A Stroke or “brain attack” is a form of cardiovascular disease. It affects the arteries or veins and stops the flow of blood bringing oxygen and nutrients to the brain. A stroke occurs when one of these blood vessels bursts or becomes clogged. When this happens, the brain does not receive the flow of blood that it requires, and the affected tissue starts to die.

Types of Strokes

  • Cerebral Thrombosis: This occurs when a blood clot forms in a vessel in the brain. Blood clots form most often in arteries injured by atherosclerosis. This is a disease condition in which fatty deposits build up in the inner walls of the arteries.
  • Cerebral Embolism: This occurs when a clot or other particle gets stuck in the artery leading to the brain, or in the brain itself. Such clots are carried by the bloodstream and most often come from diseased areas of the heart. Subarachnoid Hemorrhage This occurs when a blood vessel on the brain ruptures and bleeds between the brain and the skull.
  • Cerebral Hemorrhage: This occurs when a defective artery in the brain bursts, flooding the surrounding tissue with blood. This type of stroke is often associated with high blood pressure.

Warning Signs of a Stroke

  • Sudden weakness or numbness of the face, arm and leg of one side of the body • Loss of speech, or trouble talking or understanding speech
  • Dimness or loss of vision, particularly only in one eye
  • Unexplained dizziness, unsteadiness, or sudden falls, especially along with any of the previous symptoms

One or more of these warning signs, indicates a need to seek medical treatment immediately.

TIAs (transient ischemic attacks) – About 10% of strokes are preceded by these “temporary brain attacks”. They can occur days, weeks, or even months before a major stroke. TIAs result when a blood clot temporarily clogs an artery and part of the brain doesn’t get the supply of blood it needs. The symptoms occur rapidly and last a relatively short time, usually a few minutes to several hours. These symptoms are similar to the stroke symptoms. However, they are temporary, lasting 24 hours or less. TIAs are warning signs of a stroke. They should not be ignored!

Risk Factors of a Stroke

The following risk factors cannot be changed:

  • Increasing Age: The older the person gets, the greater the risk of stroke.
  • Being Male: Men are at higher risk of a stroke.
  • Race: African-Americans are at higher risk than Anglo-Americans.
  • Diabetes Mellitus: Diabetics have a higher risk of stroke.
  • A Prior Stroke: Someone who has already had a brain attack is at higher risk for having another one.
  • Heredity: People who have a family history of brain attacks are at higher risk themselves of stroke.
  • Asymptomatic Carotid Bruit: A bruit is an abnormal sound that is heard with the aid of a stethoscope. It indicates that atherosclerosis (hardening of the arteries) is present in the carotid artery.

The following risk factors can be modified with medical treatment:

  •  High Blood Pressure: This is the most important modifiable risk factor for stroke.
  •  Heart Disease: Clots that form in the heart can break away and lead to brain attack.
  •  TIAs: Proper medical treatment of TIAs can reduce the risk of a major stroke occurring.
  •  High Red Blood Cell Count: Too many red blood cells thicken the blood and make clots more likely. Blood thinners or removing blood can treat this factor.

The following risk factors can be modified with lifestyle changes:

  • Cigarette Smoking: Smoking increases blood pressure, reduces the amount of oxygen in the blood, thickens the blood, and makes clots more likely to form.
  • Elevated Blood Cholesterol and Lipids: High blood cholesterol increases the buildup of fats in artery walls, increasing the risk of heart disease.
  • Physical Inactivity and Obesity: Being inactive, obese, or both can increase blood pressure and make the accumulation of cholesterol in artery walls more likely.
  • Drinking Too Much Alcohol: More than two drinks per day elevates blood pressure. Binge drinking can lead to a brain attack.
  • Certain Kinds of Drug Abuse: Intravenous drug abuse carries a high risk of stroke from cerebral embolisms. Cocaine users had also been linked to stroke, even in first-time users.

Rehabilitation from Stroke

Successful rehabilitation depends on the extent of the brain injury, the stroke survivor’s attitude, the skill of the rehabilitation team and the cooperation of family and friends. Most stroke survivors can benefit from rehabilitation, and today, the outlook for them is more hopeful than ever. Many stroke survivors are able to return to an active lifestyle.

Points to Consider

  • Brain attacks affect different people in different ways. Recovery may depend on the type of stroke and the area of the brain affected.
  • Brain injury from a stroke can affect the senses, speech and the ability to understand speech, behavioural patterns, thought patterns and memory.
  • Paralysis on one side of the body can also occur.
  • The part of the body affected by the stroke may eventually improve or even return to normal. This is made possible by the body’s compensation, causing growth of the neighbouring blood vessels, improving the blood supply to that area.
  • Not everyone recovers spontaneously. Many people need rehabilitation to learn new skills.
  • For many reasons, it is important to maintain and improve the stroke survivor’s physical condition whenever possible.
  • Rehabilitation should begin as soon after a brain attack as possible.
  • Along with the primary goal of rehabilitation (helping survivors develop new motor skills), nurses and other hospital personnel work to prevent secondary complications from arising (joint stiffness, bedsores and pneumonia).
  • Many people play an important role in the rehabilitation. All should understand the emotional and physical challenges the stroke survivor faces.

For stroke survivors, the goal of rehabilitation is to be as independent and productive as possible.

Source: This article was adapted from information through the Heart and Stroke Foundation of Canada.