04.12.2020 in Medicine
Stroke Stroke Diagnosis

Stroke

Stroke is a cardiovascular disease that affects millions of people all over the world. It is the second reason of death after ischemic heart disease. Stroke is a violation of blood circulation in the brain, causing damage to its tissues, and has dangerous consequences to a humans health. As a rule, genetics and the modern environment, which is full of stress, pollution, unhealthy lifestyles, and so on result in stroke. This disease develops suddenly and prevents blood flow to the brain. The most common cause of stroke is the formation of fatty deposits on the inner walls of the blood vessels supplying blood to the brain. This paper aims to observe stroke, its symptoms, diagnosis, treatment, and prevention.

History of Stroke

Hippocrates made the first mention of a stroke in 460 BC, which referred to the cases of loss of consciousness due to brain disease. Later, Galen introduced apoplexy (stroke) concept, which has designated such events. Subsequently, brain studies had determined that the main function of the brain was a thinking activity. In 1628, William Harvey suggested a pumping function of the heart while he studied the blood circulation. This knowledge contributed to the understanding of the role of vessels in this process. In 1658, Verfer found out stroke was accompanied by blood rupture in the brain tissue and hardening of the arteries. He also described the cases of transient ischemic attacks. Furthermore, in 1664, another scientist, Thomas Willis, found how to prevent stroke.

In the past, doctors called stroke apoplexy as they knew very little about its etiology.

The only treatment for stroke was meticulous care of the patient. Over the past two decades, scientists have conducted a significant amount of basic and clinical research. They found out how to identify the main risk factors of the disease and develop surgical methods of treatment. Perhaps, the most significant result of these studies was recently approved medication, which could completely change the pathology, if provided within the first few hours after the onset of the initial symptoms of the disease. Therefore, nowadays, scientists have developed new methods of treatment, broking old medical stereotypes.

The Causes of Stroke

To understand the causes of stroke, it is necessary to know that it can manifest in two types: ischemic and hemorrhagic that have their own predisposing factors and mechanisms of development. Ischemic stroke occurs in 75 percent of cases, and its cause is a blood clot or thrombus that clog a brain vessel. The thrombus or clot formed in the vessels of the brain or any other vessel of the body, where along with blood it can get into the brain blood vessels and clog them. Hemorrhagic stroke is the cause of a violation of the integrity of the brain vessels. When the blood vessel breaks, blood starts to accumulate in the adjacent tissues, creating increased pressure on the brain tissue, thereby disrupting their activities. Risk factors and causes of stroke include high blood pressure, or hypertension; cardiac diseases, mostly arrhythmias; atherosclerosis and elevated blood cholesterol, which can accumulate and be deposited in the form of fatty plaques in the walls of blood vessels, thereby narrowing their lumen. Furthermore, diabetes, cerebral aneurysms, obesity and overeating, and some other factors can lead to stroke.

Stroke symptoms depend on which part of the brain is damaged, and they, usually, develop suddenly or may appear and disappear within one or two days. The main symptom is a severe headache that appears suddenly without any reason. Other symptoms depend on the severity of the stroke and its location, including drowsiness, loss of consciousness, Confusion in thought, memory loss, difficulty in swallowing, violation of the ability to write or read, violation of urination and defecation, violation of coordination and orientation in space, and some others. The correct diagnosis and the detection of the exact location of a stroke, as well as the data volume of damaged tissue, allows a doctor to choose the right treatment and avoid more serious consequences.

Statistics of Stroke

According to the U.S. statistics, stroke takes the fifth place of a mortality rate in the United States. The majority of people, who suffer this disease, reach 65 years old, however, each year this threshold is getting younger. Moreover, it can occur at any age, and on average, in the USA every 40 seconds someone has a stroke. Each year, 15 million people die from stroke globally, and 140,000 of them are from the USA. Currently, 795,000 Americans have stroke attacks in a year. Death rates related to stroke are twice times higher in African-Americans, Native Indians, and Alaska Natives than other population groups. The risk groups include current smokers who outnumber two times their non-smoker counterparts.

Most commonly, stroke affects people suffering from atherosclerosis, hypertension, and cerebral aneurysms. Thus, in most cases, a thrombus formed of atherosclerotic plaque that penetrates into the brain from the bloodstream becomes a cause of stroke.

The Diagnosis, Treatment, and Prevention of Stroke

Stroke diagnosis is based on symptoms and signs, visual examination, and the results of tests. In the process of diagnosis, a doctor determines which type of stroke occurs, which areas of the brain are damaged and to what extent. Primarily, it is necessary to make MRI ECG, ultrasound of the heart, blood tests, and inspection of an ophthalmologist. A patient with stroke also takes computed tomography (CT) that is performed to take pictures from different angles and thus get a complete picture of the horizontal sections of the brain.

The treatment of stroke depends on its cause. Patients with an ischemic or hemorrhagic stroke may receive drug treatment. Tissue plasminogen activator (tPA) helps dissolve the clot and improve blood flow to the brain. It is given via intravenous therapy. In some cases, surgeons insert small mechanical devices in aneurisms that break up or remove blood clots. Nilsen et al. assume that in parallel, symptomatic therapy is carried out, which may consist of hypothermic agents (acetaminophen and naproxen) and anticonvulsants (diazepam, valproate sodium thiopental, and hexenal). Doctors may also use angioplasty, stenting and carotid endarterectomy.

Primary prevention of stroke is a healthy diet with a minimal amount of animal fat and salt; sedentary life; a balanced and calm character that allows avoiding sharp stress, and absence of bad habits. In some cases, the prevention of stroke is surgery such as carotid endarterectomy, reconstruction of the vertebral artery, the formation of the extra-intracranial anastomosis, and surgical treatment of AVM.

Conclusion

To sum up, stroke is one of the most common cardiovascular diseases that has dangerous consequences. It takes the second place for causes of death worldwide. If someone has a stroke, it is necessary to call for ambulance right away because such a person requires professional medical care in a hospital. Time delays may worsen a patients condition. I have chosen this disorder for my research because I have a predisposition to stroke since my blood pressure is high and all members of our family have died from a stroke. Therefore, it is extremely important to know its signs and symptoms in order to provide timely treatment. Modern medicine has a variety of treatment choices, diagnostics, and prevention. A person should be well-informed about this disease to avoid disability and death.

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