A stroke may cause a decrease and/or loss of brain function caused by destruction of Brain Tissue.
Can occur as a result of lack of oxygen [Ischemia] or bleeding [Hemorrhage].
Often are seen in the elderly or those with increased risk factors.
Stroke causes 10% of the deaths worldwide.
Men are 1.25 times more likely to suffer a stroke than women.
95% of stokes occur in someone who is 45 years of age and older
60% of strokes occur when over 65
Although stroke can occur at any age
Incidence has been expanding and increasing dramatically over the past 3 decades.
- Thrombosis – clotting
- Embolus – clotted blood or other foreign matter that obstructs in a blood vessel.
- Tearing or rupture of blood vessel
- Brain Trauma [Head injury]
- Brain aneurysm
- Certain medications
- Certain drugs
- Very quick symptoms may be seen
- Loss or change in sensation
- Loss of consciousness
- Speech pattern changes
- Loss of speech [can be Complete]
- Motor skills changes
- Paralysis [Typically on one side of the body]
- Seen in 80% of strokes
- Occurs when oxygen is lacking in a portion of the brain
- Caused by a stoppage in blood flow to a certain area.
1.) Thrombotic [blood clot that has formed locally]
2.) Embolic [blood clot or foreign matter from somewhere else in body]
3.) Systemic Hypoperfusion [Decreased blood flow due to shock or other factor]
4.) Cryptogenic [Unknown origin]
- Seen in 20% of strokes
- A tear or rupture of a blood vessel
- Is the pooling of blood anywhere within the skull
1.) Tearing or rupture of blood vessel
2.) Brain Trauma [Head injury]
3.) Brain aneurysm
4.) Certain medications
1.) Intra-axial hemorrhage [Blood inside the brain]
2.) Extra-axial hemorrhage [Blood inside skull but outside brain]
- Bleeding into brain itself
- Also called cerebral hemorrhage
- Can see bleeding into ventricles
- Very dangerous
- Very difficult to treat
- Bleeding that occurs within the skull but outside the brain
Overall exam for concern for strokes are essential
- Exam by a provider is essential if any concern
- CT and MRI are useful and quite helpful for evaluation of the brain
- Angiography can be used to find aneurysms
- Evaluation in Emergency room is often necessary and essential
- Stay at hospital (ICU department) is often necessary
Treatment is largely dependent on type of stroke. Ischemic stroke and Hemorrhagic stroke are treated differently in some specific areas.
- Thrombolytic (Fibrinolytic) Drugs:
. Tissue Plasminogen Activator (tPA)
- Blood thinners
- Hyper-osmotic agents
. Hypertonic saline solutions
- Hypertension treatment
- Pain management as required
- Surgical treatment
- Monitoring and Management may depend on cause.