All You Need to Know About A Brain Stroke
Upendra Kaul
Founder Director, Gauri Kaul foundation at Gauri Heart Centre Srinagar and Delhi
Stroke or paralysis is a devastating problem which can make the sufferer totally incapacitated and dependent. It is caused by sudden interruption of blood supply to a portion of the brain depending on the artery involved. It is often preceded by warning symptoms of short-lasting symptoms with full recovery called Transient Ischemic Attack (TIA). Common symptoms are: weakness on one side of the body, numbness of the face, unusual and severe headache, vision loss, numbness and tingling and unsteady walk. TIA should never be ignored.
Strokes can be Ischemic or haemorrhagic. Ischemic strokes are usually because of blockade of the artery by a blood clot and haemorrhagic strokes because of a bleeding or rupture of a artery of the brain. Brain haemorrhage is a very catastrophic event, needing immediate diagnosis of the cause like rupture or a leak of a birth malformation which can be clipped or coiled by experts.
The risk factors for the commonest stroke is ischemic :are like a heart attack : High BP, Diabetes, High cholesterol , smoking, obesity and if these are kept under control, minimizes the chance. In addition, there is an important cause called atrial fibrillation (AF) which is an abnormally rapid and irregular heart rate either continuously or intermittently. Stroke is a very serious complication of this very common arrhythmia. It is more often seen in persons beyond the age of 65 years. It can be associated with underlying heart disease including Rheumatic heart disease and heart attacks in much younger people.
Like a heart attack if the ischemic stoke patient is treated very early complete recovery can occur by administering clot dissolving medicines after ruling out bleeding as the cause by imaging (CT or MRI). They also need High dose of cholesterol lowering drugs and Aspirin etc. Patients with AF with even a modestly high risk need blood thinners. These days we have much simpler to use drugs like dabigatran, apixaban and rivaroxaban in fixed doses without need for monitoring unlike Warfarin. Bleeding risks are low with a very good efficacy.