Neurological Conditions

Brain Stroke

Brain Stroke

Brain stroke causes long-term and, in some cases, lifelong disability if not addressed promptly in-time. In other words, brain stroke is a serious and often a life-threatening medical emergency condition. These are the potential risks associated with stroke: brain injury, long-term disability and paralysis. The risk of sudden death is also high with stroke.

Why a better understanding of stroke is important?

First of all, stroke is a medical emergency and its after effects are long-lasting. The next thing is that a majority of people don’t have any idea or clue whatsoever as what to do when a stroke strikes suddenly. Therefore, a better understanding, awareness of signs and symptoms and potential consequences is a must as far as stroke is concerned.

The next important aspect is the sooner one acts the better. It is as simple as this – a swift and responsive action can prevent potential damage to the brain, long-term disability and saves life.

The need of the hour is this: one must learn how to act swiftly when a stroke strikes suddenly.

Blood vessels narrow over a period of time and the arteries supplying blood to the brain get blocked suddenly due to plaque formation in them. The narrowing down of arteries and plaque formation is a progressive and continuous process that occur due to fatty acid deposits. When the blood supply to the brain stops suddenly brain stroke strikes. The risk factor for brain stroke is uncontrolled and high blood cholesterol levels. The risk of fatty acid deposits and plaque formation increases with obesity, unhealthy lifestyle, diabetes and high cholesterol levels in the blood.

Types of Strokes

Ischemic Stroke

The blockage of arteries that supply blood to the brain due to plaque formation or blood clot formation results in a type of stroke called ischemic stroke. This is the most common type of brain stroke.

Haemorrhagic stroke

When the blood vessels bursts and bleed inside the brain, stroke occurs. This type of stroke is known as haemorrhagic stroke.

Ischemic Attack (TIA)

Unlike a full-blown stroke, the blockage and interruption in the supply of blood to the brain is temporary or for a short duration. This type of stroke is known as Trans ischemic attack (TIA). Stroke may continue for up to 20 to 30 minutes or more or may be up to several hours. A person can experience TIAs once or twice or may be more times. In any case, the risk associated with this type of stroke is very high in people who are obese, have high blood pressure and cholesterol levels. If someone experiences, TIAs, the risk of future full-blown stroke is very high. Prompt treatment in the beginning can mitigate the future risk of stroke.

The warning signs of stroke

Sudden weakness, numbness in one arm or one leg or one side of the body, dizziness, loss of balance, drooping face, speech disturbances – trouble speaking or understanding, uneven smile, slurred speech, blurred vision, trouble seeing, sudden severe headache, confusion, trouble in coordination and trouble walking are the typical signs and symptoms of stroke.

Unique Symptoms of Stroke in Women

Women tend to experience some unique signs and symptoms of stroke including weakness, fainting, body aches, nausea and vomiting, agitation, hiccups, seizures, extreme weakness in arms and legs, hallucinations, shortness of breath and behavioural changes.

FAST test for the Identification of Stroke

This is an important test for the identification of stroke. Someone with a better understanding and knowledge of signs and symptoms of stroke can quickly and easily identify the most eminent signs and symptoms of stroke that are designated as FAST. This test helps in quickly identifying the following signs of stroke quite diligently.

Face: Drooping face is a prominent sign and the smile becomes uneven.

Arms: Weakness in one or both the arms. The quickest test is to see whether the person experiencing the typical signs of stroke is able to hold the arms up and raised.

Speech: Slurred speech (difficulty speaking -inability to pronounce words properly while speaking is another prominent sign).

Time: Time is very important – act fast if you notice all the above symptoms. Swift and responsive action can prevent disability. Life-threatening consequences and saves life. Time and quick action is important as it is a key to successful treatment.

Diagnosis of Stroke

Diagnosis for stroke is based on physical and clinical examination of the patient, and the signs and symptoms that the patient experienced before and after experiencing stroke. Based on the present symptoms, associated conditions and past medical history of the patient – if the neurologist suspects anything unusual he or she may recommend brain or MRI scans. But the diagnostic tests and scanning tests depend on the symptoms and severity of the condition.

When Should You See Brain Haemorrhage Doctors?

Don’t search for brain haemorrhage doctors or the best doctors for brain haemorrhage unless your problem is bleeding in and around the brain. Let us first understand what exactly is brain haemorrhage.

What is brain haemorrhage?

Bleeding in and around the brain when a weak blood vessel (an artery) bursts is known as brain haemorrhage. It is a type of brain stroke. A weak artery (brain aneurysm) often results in this condition. This type of brain stroke is known as haemorrhagic stroke as it causes localized bleeding in the surrounding tissues. The reason or cause for this type of condition can be a brain injury, trauma, high blood pressure, drug abuse and weak blood vessels.

What are the symptoms of brain haemorrhage?

Brain haemorrhage and stroke share almost same symptoms

Almost 12 to 15% of brain stroke fall under brain haemorrhage type of strokes. The symptoms associated with brain haemorrhage include weakness in upper and lower limbs (hands and legs), trouble speaking, weakness in the body, numbness in hands and legs; weakness in one side of the body, slurred speech, headache, and difficulty in performing day to day activities.

