Brain Stroke - Symptoms and Causes

When the blood supply to the brain is suddenly halted due to blockage in the blood vessels, resulting in specific symptoms and signs, this condition is known as Stroke. A recent Lancet study suggests that the incidence of brain strokes is expected to increase by 50 percent in younger individuals. Stroke is globally ranked as the second leading cause of death, with an annual mortality rate of approximately 5.5 million. The impact of stroke extends beyond high mortality, as up to 50% of survivors experience chronic disabilities. Stroke presents a substantial and increasing public health burden due to demographic transitions, particularly in developing countries. 

Strokes are generally classified into two major categories: ischemic stroke and hemorrhagic stroke. Ischemic stroke occurs due to the interruption of blood supply to a part of the brain, resulting in a sudden loss of function. 

Recognizable symptoms and signs of a stroke include numbness or weakness in the face, arm, and leg, sudden confusion, difficulty in speaking or understanding speech, dizziness, loss of balance, and trouble walking. The impact of a stroke can lead to permanent or temporary damage to a part of the brain, potentially causing death or long-term disability, according to a statement issued by the hospital.

Fortunately, preventive measures can be taken to reduce the risk of 90% of brain strokes. These measures include avoiding smoking, limiting alcohol consumption, maintaining a healthy lifestyle, engaging in regular physical activity, restricting the intake of sodium, meat, and sweets, and undergoing regular health check-ups. 

A stroke is a life-threatening condition resulting from insufficient blood flow to part of the brain, typically due to a blocked artery or brain bleeding. The lack of blood supply leads to the death of brain cells due to oxygen deprivation.

IMPORTANT: A stroke is a medical emergency where prompt action is crucial. If you or someone shows stroke symptoms, call your local emergency services number immediately. Prompt treatment increases the likelihood of recovery without lasting disability.

To identify stroke warning signs, remember the acronym BE FAST:

• B. Be watchful for a sudden loss of balance.
• E. Look out for a sudden loss of vision in one or both eyes. Check if there's double vision.
• F. Ask the person to smile. Observe for a droop on one or both sides of their face, indicating muscle weakness or paralysis.
• A. A person experiencing a stroke often has muscle weakness on one side. Ask them to raise their arms; if one arm stays higher while the other sags and drops, it's a sign of one-sided weakness.
• S. Strokes can impair speech. The person might slur their speech or struggle to choose the right words.
• T. Time is critical, so seek help immediately! If possible, note the time when symptoms begin. Providing this information to healthcare providers helps determine the most suitable treatment options.

Various brain regions govern distinct functions, so stroke symptoms are contingent on the affected area. For instance, a stroke impacting Broca’s area, responsible for coordinating facial and mouth muscles for speech, may result in slurred speech or difficulty speaking.

Stroke symptoms may include:

1. One-sided weakness or paralysis
2. Aphasia (difficulty with or loss of speaking ability)
3. Slurred or garbled speech (dysarthria)
4. Loss of muscle control on one side of the face
5. Sudden loss, either partial or total, of one or more senses (vision, hearing, smell, taste, and touch)
6. Blurred or double vision (diplopia)
7. Loss of coordination or clumsiness (ataxia)
8. Dizziness or vertigo
9. Nausea and vomiting
10. Neck stiffness
11. Emotional instability and personality changes
12. Confusion or agitation.
13. Seizures
14. Memory loss (amnesia)
15. Headaches (usually sudden and severe)
16. Passing out or fainting
17. Coma

A transient ischemic attack (TIA), commonly known as a "mini-stroke," mimics a stroke, but its effects are temporary. TIAs serve as warning signs, indicating a heightened risk of an actual stroke in the near future. Given this risk, individuals experiencing a TIA should seek emergency medical care promptly.

Hemorrhagic and ischemic strokes can occur due to various causes. Blood clots are typically the cause of ischemic strokes. Various brain stroke reasons are:

• Atherosclerosis
• Blood clotting disorders
• Atrial fibrillation, particularly in cases where sleep apnea is the cause
• Heart Defects
• Microvascular ischemia (condition where your brain's tiny blood vessels become blocked)
• Hemorrhagic strokes can also occur for a number of reasons, such as:
• High blood pressure, particularly if it's extremely high, persistent, or both.
• Brain aneurysms
• Tumors of the brain 
• Diseases, like moyamoya disease, causing unusual changes in brain blood vessels 

There are various conditions and factors that can increase a person’s stroke risk. These include:

• Excessive alcohol consumption
• High blood pressure
• High blood cholesterol levels
• Migraine headaches 
• Type 2 diabetes
• Smoking 
• Other forms of tobacco use like vaping and intake of smokeless tobacco
• Drug abuse

How is Brain Stroke Diagnosed?

