Brain Stroke

Overview

A brain stroke is a brain attack that occurs due to reduced or interrupted blood supply to a part of brain. It can occur to anyone at any point of time. The decreased blood supply results in deprivation of nutrients and oxygen in brain, resulting in death of brain cells.

Brain stroke is always an emergency condition that needs immediate care and treatment to prevent brain damage. Earlier the treatment, more are the chances of survival and less damage to body parts.

Risk factors of stroke

Obesity or being overweight
Sedentary lifestyle
Excessive alcohol intake
Smoking cigarette
Drug addiction
Uncontrolled high blood pressure
Hypercholesterolemia
Diabetes
Cardiovascular disease like heart failure, infection or defects
Use of birth control pills or hormone therapies

Causes of stroke

There can be following causes of stroke resulting in corresponding types of stroke:
- A blocked artery causes ischemic stroke
- Leaking or bursting of a blood vessel causes hemorrhagic stroke
- Temporary disruption of blood flow to the brain causes transient ischemic attack, or TIA

Symptoms of Stroke

The symptoms of stroke depend upon the brain area affected. But in most cases, patient complains of the following

Trouble while speaking (slurring) and understanding what the other person is saying
Trouble while walking
Excessive confusion
Sudden paralysis, numbness or weakness of the arm, leg or face, mainly on the one side of the body.
Sudden blurred vision or blackened vision in one or both eyes
A sudden and severe headache
Vomiting
Dizziness
Altered consciousness

Emergency symptoms of stroke

Immediate medical attention is required if any person notices following symptoms in himself or any known person (the easy way to remember them is to remember “FAST”):

Diagnosis of stroke

Stroke is an emergency condition and immediate action is required to minimize brain damage and increase the chances of survival of the patient. But for proper management of the stroke, it is important to know the type of stroke as treatment modalities are different for different types of stroke. So, first of all following are immediately done to find out the cause of stroke and its type:
- Physical examination and thorough history taking from patient’s relatives
- Blood tests to evaluate blood sugar levels, cholesterol levels, blood clotting time etc.
- CT scan to find out any hemorrhage, tumor or blockage in the brain blood vessels
- MRI scan to find out if any brain tissue is damaged by an ischemic stroke and brain hemorrhages.
- Carotid ultrasound to find out if th o ere is any buildup of fatty deposits (plaques) in the blood flow of the carotid arteries.
- An echocardiogram to find out if there can be a clot in the heart that may have traveled to brain and caused stroke.

Treatment of brain stroke

The treatment of stroke specifically depends upon the type of stroke i.e. blocking of artery or bleeding into the brain: In ischemic stroke, medications are given to restore blood flow to the brain like intravenous injection of tissue plasminogen activator (tPA). These medications dissolve the blood clot and restore the blood supply to the brain. Ischemic strokes are sometimes treated by emergency endovascular procedures that directly work inside the blocked blood vessel:

Intra-arterial thrombolysis

This involves insertion of a long and thin tube called catheter into the brain through an artery in the groin to directly deliver tPA medication into the affected area. This procedure has extended treatment window that intravenous tPA.

Clot removal with a stent retriever

If the clot is big and cannot be dissolved with medication, it is removed by using a catheter. Once the patient is given proper medication and is under controlled conditions, doctor may advise following procedures to prevent the risk for future strokes:

Carotid endarterectomy: In this procedure, the plaque from the carotid arteries are removed through an incision along the front of the neck.
Angioplasty and stents: In the angioplasty procedure, carotid arteries are accessed through an artery in the groin. Now to expand the narrowed artery, a balloon is inflated, and a stent is inserted to support the opened artery.

In Hemorrhagic stroke, emergency medications like warfarin or anti-platelet drugs such as clopidogrel are given to prevent blood clots, along with other medications to lower blood pressure in brain, or prevent vasospasm etc. Other than medications, following surgeries may also be required to repair blood vessel abnormalities:

Surgical clipping: In this procedure, a tiny clamp is placed at the aneurysm base to stop blood flow, prevent bursting of aneurysm, or to prevent re-bleeding of recently hemorrhaged aneurysm.
Coiling (endovascular embolization): This involves insertion of a catheter into a groin artery and guiding it to brain with the help of x-ray imaging. The aneurysm is filled with small detachable coils to block blood flow into the aneurysm.
Surgical AVM removal: This involves removal of the small AVM that is located into an easily accessible area to reduce future risk of stroke
Stereotactic radiosurgery: Highly focused radiations are used to repair vascular malformations.

Post-stroke care

Stroke can cause widespread and long-lasting problems that require constant care and support. The rehabilitation program after stroke may include many or all the following supportive care therapies:

Psychological support: Depression and anxiety of survival and quality of life may disturb the patient a lot. So psychological support is very important to boost the morale of the patient and increase his faith in medicine.
Physiotherapy: Physiotherapy is required to improve the muscle strength and overcome any walking or movement disabilities.
Occupational therapy: This is required to make patient learn the techniques to use equipment that may help him in carrying out daily activities effectively and on his own.
Speech and language therapist: Speech therapy can be very helpful to manage problems related with swallowing and speech.

Many more organs of body are affected by stroke and depending upon the need patient is taught various exercises, activities or techniques to improve the quality of life.

Why NICE ?

We are associated with the best hospitals globally having the emergency infrastructure, fully equipped with the latest technologies and techniques to overcome from every emergency condition.
Our team of doctors are highly experienced in ‘Emergency Patient Management’ and work together to save the patient.
Consultation from doctors through e-mail, phone, and video calling.
Rehabilitation programs are organized to assist complex surgery patients.
Complete support and assistance being given before and after treatment.
Cost of treatment is quite less as compared to other service providers.
We are always ready to offer our helping hand and our services are available 24/7