Brain doesn’t have the ability to sense the pain or any symptom if bleeding happens inside the brain. However, brain haemorrhage may be associated with a severe headache when bleeding occurs within the brain covering (meninges)

The other symptoms depend on the area of the brain affected

Blurred vision or problems with vision – if brain haemorrhage affect the part of the brain that controls vision, then the patient may experience disturbances in vision or blurred vision.

Problems with the balance and coordination: Weakness or numbness in hands and legs suggests issues with the balance and coordination centre of the brain. The other symptoms include dizziness and walking difficulty. Internal bleeding in the lower most area of the brain (Lower brain or brainstem) may lead to coma as most of the vital bodily functions are controlled by this part of the brain. There is no exact pattern of how symptoms may manifest – sometimes the symptoms come abruptly, become apparent and cause sudden trouble. At times symptoms may progress gradually.

Brain haemorrhages are also called cerebral haemorrhages, intracranial haemorrhages, or intracerebral haemorrhages. They account for about 13% of strokes.

What are the types of brain haemorrhage?

Brain haemorrhages are also known as intracranial (means occurring within the skull), intracerebral (within the brain), subarachnoid (between brain and its covering) and epidural or subdural (above or below the covering (dura) of the brain. These are actually types of brain haemorrhages.

What are the causes of brain haemorrhage?

The most common causes of haemorrhagic brain stroke may include high blood pressure, weak blood vessels, arteriovenous malformations (AVM), brain aneurysm, formation of blood clots inside the arteries of the brain, plague formation in brain arteries, weakening of arterial walls, and metastatic brain tumours. Similarly, in elderly people, amyloid proteins deposition in the blood vessels may cause brain haemorrhages. Certain liver disorders, brain trauma, drug abuse and use of certain prescription drugs can increase the risk of brain stroke.

Bleeding (haemophilia) and or blood disorders (sickle cell anaemia) may also lead to brain stroke of this type.

How is a brain haemorrhage diagnosed?

A neurologist examines the patient physically and evaluates his or her condition thoroughly. After clinical examination, if the doctor finds any sort of weakness in hands and legs of the patient, speech disturbances, memory issues and other symptoms suggestive of brain stroke, then the neurologist will order radiological tests (CT or MRI) to exactly pinpoint the location of bleeding.

Once the neurologist detects and identifies the location of bleeding in and around the brain. The doctor may recommend additional tests to rule out the presence of any abnormal blood vessels and other causes. Following the diagnosis of the condition and based on the medical history of the patient, associated health conditions and symptoms – the neurologist will plan appropriate treatment.

What should you do when you see someone experiencing the typical signs and symptoms of brain stroke?

Remember! Any type of brain stroke is a medical emergency (a life-threatening condition) – You must have to act swiftly to save the life of someone or at least avert paralysis from being occurring. Immediately seek emergency care by calling and reaching out to a nearest neurological emergency care centre.
Therefore, if you see someone with the following signs and symptoms:

  • Changes in vision, blurred or altered vision
  • A sudden severe headache
  • Decreased alertness / fatigue /Lethargy
  • Weakness in hands and legs
  • An abnormal sense of taste
  • Loss of balance
  • Loss of coordination
  • Trembling in hands and legs
  • Difficulty speaking, writing and reading
  • Difficulty understanding speech
  • Swallowing difficulty
  • Tingling sensation or numbness in hands and legs
  • Nausea and vomiting
  • Loss of consciousness
  • Seizures with no previous history of seizures

Seek immediate emergency care. Though most of the above signs and symptoms are associated with other health conditions apart from brain stroke or brain haemorrhage, you should seek immediate emergency care to rule out brain stroke.

What is the treatment?

A neurologist with an expertise of handling emergency stroke cases takes care of the patient – and therefore monitor such cases quite diligently. They do blood pressure monitoring and stabilize patient breathing and blood pressure as an initial treatment modality. To provide enough oxygen to the brain, a ventilator is used and intravenous fluids are given along with medications to the patient.

Neurologists take care of the patient quite expeditiously and judiciously after a thorough due diligence. Even a small margin of error in imparting care can have long-term adverse consequences. Doctors, therefore monitor heart rhythms, blood oxygen levels and pressure inside the skull as a special treatment measure. Once they stabilize the patient, they take subsequent measures to ensure that no more bleeding occurs inside the brain. Based on the size and location of the haemorrhage, surgical intervention may be decided.

Surgeries for the treatment of brain haemorrhage include:

Decompression of the brain – It is done by surgery
Unruptured cerebral aneurysm is treated by an angiography type of procedure by interventional neurologists to prevent future ruptures. Arteriovenous malformations (AVMs) are treated by blocking the blood flow in the smaller blood vessels leading to AVMs.

Neurologists and interventional neurologist take care of the patient. They prescribe several medicines to the patient to alleviate pain, reduce blood pressure and prevent seizures and to control swelling in and around the brain. The medicines may include osmotics, corticosteroids, painkillers and anticonvulsants to prevent seizures from occurring.