Warning signs of stroke -Stroke symptoms in men -Stroke symptoms in women

Overview of Stroke

Strokes are a heterogeneous group of disorders involving sudden, focal interruption of cerebral blood flow that causes neurologic deficit. Strokes can be

• Ischemic (80%), typically resulting from thrombosis or embolism
• Hemorrhagic (20%), resulting from vascular rupture (eg, subarachnoid hemorrhage, intracerebral hemorrhage)

Transient stroke symptoms (typically lasting < 1 hour) without evidence of acute cerebral infarction (based on diffusion-weighted MRI) are termed a transient ischemic attack (TIA). 

In the US, stroke is the 5th most common cause of death and the most common cause of neurologic disability in adults. 

Brain Vasculature

Strokes involve the arteries of the brain , either the anterior circulation (branches of the internal carotid artery) or the posterior circulation (branches of the vertebral and basilar arteries).

 

Arteries of the brain

The anterior cerebral artery supplies the medial portions of the frontal and parietal lobes and corpus callosum. The middle cerebral artery supplies large portions of the frontal, parietal, and temporal lobe surfaces. Branches of the anterior and middle cerebral arteries (lenticulostriate arteries) supply the basal ganglia and anterior limb of the internal capsule.

 

The vertebral and basilar arteries supply the brain stem, cerebellum, posterior cerebral cortex, and medial temporal lobe. The posterior cerebral arteries bifurcate from the basilar artery to supply the medial temporal (including the hippocampus) and occipital lobes, thalamus, and mammillary and geniculate bodies.

 

Anterior circulation and posterior circulation communicate in the circle of Willis.

Arteries of the brain

Risk factors

The following are modifiable factors that contribute to increased risk of stroke:

·         Hypertension

·         Cigarette smoking

·         Dyslipidemia

·         Diabetes

·         Insulin resistance (1)

·         Abdominal obesity

·         Excess alcohol consumption

·         Lack of physical activity

·         High-risk diet (eg, high in saturated fats, trans fats, and calories)

·         Psychosocial stress (eg, depression)

·         Heart disorders (particularly disorders that predispose to emboli, such as acute MI, infective endocarditis, and atrial fibrillation)

·         Hypercoagulability (thrombotic stroke only)

·         Intracranial aneurysms (subarachnoid hemorrhage only)

·         Use of certain drugs (eg, cocaine, amphetamines)

·         Vasculitis

 

 

Unmodifiable risk factors include the following:

 

·         Prior stroke

·         Older age

·         Family history of stroke

·         Genetic factors

 

 

Symptoms and Signs of Stroke 

Initial symptoms of stroke occur suddenly. Symptoms depend on the location of infarction

Thus, symptoms can include numbness, weakness of limbs or face; aphasia; confusion; visual disturbances in one or both eyes (eg, transient monocular blindness); dizziness or loss of balance and coordination; and headache.  alert-info

Areas of the brain by function

Neurologic deficits are used to determine the location of stroke . Anterior circulation stroke typically causes unilateral symptoms. Posterior circulation stroke can cause unilateral or bilateral deficits and is more likely to affect consciousness, especially when the basilar artery is involved.

 

               

Systemic or autonomic disturbances (eg, hypertension, fever) occasionally occur.

Other manifestations, rather than neurologic deficits, often suggest the type of stroke. For example,

·         Sudden, severe headache suggests subarachnoid hemorrhage.

·         Impaired consciousness or coma, often accompanied by headache, nausea, and vomiting, suggests increased intracranial pressure, which can occur 48 to 72 hours after large ischemic strokes and earlier in many hemorrhagic strokes; fatal brain herniation may result.

 

Complications

Stroke complications can include sleep problems, confusion, depression, incontinence, atelectasis, pneumonia, and swallowing dysfunction, which can lead to aspiration, dehydration, or undernutrition. Immobility can lead to thromboembolic disease, deconditioning, sarcopenia, urinary tractinfections, pressure ulcers, and contractures.

 

Daily functioning (including the ability to walk, see, feel, remember, think, and speak) may be decreased.

 

Evaluation of Stroke

Evaluation aims to establish the following:

·         Whether stroke has occurred

·         Whether stroke is ischemic or hemorrhagic

·         Whether emergency treatment is required

·         What the best strategies for preventing subsequent strokes are

·         Whether and how to pursue rehabilitation

 

 

Stroke is suspected in patients with any of the following:

 

·         Sudden neurologic deficits compatible with brain damage in an arterial territory

·         A particularly sudden, severe headache

·         Sudden, unexplained coma

·         Sudden impairment of consciousness

·         Glucose is measured at bedside to rule out hypoglycemia.

