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INTRODUCTION.

A stroke occurs when a blockage or bleed of the blood vessels either interrupts or reduces the supply of blood and oxygen to the brain. When this happens, the brain does not receive enough oxygen or nutrients, and brain cells start to die. Ig is usually rapid in onset without warning.

CAUSES AND RISK FACTORS

Each type of stroke has a different set of potential causes. Generally, however, stroke is more likely to affect a person if they:

1. Overweight or obesity
2. Old age
3. Personal or family history of stroke
4. Uncontrolled high blood pressure
5. Uncontrolled diabetes
6. have high cholesterol
7. have heart disease, carotid artery disease, or another vascular disease
8. Sedentary lifestyle
9. Consume alcohol excessively
10. Smoking
11. Use of illicit drugs

TYPES OF STROKE

1. Ischemic stroke

This type of stroke occurs due to blockages or narrowing in the arteries that provide blood to the brain. This leads to death (ischemia) of brain cells on the affected part of the brain. It can also severely reduced blood flow, which damages brain cells.

Clots can form within the brain arteries or other parts of the body and carried via the blood vessels into the brain. The clots may flow freely in other  blood vessel because of their sizes compared to some tiny vessels within the brain. Fatty plaque deposits within the arteries can also cause clots that result in ischemia.

2. HAEMORRHAGIC  STROKE

Leaky or burst arteries in the brain can give rise to hemorrhagic strokes. Leaked blood puts pressure on brain cells and damages them. It also reduces the blood supply that can reach the brain tissue after the hemorrhage.

Blood vessels can burst and spill blood into the brain or near the surface of the brain. This may also send blood into the space between the brain and the skull.

Having hypertension, experiencing physical trauma, taking blood-thinning medications, and having an aneurysm can all make a blood vessel leak or burst.

3. TRANSIENT ISCHAEMIC STROKE (TIA)

TIA’s only briefly interrupt the flow of blood to the brain leading to shortage of oxygen supply. Transient ischemic stroke similar to ischemic strokes, in that it usually occur due to impact of blood clots(s).

People should treat them as medical emergencies, even if the symptoms are usually temporary and resolves completely. They serve as warning signs for future strokes. These people have a higher chance of having a full blown stroke.

SYMPTOMS OF STROKE

The occurrence of a stroke often appear without prior notice in most cases. However, some patients may have had a form of stroke called Transient ischemic stroke (TIH) which could be a pointer of the possibility of full blown stroke in the nearest future if care is not taken.

1. Confusion, including difficulty speaking and understanding speech
2. Headache, possibly with altered consciousness or vomiting
3. Numbness or an inability to move parts of the face, arm, or leg, particularly on one side of the body.
4. Vision problems in one or both eyes. This could range from blurring of vision to total blindness.
5. Difficulty walking, poor gait, lack of coordination, falls.
6. Facial bending towards one side. Usually opposite side of the affected part of the body.

“FAST” is a cool way to remember this symptoms of stroke.

1. FACE dropping : Patient may notice facial dropping or bending towards on side.
2. ARM weakness : Affected arm may be weaker than the other arm. There is usually affectation of the leg on that same side of the body in most cases.
3. SPEECH difficulty: This is also a common presentation for stroke patients. Usually, family members or friends would notice this significant change in speech tone.
4. TIME is important for management and treatment. The importance of presenting to the hospital of healthcare facility can not be overemphasized.

DIAGNOSIS.

Stroke usually occur in a rapid manner. To get the best possible results or outcome, it is good for the patient to present to the healthcare facility early after the stroke occurrence.

1. Physical examination by medical doctor/ health care provider
2. CT scan: This would help differentiate between hemorrhagic or ischemic stroke. It is also helpful to know the extent of the stroke.
3. MRI scan
4. Blood test: Lipid profile for cholesterol check, Full blood count (FBC) or complete blood c count (CBC), renal function test, cardiac enzymes are some blood investigations that can also be helpful in the diagnosis and management of stroke.
5. Echocardiogram: This is helpful for imaging of the heart.

TREATMENT

Because ischemic and hemorrhagic strokes have different causes and effects on human body. Therefore  treatment or management of either of them differs with few similarities.

1. Drugs that break down clots and prevent others from forming. Aspirin or an injection of tissue plasminogen activator (TPA).
2. Treatment often begins with taking drugs that reduce pressure in the brain and control overall blood pressure
3. Surgeons can repair some of the problems with blood vessels that have led or could lead to hemorrhagic strokes.
4. Rehabilitation: Speech therapy,  occupational therapy, physical therapy, support group & support from family and friends.

CONCLUSION: Stroke is a life threatening condition and it’s aftermath can be devastating. Prevention is the best therapy.

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