Fascinating Insights and Life-Saving Information

June 09

By Yin Nwe Ko

 

A stroke occurs when blood circulation is cut off in the brain—causing a medical emergency that warrants immediate attention. When blood doesn’t reach brain cells, they don’t get the oxygen and nutrients they need and begin to die within minutes.

As a result, you can experience facial drooping, weakness in the limbs, confusion, slurred speech, and severe headache, among other symptoms. Knowing the symptoms of stroke and seeking medical care quickly is critical to prevent serious complications or death from occurring.

Common Symptoms

There are two main types of strokes: ischemic and hemorrhagic. Generally, symptoms of stroke tend to be similar despite the type of stroke you or someone else is having. However, symptoms can range in severity depending on the artery (blood vessel) in the brain that is affected.

Strokes can be very dangerous—and not only can they lead to permanent disability, but they’re also the fifth leading cause of death in the US That’s why it’s important to look out for the following symptoms:

• Numbness: Feeling numb, having a droopy face, or experiencing paralysis on one side of the body is common. You may feel weak or unable to move during this time.

• Cognitive (brain-related) symptoms: Cognitive symptoms of a stroke can set on quickly. These include sudden bouts of confusion, slurred or abnormal speech, difficulty understanding what others are saying, and problems with memory.

• Visual symptoms: A stroke can also disrupt your eyes, causing symptoms such as temporary loss of vision in one or both eyes, blurriness, and difficulty seeing and focusing on objects.

• Motor symptoms: It’s also common to experience difficulties with movement, such as a loss of balance, difficulty walking, dizziness, and loss of motor control.

• Other symptoms: Some people might have a severe headache that suddenly arises with no other known cause, nausea, and vomiting.

While these symptoms are most common, regardless of the type of stroke you or someone else is having, symptoms can slightly vary depending on the artery in your brain that becomes blocked.

Transient Ischemic Attack Symptoms

In some cases, people experience a transient ischemic attack, which is a warning sign and precursor of stroke. Though an ischemic attack is not viewed as serious as a stroke, this is still a medical emergency.

Symptoms of an ischemic attack typically lasting only 10 to 20 minutes—rarely over an hour–and often mimic the symptoms of a stroke. You may likely experience numbness or weakness, speech difficulties, and blurring or loss of vision in one eye.

Medial Cerebral Artery Stroke Symptoms

When strokes affect the medial cerebral artery (MCA)—a major artery that separates the frontal and temporal lobes of the brain—you might experience the following symptoms:

• Weakness in one arm or limb

• Drooping on one side of the face

• Speech problems

• Difficulties with comprehension

• Frontal lobe: Controls your executive functioning, such as problem-solving, decision-making, memory, and learning

• Temporal lobe: Gives you the ability to understand language and controls your hearing

• Parietal lobe: Helps your process sensory information and manages your senses, including touch, temperature, pressure, and pain

• Occipital lobe: Manages your visual perception and eyesight, including recognizing shapes and colours, seeing objects, and recognizing visual stimuli

Anterior Cerebral Artery Stroke Symptoms

If a stroke affects your anterior cerebral artery—a blood vessel that supplies the frontal and parietal lobes of the brain—becomes blocked, you might experience:

• Impaired judgment

• Loss of sight or blurry vision on one side

• Weakness or numbness on one side

• Urinary incontinence (not being able to hold in your pee)

• Changes in a walking pattern or the inability to lift your feet

Posterior Cerebral Artery Stroke Symptoms

The two posterior cerebral arteries supply blood to the occipital lobes of the back of the brain. If blood flow in either of these arteries becomes interrupted, you may experience cognitive symptoms such as:

• Blindness in one or both eyes

• Sudden changes in mood

• Difficulty recognizing or making out objects

• Trouble remembering things

Vertebral/Basilar Artery Stroke Symptoms

If the vertebral or basilar arteries—major vessels that supply blood to the back of the brain—are blocked due to a stroke, you can have the following symptoms:

• Rapid and repetitive eye movements (known as nystagmus)

• Dizziness

• Double-vision

• Blindness in one eye

• Trouble understanding language

• Difficulty swallowing (known as dysphagia)

• Fainting

• Tingling in the face (known as facial hyperesthesia)

• Loss of coordination or motor skills

When to See a Healthcare Provider

Any sign of a stroke is a medical emergency and warrants visiting the emergency department or calling 911. As laid out by the Centers for Disease Control and Prevention (CDC), an acronym, FAST, can help you remember the signs of a stroke in another person. This stands for:

• Face (F): Facial symptoms such as drooping or an uneven smile

• Arms (A): Arm weakness or numbness, which can sometimes affect one whole side of the body

• Speech (S): Speaking problems such as trouble forming words or having slurred speech

• Time (T): Time to seek immediate help if you’re noticing any of the above symptoms

As mentioned above, a stroke occurs when something restricts blood flow to your brain, causing a variety of symptoms including weakness or paralysis in the face or limbs, vision problems, speech difficulties, and loss of balance, among others. A stroke is a medical emergency and can be fatal or lead to permanent disability. If you notice signs of someone having a stroke, it’s critical to seek medical care immediately.

Summary

Occurs when the supply of blood to the brain is reduced or blocked completely, which prevents brain tissue from getting oxygen and nutrients.