A combination of a neurological examination, diagnostic imaging, and other tests are employed to diagnose a stroke. During the neurological examination, you'll be asked to perform specific tasks or answer questions. Your doctor observes telltale signs indicating issues with certain brain functions. Common tests conducted when a stroke is suspected include:

• Computerized tomography (CT) scan.
• Lab blood tests, checking for signs of infections or heart damage, assessing clotting ability, and monitoring blood sugar levels, kidney and liver function, etc.
• Electrocardiogram (ECG or EKG) to ensure that a heart issue is not the root cause.
• Magnetic resonance imaging (MRI) scans.
• Electroencephalogram (EEG), though less frequent, can help rule out seizures or related problems.

What are Brain Stroke Treatments?

Ischemic stroke or transient ischemic attack (TIA) management involves a combination of medicines and medical procedures.

Medicines:

The primary medication for an ischemic stroke is tissue plasminogen activator (tPA), which breaks up blood clots obstructing blood flow to the brain. Administered through a vein in your arm, tPA should be given within 3 hours of stroke symptoms onset. In certain cases, it may be considered up to 4.5 hours later, especially if substantial brain damage hasn't occurred. If tPA is not an option, anticoagulants or blood-thinning drugs like aspirin or clopidogrel may be prescribed to prevent clot formation. However, these medications pose a risk of bleeding.

Medical Procedures:

To restore blood flow to the brain, a procedure may be necessary.

• Thrombectomy: This procedure removes clots from blood vessels. A catheter is inserted through the upper thigh to the blocked artery, utilizing angioplasty, stenting, or a stent retriever to open the artery.
• Angioplasty and Stenting: Involves inserting a balloon or mesh tube into the artery to clear space for improved blood flow.
• Carotid Endarterectomy: If carotid artery disease is the cause, this surgery removes plaque from the carotid artery in the neck.

For hemorrhagic stroke management, immediate medical intervention is crucial. It includes:

Medicines:

1. Blood pressure medication.
2. Discontinuation of blood-thinners
3. Vitamin K administration for enhancing blood clotting

Medical Procedures:

1. Aneurysm Clipping: This surgical procedure involves placing a small clamp at the base of the aneurysm, preventing further bleeding and reducing the risk of recurrence.
2. Blood Transfusion: Replacing lost blood through a transfusion is a standard and safe medical procedure.
3. Coil Embolization: This procedure blocks blood flow to or seals an aneurysm by inserting a catheter into an artery, threading it to the aneurysm, and deploying a tiny coil to induce clotting.
4. Draining Excess Fluid: Removal of accumulated fluid in the brain post-stroke alleviates pressure and prevents damage.
5. Skull Surgery: Temporary removal of part of the skull may be necessary in cases of significant swelling, allowing the brain to expand without increased pressure.
6. Treatment for Arteriovenous Malformation (AVM): Surgical removal or radiation may be employed to address AVM, a tangled network of arteries and veins prone to rupture.
7. Surgery to Remove Pooled Blood: Surgical intervention may be considered if the patient's condition worsens, aiming to eliminate accumulated blood.

Which are the Best Brain Hospitals and Best Doctors For Brain Stroke Treatment In India?

Medanta the Medicity, Gurugram, Sir H. N. Reliance Foundation Hospital and Research Centre, Apollo Hospitals, Chennai, KIMS Hospitals, Hyderabad, Fortis hospital, Bengaluru, and Jaslok Hospital & Research Centre, Mumbai are some of the are the best brain hospitals in India. 

Dr Sandeep Vaishya, Dr Vikas Kathuria, Dr Rajvendra Singh, and Dr Manoj Miglani are some of the are the best doctors for brain stroke treatment India.

Q1: What is the main cause of brain stroke?

A: The main cause of brain stroke insufficient blood flow to part of the brain, typically due to a blocked artery or brain bleeding. The lack of blood supply leads to the death of brain cells due to oxygen deprivation.

Q2: Can brain stroke be cured?

A: Yes. Brain stroke be cured if provided prompt medical care.

Q3: Can you recover from stroke?

A: Yes. One can recover from stroke after effects over a period of time. The patient must follow the instructions provided by the healthcare provider to recover well.

Q4: What are 5 symptoms of a brain stroke?

A: 5 symptoms of a brain stroke are one-sided weakness or paralysis, difficulty with or loss of speaking ability, slurred or garbled speech, loss of muscle control on one side of the face, and sudden loss, either partial or total, of one or more senses (vision, hearing, smell, taste, and touch).