Stroke is the occurrence of a blockage or rupture of a blood vessel in the brain, thereby disrupting or reducing the blood supply to the brain suddenly. The brain then cannot receive enough oxygen or nutrients, and brain cells begin to break down and die. This is an emergency condition and requires emergency treatment.
Stroke is the fifth leading cause of death in the world. Nearly 800,000 people have a stroke every year. That equates to about one person every 40 seconds. But on the other hand medical science has made a lot of progress in stroke management so that death and disability rates are gradually decreasing every year.
STROKE TYPE
There are three main types of stroke:
- Ischemic stroke: the most common type of stroke, accounting for 87% of all cases. The blockage caused by a blood clot prevents blood and oxygen from reaching areas of the brain.
- Hemorrhagic stroke: this type of stroke occurs when a blood vessel bursts. This is usually caused by uncontrolled high blood pressure or a brain blood vessel abnormality such as an aneurysm or arteriovenous malformation (AVM).
- Transient ischemic attack (TIA): this condition occurs when blood flow to the brain is temporarily inadequate. Blood flow can then return to normal within a short time, symptoms disappear without treatment, usually in under 24 hours. Some people call it a mini stroke.
STROKE RISK FACTORS
Each type of stroke has different risk factors. But in general, here are some risk factors for stroke:
- Age 60 or over.
- Obesity (overweight).
- Previous or family history of stroke.
- Hypertension (high blood pressure).
- Diabetes (diabetes / high blood sugar).
- Dyslipidemia (high cholesterol).
- Heart disease or other blood vessel disorders.
- Abnormalities of the blood vessels of the brain (AVM, aneurysm).
- Sedentary (rarely exercise).
- Excessive alcohol consumption.
- Smoker.
It is recommended to carry out routine checks, especially if you have some of the risk factors above. It is highly recommended to do a GENERAL CHECK UP screening from the age of 30 and over. Early prevention will provide more benefits than it's too late.
STROKE SYMPTOMS
Stroke symptoms often appear without warning, and occur SUDDENLY . Some of the main symptoms include:
- Headache, may be accompanied by vomiting and decreased consciousness.
- Difficulty walking, including dizziness and impaired coordination.
- Visual disturbances (blurred eyes or double vision).
- Numbness or inability to move one side of the face.
- Weakness of the arm and leg on one side of the body.
- Difficulty speaking and understanding speech.
If any of these symptoms occur, IMMEDIATELY contact the nearest Hospital Emergency services. Healing is very dependent on how quickly the treatment is carried out. If it is too late, permanent brain damage or death can occur. For best results, treatment should be started within 3 HOURS of first symptoms appearing. TIME IS BRAIN!
STROKE CHECK
There are several kinds of examinations that can be done to determine the type of stroke, including:
- History and physical examination.
Ask about current symptoms and previous medical history. Next will be checked muscle strength, reflexes, sensation, vision, and coordination, as well as blood pressure and other vital signs.
- Blood test.
Measures the levels of certain substances in the blood, including clotting factors, blood cell counts, blood sugar, lipid factors, and others.
- CT scans and MRIs.
CT scan has a better ability to see hemorrhagic stroke while MRI is better at ischemic stroke.
- Angiography
Done if there is suspected brain blood vessel abnormalities such as an aneurysm or AVM.
TREATMENT: STROKE THERAPY
Ischemic and hemorrhagic strokes have different causes and effects on the body, so they require different therapies. Rapid diagnosis is essential to reduce the occurrence of brain damage and allow for treatment using methods suitable for its type.
- Ischemic stroke
- Therapy begins with giving drugs to break up blood clots and prevent other blood clots from forming. Drugs given in the form of blood thinners such as aspirin or tissue plasminogen activator (TPA). TPA is very effective at breaking up blood clots.
- Therapy begins with giving drugs to break up blood clots and prevent other blood clots from forming. The drugs given are in the form of blood thinners such as aspirin or tissue plasminogen activator (TPA). TPA is very effective at breaking up blood clots.
- Other procedures include administering TPA directly into a blood vessel in the brain or using a catheter to remove the blood clot directly.
- There are other procedures that can be performed to reduce the risk of stroke or TIA, namely carotid endarterectomy, which is surgery on the carotid arteries to remove plaque that can break and block blood vessels in the brain.
- Another option is angioplasty. This procedure is done by inflating a small balloon inside the narrowed blood vessel using a catheter. After that, a mesh or stent will be inserted into the vein to prevent narrowing.
- Hemorrhagic stroke
- Therapy begins with giving drugs that can reduce high pressure in the brain and control blood pressure overall, preventing seizures and sudden narrowing of blood vessels.
- If a person is taking anticoagulants, blood thinners, or antiplatelets, such as warfarin or clopidogrel, then these drugs are temporarily stopped.
- Surgery to remove blood clots can be performed under certain conditions, including the amount of bleeding of more than 20cc, accumulation of brain fluid, and the presence of brain blood vessel abnormalities such as aneurysms and AVMs.
TREATMENT: STROKE REHABILITATION
Stroke is an event that can change a person's life in the form of long-lasting physical and mental disorders. Rehabilitation involves specific therapies and support systems, including:
- Speech therapy: helps with problems speaking or understanding speech. Practice, relaxation, and changing communication styles can make communication easier.
- Physical therapy: helps relearn movement and coordination. It's important to stay active, even though this may be difficult at first.
- Occupational therapy: helps improve the ability to perform daily activities, such as bathing, cooking, dressing, eating, reading, writing, and more.
- Support groups: help with mental health problems that can occur after a stroke, such as depression. Many find it useful to share experiences and exchange information.
- Support from friends and family: close friends and relatives should provide support. Letting friends and family know what can be done to help is very important.
Rehabilitation is an important and ongoing part of stroke care. With the right help and support from loved ones, the quality of life for stroke sufferers can return or be close to normal.
Article written by dr. I Gde Anom Ananta, Sp.BS (Neurosurgeon Specialist at EMC Hospital Tangerang).