Question

What would you do if a patient presented to your outpatient clinic with symptoms of a stroke?

How would you treat an ischemic vs. a hemorrhagic stroke?

What would you do with or recommend for a person who is having frequent TIAs?

Answer 1

A stroke is a medical emergency. The patient found affected with symptoms of a stroke need to access emergency care treatment. There are only three to four hours time to restore the blood supply in brain affected part by use of thrombolytic medications.

Definition of stroke :- stroke is a life threatening disorder which occurs when parts of brain stop working because of disrupted blood supply. Because of disrupted blood supply brain stop working and it affects the part of body which are controlled by the injured brain.

Types of stroke:- There are three types of stroke which differ in warning signs and symptoms.

(1.) Ischemic stroke

(2.) Hemorrhagic stroke

(3.) Transient ischemic attack, TIA, or mini-stroke

Risk factors of stroke are as follows:-

(1.) smoking is most common cause of stroke.

(2.) Stroke is also found in diabetes patients.

(3.) high blood pressure (hypertension),

(4.) high cholesterol,

Causes of stroke :- stroke is caused by loss of blood supply or bleeding in the brain parts .

Bleeding in the brain part causes the formation of clot in brain blood vessels which cause the disrupted blood supply. Because of disrupted blood supply flow of oxygen through brain cells stopped which cause the stroke. And brain stop working. It affects the part of body which are controlled by the brain

Signs and symptoms of stroke :- The signs and symptoms of stroke differ and depend upon the part of brain affected by loss of blood supply.if anyone found with sign and symptoms of stroke. It’s a medical emergency and do not delay because timely treatment is critical to recovery of patient . stroke symptoms arise gradually and most commonly occur on one side of body.

There are few common Symptoms and signs of stroke :-

• Partial vision loss or double vision

• Changes in level or consciousness or patient get confused.

• Numbness in part of body or weakness or paralysis in half or part of body

• Difficulties in body balance

• Difficulties in speaking and Understanding speech.

• Mostly symptoms of ischemic and hemorrhagic stroke are same, but patients with hemorrhagic stroke may complain of headache and vomiting.

(1.) Ischaemic stroke:- Ischaemic stroke occurs because of a blockage of the blood vessels supplying blood and oxygen to the brain.

There are two types of ischaemic stroke:

(a.) Thrombotic stroke :- A thrombotic stroke is occur by a blood clot (thrombus) forming in one of the arteries of the brain, which disrupt the blood flow. The thrombus because of a build-up of plaque in the blood vessels.

(b.) Embolic stroke :- An embolic stroke occurs because of a blood clot that forms in any part of the body which travels through the circulatory system to the brain. The travelling clot is called an embolus.

(2.)Haemorrhagic stroke:- A haemorrhagic stroke occurs Because of bleeding in part of brain. Which cause the blockage of blood supply and oxygen and damaging brain cells of the brain.

Damage to brain cells from a haemorrhagic stroke maybe because of inadequate blood supply to areas of the brain, especially beyond the leaking vessel; andpressure and swelling within the brain due to irritation from the leaked blood.

(3.) Transient ischaemic attacks (TIAs), also called mini-strokes or temporary strokes. TIAs occur when there is a temporary blood clot and part of the brain does not get the supply of blood it requires

Symptoms of TIAs strokes are rapidly and usually last for a short while, from a few minutes to 24 hours. Similar to other stroke, the symptoms will differ depending on which part of the brain is affected.

Diagnosis of stroke :-Reviewing patient medical history , evaluation of symptoms of stroke conducting medical test and physical examination of patient helps in diagnosis of patient affected with stroke

Various imaging tests recommended by doctor such as CT scan, MRI scan , an ultrasound scan, some blood tests , these tests help doctor to identify the type of stroke and assess the extent of the damage to the brain

treatment of an ischaemic stroke :-Ischaemic stroke is caused by the clot of blood in brain cells. Clot dissolving medication are use to treat clot . Sooner the treatment done after the diagnosis of stroke better is the chance of treatment of Ischaemic stroke. Neurointerventional therapy sometimes used to treat some people with ischaemic stroke. a catheter is inserted into a blood vessel in the groin and threaded through the body to reach the blocked artery that has caused the stroke. The catheter is used to remove or dissolve the blood clot. Again, early treatment is important – this treatment needs to be done within several hours of the onset of symptoms.

Treatment of haemorrhagic stroke:- Haemorrhagic stroke treatment depends upon the cause of stroke . Sometimes brain surgery is recommended by the doctor for treatment of bleeding in brain.

The anti coagulant drugs are needed to be stop taking by patient .And to stop bleeding other medication is preferred by doctor to stop the bleeding inside brain. The treatment of high blood pressure also help in prevention of another stroke.

Lifestyle changes that can help reduce your risk of stroke are :-

• Stop drinking alcohol or limit the intake of alcohol.

• Eating a nutrition full diet. Or a balance diet recommended by doctor.

• Obesity is to be reduce by exercising , and lose fat if you are overweight.

• Stop smoking.

• Involve in physical activities.