A stroke occurs when the blood supply to a part of the brain is suddenly blocked (Ischemic Stroke) or when a blood vessel in the brain bursts (Haemorrhagic Stroke). As brain cells constantly need glucose and oxygen, the affected brain cells die.
Symptoms depend on the parts affected in the brain due to the stroke. The common symptoms are:
Sudden drooping of face
Sudden weakness or numbness of upper or lower limb on either side
Difficulty in speaking and understanding
Sudden onset of vertigo, imbalance, difficulty in swallowing and sometimes, coma
If you notice any of these symptoms, immediately rush to a hospital that has a Stroke Unit.
Doctors perform a brain scan like CT (Computed Tomography) or MRI (Magnetic Resonance Imaging). This scan helps them diagnose whether the patient has a clot or bleeding inside the brain.
For patients with a clot inside the brain, the clot can be dissolved by administering an injection called recombinant tissue plasminogen activator, within 3 hours of having a stroke. In some cases, this window might be extended to 4.5 hours.
Mechanical Thrombectomy is a minimally invasive procedure that uses a stent device to remove a clot from an artery, restoring blood flow to the brain within 8 hours of the stroke onset. This therapy is for patients who are outside of the indicated time window.
When a blood vessel on the surface of the brain ruptures, it is called SAH. In this condition the patient will experience a sudden and very severe headache. It is due to the rupture of an aneurysm (a bleb or a weak spot on the blood vessel).
Choice of treatment depends on various factors, such as the size, location and type of aneurysm, whether the aneurysm has ruptured or not, and the patient’s general condition as well as medical history.
Microvascular Clipping is a surgical procedure where the skull is cut open and a small clothespin-like clip is placed on the neck of the aneurysm. This cuts off the blood supply to the aneurysm.
There are now other alternative treatment options to surgical procedures. One of them is a minimally invasive technique to treat the aneurysm by introducing coils in the aneurysm sac to prevent bleeding. The most advanced treatment is using a PipelineTM Embolization Device. This is a wire-meshed cylindrical tube implanted across the opening of the aneurysm. It serves to divert blood flow away from the aneurysm while maintaining the flow through the artery. This leads the blood in the aneurysm to clot, thereby reducing the chance of aneurysm rupture or aneurysm size growth.
Stroke patients are admitted to the Stroke ICU/Stroke Unit. The Stroke Unit is a team comprising neurologists, neurointerventionalists, neurointerventionalists, nurses, neurosurgeons and rehabilitation doctors. The entire team strives to provide care to stroke patients to help them get back to normal life.
A stroke occurs due to vascular risk factors like hypertension, diabetes mellitus, and increased blood lipids. Obesity, excessive smoking, alcohol abuse, lack of physical activity, advancing age and genetic conditions may also increase a person’s risk of suffering a stroke.
Yes, it is possible to predict a person’s risk of developing a stroke and provide treatment to prevent it. The common risk factors mentioned above can be assessed by physical examination and blood tests.
The most common cause of a stroke is atherosclerosis, which happens when blood vessels have a deposit of lipids (cholesterol) within their lumen. Doctors can identify them by doing an ultrasound scan of the neck. These changes are medically called as intima-media thickness or plaque.
Transcranial Doppler or TCD is called a doctor’s stethoscope for the brain. This specialized instrument can detect the blood flow velocities within our brain and can detect small clots passing through the brain vessels called “microemboli”.
With the above mentioned tests, the doctors can predict the risk of a stroke and start treatment which can drastically bring down the risk.