or blood vessels (arteries).

If blood supply isn’t restored or reestablished, permanent damage usually occurs. The part of our body controlled by those damaged cells cannot work.

This loss of function may be mild or severe. It may be temporary or permanent. It usually depends on where and how much of the brain is damaged because of the attack. Other than that, it also depends on how fast the blood supply can be returned to the affected cells. Life-threatening complications may also occur. This is why it’s important to know what stroke attack factors and treatments as soon as possible.

How to treat strokes

To determine what is the best treatment for your stroke, the doctor needs to decide on the type of stroke you’re having by running a few tests. The doctor also needs to clarify the areas of your brain affected by the stroke. They also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction.

Doctor need to know a few things before starting the emergency treatment. Whether the patient is having an ischemic stroke blocking an artery or a hemorrhagic stroke that involves bleeding into the brain.  Then, to treat an ischemic stroke, doctors must quickly restore blood flow to the brain.

Emergency treatment with medicines

Therapy with drugs must start within 3 hours if they are given into the vein — and the sooner, the better. This type of emergency treatment not only increases your chances of survival but also may decrease complications. You may be given:

• Aspirin. Aspirin is a treatment provided in the emergency room to reduce the possibility of having another stroke. Aspirin can help prevents blood clots.
• Intravenous injection of tissue plasminogen activator (TPA). An injection of TPA is usually given through a vein in the arm. It needs to be given within 4 to 5 hours after stroke symptoms begin if it’s given in the vein.

If you’ve had an ischemic stroke or transient ischemic attack (TIA), the doctor may recommend some pills to help reduce your risk of having another stroke attack. These include:

• Anti-platelet drugs. Anti-platelet drugs are making these cells less sticky and less likely to clot. Platelets are cells in the blood that initiate clots. The most commonly used anti-platelet medication is aspirin.
• Anticoagulants. These drugs can help to reduce blood clotting. It is fast-acting and may be used over a short period in the hospital. The doctor may prescribe these drugs if you have specific blood-clotting disorders, abnormal heartbeat or other problems with the heart.

Stroke attack factors and treatments by doctors

The treatment of stroke can involve a team of physicians from multiple different specialities.  The team make up is dependant on each hospital’s organization.  In Malaysia, a neurologist or physician will usually be the one attending to you.

However, many different types of doctors are often involved in preventing or treating stroke.  This can include providing medications to control risk factors like high blood pressure or diabetes to diagnosing and treating stroke after it occurs.

What does each stroke specialist do?

Neurologist

Specialized in the conditions and disease involving the brain, spinal cord, and nervous system, both central and peripheral.N

Neurophysiologist

Specialized in studying the central and peripheral nervous system through the recording of bioelectrical activity, whether spontaneous or stimulated.N

Neuroradiologist

A physician who is specialized in diagnostics central and peripheral nervous system, spine, and head and neck using imaging modalities and scans.N

Neurosurgeon

A surgeon who is specialized in surgical procedures specific to the nervous system including the brain, spinal cord, peripheral nerves, and cerebrovascular system.N

Physical Medicine & Rehabilitation (PM&R) or Physiatrist

Specialized in improving and restoring functional ability and quality of life.N

Vascular Neurologist

A medical doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system.  Vascular neurologists treat disorders of the nervous system, brain, spinal cord, nerves, muscles and pain.

How much does it cost to treat stroke

The cost that can be expected in stroke treatment depends on the condition of the stroke experienced by the patient himself.  The doctor will do some tests for the patient to know whether the patient had an ischemic stroke, transient ischemic attack (TIA) or anything else.  One of the ways to know the overall cost of this treatment is best to check the hospital.

Who can help you with this cost

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