Mercy Eka's Blog

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This section of my blog will provide the readers an educational opportunity on some common deadly diseases; their signs and symptom, and what you can do to minimize progression.




STROKE. What is stroke?
A stroke is a "brain attack". It can happen to anyone at any time. It occurs when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells begin to die during a stroke, abilities controlled by that area of the brain such as memory, speech, and muscle control are lost according to National stroke Association ( 2018).
How a person is affected by their stroke depends on where the stroke occurs in the brain and how much of the brain cells are affected or damaged. For example, someone who had a small stroke may only have minor problems such as temporary weakness of an arm or leg. People who have larger strokes may be permanently paralyzed on one side of their body or lose their ability to speak. Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability.

EPIDEMIOLOGY
Each year nearly 800,000 people experience a new or recurrent stroke.
A stroke happens every 40 seconds.
Stroke is the fifth leading cause of death in the U.S. But in Nigeria, may be 2nd leading
Every 4 minutes someone dies from stroke.
Up to 80 percent of strokes can be prevented.
Stroke is the leading cause of adult disability in the U.S.

TYPES OF STROKE: There are two types of stroke, hemorrhagic and ischemic. Hemorrhagic strokes are less common, in fact only 15 percent of all strokes are hemorrhagic, but they are responsible for about 40 percent of all stroke deaths.
Hemorrhagic stroke: A hemorrhagic stroke is either a brain aneurysm burst or a weakened blood vessel leak. Blood spills into or around the brain and creates swelling and pressure, damaging cells and tissue in the brain. There are two types of hemorrhagic stroke called intracerebral and subarachnoid (NSA 2018).

The most common hemorrhagic stroke happens when a blood vessel inside the brain bursts and leaks blood into surrounding brain tissue (intracerebral hemorrhage). The bleeding causes brain cells to die and the affected part of the brain stops working correctly. High blood pressure and aging blood vessels are the most common causes of this type of stroke.
Sometimes intracerebral hemorrhagic stroke can be caused by an arteriovenous malformation (AVM). AVM is a genetic condition of abnormal connection between arteries and veins and most often occurs in the brain or spine. If AVM occurs in the brain, vessels can break and bleed into the brain. The cause of AVM is unclear but once diagnosed it can be treated successfully.

This type of stroke involves bleeding in the area between the brain and the tissue covering the brain, known as the subarachnoid space. This type of stroke is most often caused by a burst aneurysm. Other causes include:
AVM
Bleeding disorders
Head injury
Blood thinners
The second type of stroke is Ischemic stroke
Ischemic stroke occurs when a blood vessel carrying blood to the brain is blocked by a blood clot. This causes blood not to reach the brain. High blood pressure is the most important risk factor for this type of stroke. Ischemic strokes account for about 87% of all strokes. An ischemic stroke can occur in two ways (NSA 2018)

*In an embolic stroke, a blood clot or plaque fragment forms somewhere in the body (usually the heart) and travels to the brain. Once in the brain, the clot travels to a blood vessel small enough to block its passage. The clot lodges there, blocking the blood vessel and causing a stroke. About 15% of embolic strokes occur in people with atrial fibrillation (Afib). The medical word for this type of blood clot is embolus.

*A thrombotic stroke is caused by a blood clot that forms inside one of the arteries supplying blood to the brain. This type of stroke is usually seen in people with high cholesterol levels and atherosclerosis. The medical word for a clot that forms on a blood-vessel deposit is thrombus.
Two types of blood clots can cause thrombotic stroke: large vessel thrombosis and small vessel disease.

Large Vessel Thrombosis
The most common form of thrombotic stroke (large vessel thrombosis) occurs in the brain’s larger arteries. In most cases it is caused by long-term atherosclerosis in combination



with rapid blood clot formation. High cholesterol is a common risk factor for this type of stroke.
Small Vessel Disease
Another form of thrombotic stroke happens when blood flow is blocked to a very small arterial vessel (small vessel disease or lacunar infarction). Little is known about the causes of this type of stroke, but it is closely linked to high blood pressure.

What is TIA?
When blood flow to part of the brain stops for a short period of time, also called transient ischemic attack (TIA), it can mimic stroke-like symptoms. These symptoms appear and last less than 24 hours before disappearing. While TIAs generally do not cause permanent brain damage, they are a serious warning sign that a stroke may happen in the future and should not be ignored

TIAs are usually caused by one of three things:

Low blood flow at a narrow part of a major artery carrying blood to the brain, such as the carotid artery.
A blood clot in another part of the body (such as the heart) breaks off, travels to the brain, and blocks a blood vessel in the brain.
Narrowing of the smaller blood vessel in the brain, blocking blood flow for a short period of time; usually caused by plaque (a fatty substance) build-up.

Some important facts to keep in mind include:

Generally, 40 percent of people who have a TIA will have an actual stroke
Nearly half of all strokes occur within the first few days after a TIA
Symptoms for TIA are the same as for a stroke

MANAGEMENT OF TIA
The goal of TIA management is to prevent a future stroke. The medicine and therapy used depends on the exact cause of the TIA. In addition to lifestyle changes such as diet, physical activity, limiting alcohol intake, and not smoking, your healthcare provider may recommend medications to treat high blood pressure, high cholesterol, or heart disease. These changes may reduce your risk of further TIA or stroke.
There are many medications that help prevent blood clots from forming—reducing the risk of full-blown stroke.
If a TIA is caused by blockage in the main artery in the neck that supplies blood to the brain, called the carotid artery, surgeries may be required to open the artery, and prevent a stroke. These procedures are known as endarterectomy and stenting.

Talk to a healthcare provider about the best stroke prevention options for you. Then take responsibility and enjoy a healthy lifestyle. The lifestyle adjustments such as eating healthy foods and quitting smoking—made today may reduce the risk of stroke tomorrow (NSA 2018).

by Mercy Eka at 13/08/2018 7:41 AM
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