Stroke

Stroke has two basic causes: an artery blockage (ischemic stroke) or a blood vessel rupture (hemorrhagic stroke). Some patients may only experience a brief disruption in blood supply to the brain, known as a transient ischemic attack (TIA), which does not result in long-lasting symptoms.

Ischemic stroke

This is the most prevalent form of stroke. It happens when the blood arteries in the brain narrow or block, resulting in an abrupt decrease in blood flow (ischemia). Blood vessel blockage or narrowing is typically caused by atherosclerotic plaques that develop in the blood vessels, or by blood clots (thrombi) that travel through the bloodstream, most commonly from the heart, and "settle" in the blood arteries of the brain.

Hemorrhagic stroke

A hemorrhagic stroke happens when a blood vessel in the brain becomes damaged or ruptured. Brain hemorrhages can be caused by a variety of blood vessel illnesses. Factors related to hemorrhagic stroke include:

• Uncontrolled high blood pressure.
• Overtreatment with blood thinners (anticoagulants)
• aneurysms are protrusions in the weak spots of the blood artery walls.
• Trauma (e.g., vehicle accident)
• Protein deposition in blood vessel walls causes vessel wall weakness (cerebral amyloid angiopathy).
• Ischemic stroke causes bleeding.
• A rupture of an irregular tangle of thin-walled blood arteries (arteriovenous malformation) is a less common cause of cerebral bleeding.

Many variables can raise the risk of a stroke. Some potentially treatable stroke risk factors are:

Lifestyle Risk Factors

• Being overweight or obese.
• Physical inactivity.
• Excessive or binge drinking.
• Use of illicit substances like cocaine and methamphetamine.

Medical Risk Factors

• High blood pressure.
• Smoking cigarettes or being exposed to secondhand smoke.
• High cholesterol.
• Diabetes.
• Obstructive Sleep Apnea.
• Cardiovascular illness includes heart failure, heart defects, heart infections, and abnormal heart rhythms like atrial fibrillation.
• A personal or family history of stroke, heart attack, or transient ischemic attack.
• Covid-19 infection.

Other variables associated with a greater risk of stroke are:

• Age – persons 55 and older are more likely to suffer a stroke than younger persons.
• African Americans and Hispanics are more likely to suffer a stroke than those of other races or ethnicities.
• Sex – Men have a greater risk of stroke than women. Women are often older when they have a stroke, and they are more likely than males to die from it.
• Hormones – Taking estrogen-containing birth control pills or hormone therapy may raise your risk.

If someone suffers a stroke, pay close attention to the timing of symptoms. Some treatments are most successful if administered as soon as the stroke occurs.

• Symptoms of a stroke include impaired speech and comprehension. Someone may slur their words or have difficulties understanding discourse.
• Sudden numbness or paralysis in the face, arm, or leg. It usually affects just one side of the body. You should strive to raise both arms above your head simultaneously. If one arm begins to droop voluntarily, you may be experiencing a stroke.
• Vision issues in one or both eyes. Someone who has had a stroke may experience blurry or black vision in one or both eyes. Another possible symptom is double vision.
• Headache. A sudden, intense headache, maybe followed by vomiting, dizziness, or changes in consciousness, may suggest a stroke.
• Having difficulty walking. Someone who has had a stroke may stumble or lose their balance. It is also possible to have sudden dizziness or loss of coordination.

A stroke can occasionally result in temporary or permanent impairments. Complications vary depending on how long the brain is without blood supply and which parts are impacted. Complications could include:

• Paralysis is defined as the inability to move muscles. You may have paralysis on one side of your body. Alternatively, you may lose control of certain muscles, such as those on one side of your face or one arm.
• Trouble speaking or swallowing. A stroke may damage the muscles of the mouth and throat. This may make it difficult to speak correctly, swallow, or eat. You may also struggle with language skills, such as speaking, understanding, reading, and writing.
• Memory loss or difficulty thinking. Many people who have had strokes suffer from memory loss. Others may have difficulty thinking, reasoning, making decisions, and comprehending concepts.
• Emotional symptoms. People who have had strokes may have difficulty managing their emotions. Alternatively, they may develop depression.
• Pain. Pain, numbness, and other sensations may develop in areas of the body affected by a stroke. If you have a stroke and lose feeling in your left arm, you may experience tingling.
• Changes in behavior and self-care. People who have suffered a stroke may become more withdrawn. They may also require assistance with grooming and everyday tasks.