Causes:

It is caused by the interrupted blood supply to the brain.

Symptoms:

Symptoms include weakness of the face, and limbs, confusion, and trouble speaking.

Diagnosis:

To determine the most appropriate stroke treatment, an emergency team needs to evaluate the type of stroke a person is having and the areas of the brain affected.

Facts

Treatable by a medical professional

Diagnosed by a medical professional

Often requires lab tests or imaging

Can last several years or be lifelong

Common for ages 60 and older

May be dangerous or life-threatening

Urgent medical attention recommended

Types of strokes:

Ischemic stroke:

It refers to the neurological symptoms and signs that occur due to sudden interruption or reduction in the blood supply to a part of the brain.

Haemorrhagic stroke:

It may arise from coup and contrecoup injury during brain deceleration following head trauma, chronic hypertension which results in bleeding from small vessels, the transformation of prior ischemic infarction, metastatic brain tumours like choriocarcinoma, malignant melanoma, renal cell carcinoma and bronchogenic carcinoma, blood coagulopathies, angiopathy following degenerative disease of intracranial vessels, or intake of sympathomimetic drugs like cocaine and amphetamine, especially in younger individuals.

Haemorrhagic stroke is of two types – intracerebral haemorrhage, which occurs within the brain tissue, and subarachnoid haemorrhage, where the leaked blood occupies the subarachnoid space. The bleed may be small or large. Transient ischemic attack: A transient ischemic attack (TIA) refers to transient neurological symptoms that occur due to temporary ischemia to a part of the brain.

Symptoms

As different parts of the brain control different parts of the body, symptoms will depend on the part of the brain affected and the extent of the damage.

The main symptoms are:

Paralysis or numbness or inability to move parts of the face, arm, or leg – particularly on one side of the body.

Confusion- including trouble with speaking

Headache with vomiting

Trouble seeing in one or both        eyes

Metallic taste in the mouth

Difficulty in swallowing

Trouble in walking (impaired coordination)

Dystonia

Alexia

Agnosia

The risk factors include:

Overweight

Sedentary life

Binge Drinking

Diabetes

Smoking

High blood pressure

High cholesterol

Family history of stroke

Cardiovascular diseases

Age – people above age 55 are at higher risk

Gender – men are at high risk of stroke than women

Diagnosis

To determine the most appropriate stroke treatment, an emergency team needs to evaluate the type of stroke a person is having and the areas of the brain affected.

Physical examination

The patient’s symptoms, medical history, blood pressure, and blood vessels at the back of the eyes are checked.

Blood test

To find out the time taken for clotting of blood.

CT scan

Images of the brain can show a haemorrhage, tumour, stroke, or other medical conditions.

Ultrasound

To check the blood flow in the carotid arteries and to check for plaque, if any.

Magnetic resonance imaging (MRI)

MRI of brain tissue to diagnose an ischemic stroke or brain haemorrhages.

Cerebral angiogram

Dyes are injected to get a detailed view of brain and neck blood vessels visible under X-ray.

Echocardiogram

To check for any sources of clots that could have travelled to the brain and led to a stroke.

Treatments

Treatment is based on the type of stroke. For ischemic stroke or transient ischemic attack, medication or surgery or both can be recommended and for hemorrhagic stroke, surgery is recommended.

Complications

Stroke may lead to severe complications:

• Paralysis or loss of muscle movement: The patient may become paralyzed on one side of the body, or lose control of certain muscles, such as those on one side of the face or one arm

• Difficulty in talking or swallowing

• Memory loss or thinking difficulties: It also affects thinking, making judgments, reasoning, and understanding concepts

• Emotional problems: stroke survivors may develop depression

• Changes in behaviour and self-care ability: Stroke survivors may become more withdrawn and less social or more impulsive. They may need help with grooming and daily chores

Prevention

Many stroke prevention strategies are the same as the strategies to prevent heart disease. In general, some preventive tips for stroke patients are as follows:

• Diet and healthy eating: Following a proper diet may avoid the risk of a second stroke.

• Decreasing the amount of cholesterol and saturated fat in your diet.

• Controlling Diabetes

• Monitoring blood pressure: As high blood pressure exerts continuous pressure on the walls of the arteries it may lead to an arterial block.

• Avoiding illicit drugs

• Exercising: Consult your doctor before starting an exercise program.

• Quit smoking and alcohol.

Questions To Ask Your Doctor

• How long should I continue the medication?

• Can I stop the medication once the symptoms subside?

• How frequently should I do the follow-up check?

• What are the foods to avoid?

• When can I start going to work?

Nutrition

Foods to eat:

Fruits and vegetables: eat plenty of fruit and vegetables; between 5-7 servings per day

Whole grain bread and cereals containing fibre and vitamins: May reduce the risk of stroke

Lean protein: Limiting the amount of cholesterol is another important step in reducing the risk of another stroke

Choose low-fat meats or other protein

Limit salt:

Eating too much salt/sodium may cause you to retain water and raise your blood pressure

Foods to avoid:

Heavy cholesterol foods

foods rich in salt and sugar

Alcohol

Now, I assume that my reader might have understood somewhat knowledge about stroke and some dos and don’ts. May all of us escape from the bad effect of stroke forever.

Reference: Reader’s Digest Jan 2023.