 

If stroke is still suspected, immediate neuroimaging is required to differentiate hemorrhagic from ischemic stroke and to detect signs of increased intracranial pressure. CT is sensitive for intracranial blood but may be normal or show only subtle changes during the first hours of symptoms after anterior circulation ischemic stroke. CT also misses some small posterior circulation strokes. MRI is sensitive for intracranial blood and may detect signs of ischemic stroke missed by CT, but CT can usually be done more rapidly. If CT does not confirm clinically suspected stroke, diffusion-weighted MRI can usually detect ischemic stroke.

 

If consciousness is impaired and lateralizing signs are absent or equivocal, further tests to check for other causes are done.

After the stroke is identified as ischemic or hemorrhagic, tests are done to determine the cause. Patients are also evaluated for coexisting acute general disorders (eg, infection, dehydration, hypoxia, hyperglycemia, hypertension). Patients are asked about depression, which commonly occurs after stroke. A dysphagia team evaluates swallowing; sometimes a barium swallow study is necessary.

Treatment of Stroke

·         Stabilization

·         Reperfusion for some ischemic strokes

·         Supportive measures and treatment of complications

·         Strategies to prevent future strokes

Stabilization may need to precede complete evaluation. Comatose or obtunded patients (eg, Glasgow Coma Score ≤ 8) may require airway support. If increased intracranial pressure is suspected, intracranial pressure monitoring and measures to reduce cerebral edema may be necessary.

 

Specific acute treatments vary by type of stroke. They may include reperfusion (eg, recombinant tissue plasminogen activator, thrombolysis, mechanical thrombectomy) for some ischemic strokes.

 

Strategies to Prevent and Treat Stroke Complications      

After a stroke, most patients require rehabilitation (occupational and physical therapy) to maximize functional recovery. Some need additional therapies (eg, speech therapy, feeding restrictions). For rehabilitation, an interdisciplinary approach is best.

 

Depression after stroke may require antidepressants; many patients benefit from counseling.

Modifying risk factors through lifestyle changes (eg, stopping cigarette smoking) and drug therapy (eg, for hypertension) can help delay or prevent subsequent strokes. Other stroke prevention strategies are chosen based on the patient's risk factors. For ischemic stroke prevention, strategies may include procedures (eg, carotid endarterectomy, stent placement), antiplatelet therapy, and anticoagulation.

 

 Note you can cut srtoke by 40% now see here. alert-success

 

 

1. CORONA VIRUS
2. MONKEY POX
3. VAGINAL DRYNESS
4. FIBROID
5. INFERTILITY
6. OVULATION CYCLE
7. OVARIAN CANCER
8. VAGINAL BACTERIA
9. MALE INFERTILITY
10. BEST DAYS OF CONCIEVING
11. MUCUS AFTER OVULATION
12. FOODS FOR ERECTILE FUNCTIONS
13. PREGNANCY ANEMIA
14. DO AND DONT DURING PREGNANCY
15. ERECTILE DYSFUNCTION
16. U.T.I IN PREGNANCY
17. STROKE RISK
18. EAT THIS NOT THAT
19. HOOKWORMS INFECTION
20. OMEGA 3 BENEFITS
21. FASTING
22. WEIGHT LOSS TIPS
23. vitiligo
24. ABORTION
25. DENGUE VIRUS
26. EBORA VIRUS
27. FEVER
28. URINARY TRACT INFECTION
29. HOSPITAL INFECTIONS
30. WEST NILE VIRUS
31. YELLOW FEVER
32. EYE DISEASE
33. ZIKA VIRUS
34. STRESS
35. IRON DEFFICIENCE
36. INSOMNIA (SLEEPING PROBLEMS)
37. HEART PROBLEMS
38. COMPONENTS OF BLOOD
39. BLOOD DISORDER
40. LABORATORY TEST OF BLOOD DISORDER
41. BONE MARROW EXAMINATION
42. BLOOD ANEMIA
43. ANIMAL BITES
44. EYE BURN
45. CHOCKING
46. HEAT STROKE
47. SMOKE EFFECTS
48. SNAKE BITE
49. MALARIA VACCINE
50. BEST WAY TO SLEEP A CHILD
51. CHILD FEVER REDUCING
52. ELEPHANTIASIS
53. WOMEN BEARDS
54. DATES
55. PAPAYA FRUITS