If you experience any stroke symptoms, get medical assistance right away, even if they appear to come and go or resolve entirely. Think "FAST" and follow these steps:

• Face. Ask the person to smile. Does one side of your face droop?
• Arms. Ask the individual to extend both arms. Is one arm drifting downward? Is one arm impossible to rise?
• Speech. Ask the subject to repeat a simple phrase. Is the person's speech slurred or different than usual?
• Time. If you see any of these symptoms, contact 911 or emergency medical services straight away.

Call 103 (Ukraine). Don't wait to see whether the symptoms resolve. Every minute matters. The longer a stroke remains untreated, the higher the risk of brain damage and disability.

If you are with someone who appears to be experiencing a stroke, keep a close eye on them while you await emergency aid.

The type of stroke determines the emergency care required.

Ischemic stroke

To treat an ischemic stroke, you must promptly restore blood flow to the brain. This can be completed with the assistance of

• Medication may be administered intravenously in an emergency. The sooner the medications are administered, the better.
• The gold standard for treating ischemic stroke is an intravenous injection of recombinant tissue plasminogen activator (alteplase or tenecteplase).
• Endovascular procedures. Endovascular treatment has been shown to considerably enhance outcomes and lower the likelihood of impairment following an ischemic stroke.

Hemorrhagic stroke

The primary goal of emergency hemorrhagic stroke treatment is to reduce bleeding and relieve cerebral pressure. Treatment alternatives include:

• Emergency measures. If a person is on blood thinners, medicines or blood transfusions may be recommended to counteract their effect in the event of a hemorrhagic stroke. In addition, drugs are administered to reduce blood pressure, prevent blood vessel spasms, and avoid seizures.
• Surgical intervention. If the bleeding is extensive, surgical intervention may be necessary. Surgical clipping is also done to treat aneurysms.
• Stereotactic radiosurgery is a sophisticated minimally invasive therapy procedure for eliminating blood vessel abnormalities.

Treatment and rehabilitation following a stroke necessitate a comprehensive strategy. Transcranial electrical stimulation (tDCS) and transcranial pulse stimulation (TPS) are used to aid in stroke recovery. These methods aid in the treatment of limb spasticity caused by a stroke (hemiparesis), swallowing issues (dysphagia), and speech disorders (aphasia).

If a stroke occurs on the right side of the brain, it can impair motor function and sensation on the left side of the body. If a stroke has affected brain tissue in the left hemisphere, it can impair motor function and sensation on the right side of the body, resulting in speech difficulties.

Rehabilitation might begin before a patient leaves the hospital. Recovery from a stroke varies from person to person. Depending on the ailment, the treatment and rehabilitation team may consist of the following specialists:

• Neurologist
• Rehabilitation therapist (physiotherapist)
• Rehabilitation nurse
• Nutritionist
• Occupational Therapist
• Recreational Therapist
• Speech therapists
• Social worker or case manager.
• Psychologist or psychiatrist?

What does stroke rehabilitation entail?

There are numerous techniques to assisting people in recovering from a stroke. However, in general, rehabilitation relies on precise, targeted, and repetitive activities, such as performing the same exercises repeatedly. The rehabilitation plan will be determined by whatever body functions are impaired by the stroke.

• Physical workouts can help enhance motor skills. Exercises can assist enhance muscle strength and coordination throughout the body. These could be exercises to improve balance, walking, or even swallowing.
• Mobility training. People who have had a stroke frequently learn to use mobility aids, such as a walker, cane, wheelchair, or ankle brace, to support their body weight while relearning how to walk.
• Range of motion therapy. Certain workouts and therapies can help reduce muscle tension (spasticity) and improve range of motion.

Rehabilitation should also include cognitive and emotional recovery:

• Therapy for cognitive disorders. Occupational therapy and speech therapy can help with lost cognitive abilities, such as memory, information processing, social skills, judgment, and safety awareness.
• Therapy for communication disorders. Speech therapy can help restore the lost abilities of speech, speech comprehension, and writing.
• Psychological assessment and treatment. Emotional adaptation of people is a very important part of rehabilitation.
• Medications. The doctor may recommend antidepressants or other medications to improve the patient's condition.

As we mentioned above, a comprehensive approach is needed in the treatment and rehabilitation of stroke, which includes the use of brain neuromodulation methods: transcranial electrical stimulation (tDCS) and transcranial pulse stimulation (TPS). These methods help with limb spasticity that occurs after a stroke (hemiparesis), as well as swallowing disorders (dysphagia) and speech disorders (aphasia). International practice has shown that patients who received a course of electrical stimulation had significantly better results compared to those who received only medication and physical therapy.

Recovery from a stroke can be long. It is normal to face difficulties along the way. Dedication and willingness to work on improvement will help you get the most out of it!