What is stroke?

What is stroke?

A stroke occurs when blood flow to an area of the brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells die during a stroke, abilities controlled by that area of the brain such as memory and muscle control are lost.

How do you know if you are experiencing a stroke?

The warning signs and symptoms of stroke are always sudden. The damage to brain tissue can cause:

• Sudden numbness/weakness of the face, arms or legs, usually on one side
• A sudden problem in speaking
• Abrupt dizziness or difficulty in balance, body coordination and walking
• Abrupt intense headache
• Abrupt confusion or difficulty in comprehending
• Sudden trouble seeing or blurred vision in one or both eyes 
  
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What are the risk factors?

         - Elderly (age 65 and older)

         - Men have a higher risk for stroke

         - Consistent high blood pressure

         - Obesity or being overweight

         - Physical inactivity / sedentary lifestyle

         - High level of cholesterol / Poor diet choices

         - Cigarette smoking

         - Alcohol abuse

         - Diabetes

         - Cardiovascular diseases, such as heart failure, heart defects, heart infection, or

         abnormal heart rhythm

         - Personal or family history of stroke, heart attack, or transient ischemic attack

What happens when you have a stroke?

A stroke may be caused by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA) that does not cause permanent damage.

How is a stroke diagnosed?

• Neurologic and Physical Examination - A thorough medical history as well as complete neurological evaluation will be done by a doctor to help find the location and severity of a stroke.
• Neuroimaging
  • Computerized Tomography (CT) – This provides a clear picture of the brain structure to determine if there is any abnormality. 
  • Magnetic Resonance Imaging (MRI) – Though more expensive, MRI is a better test to determine brain abnormality especially during the early moments of stroke (first 3 to 4.5 hours).
  • Blood tests -These include tests to determine blood and bleeding time (Complete blood count and Protime), Cholesterol level (Lipid profile), Kidney function (creatinine and Blood urea nitrogen) and liver function (Alanine Aminotransferase).

What are the available treatment options?

The goal in treating a stroke is to stabilize the patient, restore the lost blood flow and deliver enough oxygen to recover brain function. The treatment of stroke varies individually and depends on the extent of the brain tissue damage:

?     Thrombolysis (recombinant Tissue Plasminogen Activator or rTPA) - used to dissolve the dangerous clots in the blood vessels. It is given for the ischemic type of stroke and if the patient came in within the golden period of about 3 to 4.5 hours from the symptom onset.

?     Mechanical Thrombectomy - a procedure to remove the dangerous clot causing the signs and symptoms of stroke by using a small wire inserted in a blood vessel to retrieve/dissolve the clot directly.

?     Surgical treatment – can be done for hemorrhagic stroke wherein there is a need to remove the actual blood to minimize complications. If a ruptured aneurysm is suspected, a surgical clip or a metal coil can be inserted to seal the leak.

What are the possible complications?

• Paralysis or loss of muscle movement– permanent weakness or loss of sensation of one side of the face, arm and/or leg
• Difficulty talking or swallowing - A stroke might affect the control of the muscles in your mouth and throat, making it difficult for you to talk clearly (dysarthria), swallow (dysphagia) or eat.
• Cognitive Dysfunction - These include memory loss, difficulty thinking, making decisions, judgment, reasoning and understanding concepts.
• Poor quality of life - People who have had a stroke need assistance to accomplish their activities of daily living, such as bathing, clothing, and eating.

How can The Medical City help you?

At The Medical City, we have a complete roster of physicians who can assess, diagnose, and treat stroke. Specialists include Neurologists, Neurosurgeons, Emergency Medicine Doctors, Radiologists, Internists, as well as Rehabilitation Specialists, Nutritionists and Psychiatrists for long term care post-stroke.

Note: This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment.

For inquiries, you may contact

INSTITUTE OF THE NEUROLOGICAL SCIENCES

Department of Neurology

4^th Floor, Podium Bldg, The Medical City

Tel. No: (+632) 988-1000 / (+632) 9887000 ext. 6270

INSTITUTE OF THE NEUROLOGICAL SCIENCES

Acute Stroke Unit

3^rd Floor, Podium Bldg, The Medical City

Tel. No: (+632) 988-1000 / (+632) 9887000 ext. 6281 or 6634

EMERGENCY DEPARTMENT

Ground Floor, Podium Building, The Medical City

Tel. No.: (+632) 988-1000 / (+632) 9887000 ext. 6174 or 7876

References:

• Mayo Clinic. Updated 20 Jan 2016. Stroke
• Tintinalli, J.F., Stapczynski, J.S. , Ma, O.J., Cline, D., Meckler, G. D. & Yealy, D. M. (2016). Tintinalli Emergency Medicine; A Comprehensive Study Guide. New York: McGraw-Hill Education.
• Walls, R.M., Hockberger, R.S., Gauche-Hill, M. Rosen’s Emergency Medicine: Concept and Clinical Practice. Philadelphia: Elsevier, Inc.