Health Care and Strokes

Stroke is the third leading cause of death in America and the No. 1 cause of adult disability according to the National Stroke Association. A stroke occurs when a blood clot blocks an artery (a blood vessel that carries blood from the heart to the body) or a blood vessel (a tube through which the blood moves through the body) breaks, interrupting blood flow to an area of the brain. When either of these things happen, brain cells begin to die and brain damage occurs. When brain cells die during a stroke, abilities controlled by that area of the brain are lost.

These abilities include speech, movement and memory according to the National Stroke Association. How a stroke patient is affected depends on where the stroke occurs in the brain and how much the brain is damaged. For example, someone who has a small stroke may experience only minor problems such as weakness of an arm or leg. People who have larger strokes may be paralyzed on one side or lose their ability to speak. Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability.

Also called a brian attack according to the National Institute of Neurological Disorders and Stroke (NIH), a stroke is a medical emergency. Strokes happen when blood flow to your brain stops. Within minutes, brain cells begin to die. There are two kinds of stroke. The more common kind, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain. "Mini-strokes" or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly interrupted. Symptoms of stroke are:
--Sudden numbness or weakness of the face, arm or leg (especially on one side of the body).
--Sudden confusion, trouble speaking or understanding speech.
--Sudden trouble seeing in one or both eyes.
--Sudden trouble walking, dizziness, loss of balance or coordination.
--Sudden severe headache with no known cause.

If you have any of these symptoms, you must get to a hospital quickly to begin treatment according to the NIH. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot or by stopping the bleeding. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Drug therapy with blood thinners is the most common treatment for stroke. Each year in the United States, there are more than 700,000 strokes. Stroke is the third leading cause of death in the country. And stroke causes more serious long-term disabilities than any other disease. Nearly three-quarters of all strokes occur in people over the age of 65 and the risk of having a stroke more than doubles each decade after the age of 55. For African Americans, stroke is more common and more deadly - even in young and middle-aged adults - than for any ethnic or other racial group in the United States.

According to the American Heart Association (AHA), Ischemic Stroke is the most common type. It accounts for about 87% of all strokes. It occurs when a blood clot (thrombus) forms and blocks blood flow in an artery bringing blood to part of the brain. Blood clots usually form in arteries damaged by fatty buildups, called atherosclerosis. When the blood clot forms within an artery of the brain, it's called a thrombotic stroke. These often occur at night or first thing in the morning. Another distinguishing feature is that very often they're preceded by a TIA or "warning stroke." TIAs have the same symptoms of stroke but only last a few minutes; stroke symptoms last much longer. If someones experiences a TIA, they should urgent medical care immediately.

A wandering clot (an embolus) or some other particle that forms away from the brain, usually in the heart, may also cause an ischemic stroke according to the AHA. This is called cerebral embolism. The clot is carried by the bloodstream until it lodges in an artery leading to or in the brain, blocking the flow of blood. The most common cause of these emboli is blood clots that form during atrial fibrillation (AF). AF is a disorder found in about 2.2 million Americans. It's responsible for 15–20 percent of all strokes. In AF, the heart's two small upper chambers (the atria) quiver like a bowl of jello instead of beating strongly and effectively. Some blood isn't pumped completely out of them when the heart beats, so it pools and clots can form. When a blood clot enters the circulation and lodges in a narrowed artery of the brain, a stroke occurs. This is called a cardioembolic stroke, or a stroke that occurs because of a heart problem.

According to the American Heart Association, a subarachnoid hemorrhage occurs when a blood vessel on the brain's surface ruptures and bleeds into the space between the brain and the skull (but not into the brain itself). A cerebral hemorrhage occurs when a defective artery in the brain bursts, flooding the surrounding tissue with blood. Hemorrhage (or bleeding) from an artery in the brain can be caused by a head injury or a burst aneurysm. Aneurysms are blood-filled pouches that balloon out from weak spots in the artery wall. They're often caused or made worse by high blood pressure. Aneurysms aren't always dangerous, but if one bursts in the brain, they cause a hemorrhagic stroke. When a cerebral or subarachnoid hemorrhage occurs, the loss of a constant blood supply means some brain cells no longer can work. Accumulated blood from the burst artery also may put pressure on surrounding brain tissue and interfere with how the brain works. Severe or mild symptoms can result, depending on the amount of pressure. The amount of bleeding determines the severity of cerebral hemorrhages. In many cases, people with cerebral hemorrhages die of increased pressure on their brains. But those who live tend to recover much more than people who've had strokes caused by a clot. That's because when a blood vessel is blocked, part of the brain dies — and the brain doesn't regenerate itself; in other words, brain cells can't be replaced. But when a blood vessel in the brain bursts, pressure from the blood compresses part of the brain. If the person survives, gradually the pressure goes away. Then the brain may regain some of its former function.

According to MedicineNet.com, typically, a clot forms in a small blood vessel within the brain that has been previously narrowed due to a variety of risk factors including:
--High blood pressure (hypertension)
--High cholesterol
--Diabetes
--Smoking

According to the Mayo Clinic, stroke is a medical emergency, and prompt treatment of a stroke is crucial. Early treatment can minimize damage to your brain and potential stroke complications. The good news is that strokes can be treated, and many fewer Americans now die of strokes than was the case 20 or 30 years ago. Improvement in the control of major risk factors for stroke — high blood pressure, smoking and high cholesterol — is likely responsible for the decline.

The NIH reports that because stroke injures the brain, you may not realize that you are having a stroke. The people around you might not know it either. Your family, friends, or neighbors may think you are confused. You may not be able to call 911 on your own. That's why everyone should know the signs of stroke - and know how to act fast. Don't wait for the symptoms to improve or worsen. If you believe you are having a stroke - or someone you know is having a stroke - call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability.

Until next time. Let me know what you think.