Stroke: The Human Disease Project

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Summary

It occurs when there is a reduction in blood flow to a portion of the brain. The brain cells cannot acquire the oxygen and nutrients they require from the blood, and they begin to die within a few minutes if the blood supply is cut off. This can result in long-term brain damage, long-term disability, or even death in certain cases. A stroke is a condition that affects the arteries that connect the brain to the rest of the body. It is the fifth largest cause of mortality in the United States and a primary cause of disability. A stroke can be caused by a clot impeding blood flow to the brain (called an ischemic stroke) or by a blood vessel rupturing and impeding blood flow to the brain (called a hemorrhagic stroke) (called a hemorrhagic stroke). A transient ischemic attack (TIA), sometimes referred to as a “mini stroke,” is caused by a transitory blood clot.

History of Stroke

More than 2,400 years ago, Hippocrates, the “father of medicine,” identified stroke for the first time. He coined the term apoplexy, which is derived from the Greek word meaning “struck down by violence.” While the term alluded to the abrupt changes that might occur after a stroke, it did not always explain what is actually occurring in the brain. Centuries later, in the 1600s, a physician called Jacob Wepfer determined that something was interfering with the blood circulation to the brains of those who died of apoplexy. In some of these cases, significant bleeding into the brain occurred. Others had their arteries stopped. In the decades afterward, medical research has made significant improvements in our understanding of the origins, symptoms, and treatment of apoplexy. One of the outcomes of these improvements was the classification of apoplexy according to the etiology of the disorder. Following this, apoplexy was referred to as stroke and cerebrovascular accident (CVA).

Prevalence

There is a dearth of literature on gender-specific characteristics of cerebrovascular disorders. Stroke is more prevalent in males than in women across all age groups, and women are, on average, many years older than men when they have their first stroke. Stroke is more prevalent in males than women until roughly the age of 80 years, at which point it becomes more prevalent in women. The bulk of research suggests that female stroke patients die at a faster rate than male stroke patients; nevertheless, there is some evidence, however limited, that males have a better functional prognosis. There appear to be few gender variations in risk factor profile and treatment response. The stress of giving informal care to stroke victims appears to be a danger to the carers’ mental health, who are overwhelmingly female.

Types of Stroke

A hemorrhagic stroke occurs when a blood artery in the brain bursts or ruptures, allowing blood to pour into the surrounding tissues. Hemorrhagic strokes are classified into three categories: An aneurysm is a condition in which a segment of a weakened blood artery balloons outward and occasionally ruptures. The other type of malformation is arteriovenous malformation, which is characterized by improperly formed blood vessels.

When a blood artery of this kind ruptures, it might result in a hemorrhagic stroke. Finally, extremely high blood pressure might compromise the tiny blood arteries in the brain, resulting in brain hemorrhage An ischemic stroke occurs when blood flow to the brain is blocked by a blood clot. Blood clots are frequently caused by atherosclerosis, an accumulation of fatty deposits on the inner lining of blood vessels. A small part of these fatty deposits may rupture and obstruct blood flow to the brain. The notion is comparable to that of a heart attack, in which a blood clot prevents blood flow to a part of the heart from being blocked.

Symptoms of Stroke

The absence of blood flow to the brain causes harm to the brain’s tissues. Stroke symptoms manifest in the bodily regions controlled by the injured brain areas. The sooner a person suffering from a stroke receives treatment, the more favorable their result is likely to be. As a result, it is vital to be aware of the symptoms of a stroke so that you can respond swiftly. Stroke symptoms may include Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination. Sudden severe headache with no known cause.

Symptoms of stroke include trouble walking, speaking and understanding, as well as paralysis or numbness of the face, arm, or leg.

F.A.S.T. Warning Signs

Use the letters in F.A.S.T to Spot a Stroke.

F = Face Drooping – Does one side of the face droop, or is it numb? Ask the person to smile. Is the person’s smile uneven?
A = Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S = Speech Difficulty – Is speech slurred?
T = Time to call 911

Effect of Stroke on the Body

Muscle weakness. In the United Kingdom, about three-quarters of stroke survivors experience leg weakness, and more than three-quarters have arm weakness. If you have weak muscles, you may have difficulty walking, moving your arms, or holding objects. Hemiparesis (‘half-weakness’) is a term that frequently refers to weakness on one side of the body. Hemiplegia (‘half-paralysis’) refers to paralysis on one side of the body.

If you are weak or paralyzed, you may require assistance with daily activities. Foot drop. This is a condition in which your toes grab on the ground as you take a step forward and you may elevate your foot higher than normal or swing your leg outwards when walking. It is caused by a weakening in the foot and ankle muscular groups that elevate your foot. It can result in difficulties walking and an increased risk of falling. Many patients have weariness or exhaustion following a stroke that does not improve with rest. Additionally, you may notice that physical activities tire you out more rapidly. For instance, you may notice that items slide from your hands or that you have difficulty using your cutlery after the conclusion of a meal.

