Stroke and Paralysis - symptoms, treatment and preventation

 Paralysis is the loss of muscle function in part of your body caused by a stroke. And a Stroke is a disruption of blood flow to a part of the brain, which causes brains cells to be damaged or die because of a lack of oxygen. Paralysis can be complete or partial. It can occur on one or both sides of your body. It can also occur in just one area, or it can be widespread.

 Types of stroke:   

Ischaemic strokes: 
Ischaemic strokes occur when a blood clot completely blocks an artery in or to the brain. They are the most common type of stroke, occurring in about 85% of cases.

 Haemorrhagic Strokes:

Haemorrhagic strokes occur when an artery within the brain bursts and leaks blood into the brain. The presence of this extra blood causes pressure to build within the area of the brain where the bleed has occurred. This causes damage to the brain tissue in that area. Haemorrhagic strokes are less common than ischaemic strokes but their effects are generally more severe.

Rupture (burst) of an artery can be due to factors such as an aneurysm (where a weakened section of an artery balloons out), a congenitally abnormal connection of blood vessels, or extremely high blood pressure.

Mini stroke (transient ischaemic attack): Mini strokes, or transient ischaemic attacks (TIA), occur when there is a temporary disruption in the blood flow to the brain. This can be due to a narrowing in an artery in or to the brain, or as a result of a blood clot that quickly dislodges itself allowing blood to flow again.

Symptoms of a TIA can be similar to those of a stroke and can include: 

• sudden weakness

• numbness of face, arm or legs 

• sudden blurred or lost of vision

• sudden difficulty in speaking or understanding 

• sudden dizziness

• confusion 

• breathing problems 

• Loss of consciousness 

• sudden or severe headache 

•  loss of balance or difficulty controlling movements.

• Memory loss for a short period of time   

Stroke risk

• Age

• Male gender

• Family history

• Ethnicity

• Previous TIA.

• High blood pressure

• Heart disease

• Heart rhythm disorders eg: atrial fibrillation

• Smoking

• Diabetes

• High blood cholesterol levels

• Oral contraceptives

• Excessive alcohol intake

• Obesity.

Risk Factors:

Symptoms may last for only a few minutes or up to a few hours and resolve within 24 hours. If symptoms last longer than 24 hours the condition is diagnosed as a stroke.

People of all ages and genders can suffer a stroke. In New Zealand, approximately 24 people have a stroke each day.

Risk factors multiply and the greater the number, the greater the chance of a stroke. High blood pressure (hypertension) is the leading risk factor for stroke.

Seventy-five percent of strokes occur in people over 65 years of age. Ischaemic strokes make up the majority of strokes in older people while younger people are more likely to suffer a haemorrhagic stroke.

Ethnicity is a factor and Maori and Pacific Island New Zealanders are more likely to suffer a stroke than European New Zealanders. Men are more likely to suffer a stroke than women. Pregnant women also have a slightly increased risk of haemorrhagic stroke.

There are controllable and uncontrollable factors that increase the risk of stroke.   Uncontrollable risk factors (ie: risks you cannot reduce through treatment or lifestyle changes)  include:

Early detection and effective management of controllable stroke risk factors can greatly reduce the possibility of stroke.  Controllable risk factors for TIA and stroke include:

 Treatment 
Stroke is a medical emergency requiring immediate treatment.  Prompt treatment improves the chances of survival and increases the degree of recovery that might be expected. The treatment given will depend on the type of stroke suffered.

INITIAL TREATMENT

Immediate treatment is aimed at limiting the size of the stroke and preventing further stroke. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischaemic stroke or by stopping the bleeding of a haemorrhagic stroke.  This will involve administering medications and may involve surgery in some cases.

Medications

• Thrombolytic therapy: These medications dissolve blood clots allowing blood flow to be re-established
• Anti-platelet drugs (eg: aspirin) and anticoagulants (eg: heparin): These medications help to prevent blot clots getting bigger and prevent new blood clots from forming
• Antihypertensives:  In cases of haemorrhagic stroke these medications may be prescribed to help lower high blood pressure
• Medications to reduce swelling in the brain and medications to treat underlying causes for the stroke eg: heart rhythm disorders may also be given.

Surgery
Surgery may be needed to repair blocked or ruptured arteries. For a haemorrhagic stroke this may involve repairing a bleeding aneurysm or AVM. Where an ischaemic stroke has been caused by a blockage in a neck artery surgery to remove the blockage may be performed. This is known as a carotid endarterectomy.

Supportive treatment 
Providing adequate fluid and nutrition intake after a stroke is vital, particularly if swallowing has been affected.  This may require the insertion of an intravenous drip into a vein in the hand or arm, or it may involve inserting a feeding tube via the nose into the stomach.  Preventing complications that can occur as a result of immobility eg: pneumonia and bed sores, is also important.

Prevention 

A few methods of preventing the stroke are as follows: 

• Moderating alcohol intake (no more than 2 small drinks per day)
• Maintaining good control of existing medical conditions such as diabetes, high blood pressure and high cholesterol.
• Be physically active. Physical activity can improve your fitness level and health. Talk with your doctor about what types and amounts of activity are safe for you.
• Don’t smoke, or if you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk of stroke. Talk with your doctor about programs and products that can help you quit. Also, secondhand smoke can damage the blood vessels.
• Aim for a healthy weight . If you’re overweight or obese, work with your doctor to create a reasonable weight loss plan. Controlling your weight helps you control risk factors for stroke.
• Make heart healthy eating choices. Heart-healthy eating can help lower your risk or prevent a stroke.
• Manage stress. Use techniques to lower your stress levels                                                         Life after a stroke:  The time it takes to recover from a stroke varies—it can take weeks, months, or even years. Some people recover fully, while others have long-term or lifelong disabilities. Some of the patients suffer Paralysis. 
• Ongoing care, rehabilitation, and emotional support can help you recover and may even help prevent another stroke. We all have got one life. Live fully but consider healthy habits (https://theinspiringfacts.blogspot.com/2019/06/impressive-healthy-habits-which-will_28.html) to prevent stroke and simultaneously paralysis. Stay with me and I'll be posting more inspirational and motivational blogs soon. I hope you liked the blog, follow me and do comment if you want me to write on the topic of your choice.  Thank you.