Pain

Another prevalent physical ailment is pain. Certain individuals suffer from spasticity, or muscular stiffness, which can result in discomfort – see below. Shoulder discomfort can be caused by muscular stiffness or by weak muscles, which might result in a partial dislocation. Certain individuals experience uncomfortable or strange sensations such as tingling, freezing, or burning, which may be caused by injury to the neurological system. Following a stroke, headaches are frequent.

Spasticity

Muscle tone refers to the resistance or tension present in the muscles that enable you to move and maintain your position. Muscles never entirely relax: even when not flexed, they retain some resistance and feel springy to the touch.

Contractures

Spasticity can occasionally result in a permanent shortening of the muscles, referred to as contracture. Spasticity can cause some muscles to shorten or lengthen. Occasionally, these variations in length become permanent, and the muscles and joints become immobile. This can result in the joint being unable to be fully bent or straightened and the muscles being incapable of being stretched to their maximum extent.

Causes of Stroke

There are two main causes of stroke: a blocked artery (ischemic stroke) or leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may have only a temporary disruption of blood flow to the brain, known as a transient ischemic attack (TIA), that does not cause lasting symptoms.

Hypertension. Your physician may refer to this as hypertension. It is the most common cause of strokes. If your blood pressure is normally 140/90 or more, you will explore treatment options with your doctor. Tobacco. Smoking or chewing marijuana increases your risk of having a stroke. Nicotine causes an increase in blood pressure. Cigarette smoke deposits fatty material in the major neck artery. Additionally, it thickens your blood and increases its clotting potential.

Even passive smoking can have an effect. Cardiovascular illness. This disorder encompasses both faulty heart valves and atrial fibrillation, or irregular heartbeat, which accounts for one-quarter of all strokes in the extremely old. Additionally, fatty deposits might obstruct arteries. Diabetes. It is frequently associated with high blood pressure and an increased risk of being overweight. Both increase the risk of having a stroke. Diabetes wreaks havoc on your blood vessels, increasing your risk of having a stroke. When blood sugar levels are up, the damage to the brain is worse.

Treatment

An IV injection of recombinant tissue plasminogen activator (tPA) — also called alteplase (Activase) — is the standard gold treatment for ischemic stroke. An injection of tPA is usually given through a vein in the arm within the first three hours. Sometimes, tPA can be given up to 4.5 hours after stroke symptoms start. tPA increases the likelihood of recovery following a stroke. Patients who take tPA after having an ischemic stroke are more likely to recover completely or with less handicap than those who do not receive the medicine. Additionally, patients treated with tPA are less likely to require long-term nursing home care. Unfortunately, many stroke sufferers do not receive tPA therapy in time. This is why it is critical to immediately detect the signs and symptoms of stroke and dial 911.

Daily Life Effects

Stroke complications Trusted sources can vary. They may arise as a result of direct brain injury sustained during the stroke or as a result of permanently impaired capacities. Seizures, loss of bladder and bowel control, cognitive impairment, including dementia, decreased mobility, range of motion, or ability to control specific muscle movements, depression, mood or emotional changes, shoulder pain, bed sores, and sensory or sensation changes are just a few of these complications. Stroke can impair activities due to paralysis, poor coordination, loss of sensation, lack of awareness or neglect of one side of the body, or difficulties beginning or organizing a series of motions.

The burden of Stroke in America

Stroke was responsible for one in every six fatalities from cardiovascular disease in 2018. Every 40 seconds, someone in the United States has a stroke. Someone dies of a stroke every four minutes (Stroke Facts). In the United States, around 795,000 people experience a stroke each year. Approximately 610,000 of them are new or first strokes. Around 185,000 strokes—nearly 1 in every 4—occur in adults who have previously suffered a stroke. Around 87 percent of all strokes are ischemic strokes, in which the brain’s blood supply is cut off. Between 2014 and 2015, the United States spent over $46 billion on stroke-related expenditures (Stroke Facts). This sum includes the expense of health care services, stroke medications, and lost work days. Stroke is the greatest cause of long-term impairment in adults. More than half of stroke survivors aged 65 and above experience decreased mobility as a result of their stroke.

References

Nall, Rachel. “What Are the Different Types of Strokes?” Healthline, Healthline Media. 2016. Web.

Allen, Shari N. “Pharmacologic Management of Stroke.” Uspharmacist. 2017. Web.

Stroke Facts. 2021. Web.

“Stroke.” Medlineplus. National Library of Medicine, 2021. Web.

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