Strokes – the Number One Contributor of Adult Disabilities in the United States (From Medicalscene)

Strokes:

The World Health Organization has defined the medical emergency Strokes, the rapid developmental loss of brain functions resulting in the inability to form or understand speech, the inability to move one or more limbs on the affected side of the body, and the inability to see one side of the visual field, as “neurological deficits of cerebrovascular causes that persist beyond 24 hours or are interrupted by death within 24 hours”.

Causes:

Strokes may start suddenly and not progress any further, however, the causes of the ailment include such conditions as hypertension, elderly ages, cigarette smoking, paroxysmal atrial fibillations, cardiac arrhythmias, diabetes, high cholesterol, previous Strokes, sickle cell anemia, blocked blood vessels, blood cell clumps, arterial embolisms, the Sick Sinus Syndrome, aortic and mitral valve rheumatic diseases, artificial heart valves, cardiac thrombosis, chronic myocardial infarctions, congestive heart failure, Libman-Sacks Endocarditis, dilated cardiomyopathy, left atrial myxoma, coronary artery bypass graft surgeries, papillary fibroelastoma, Marantic Endocarditis, calcification of the mitral valve annulus ring, atrial septal aneurysms, ascending aorta complex atheromas, pericardial effusions, systemic hypoperfusion, low blood oxygen contents, Watershed Strokes, hypoxemia, cerebral venous sinus thrombosis, arteriovenous malfunctions, cerebral amyloid angiopathies, bleeding disorders, cocaine and other recreational drug use, intracerebral hemorrhages, loss of blood supplies to the brain, brain tissue deficiencies, high energy phosphate compound production failures in brain tissues, endothelium and blood vessel lining damages, apoptosis, cerebral edema, blood brain barrier blockages, cerebral infarctions, hematomas, and transient ischemic attacks of the spinal cord, brain, and retinals without tissue deaths,

Symptoms:

Typically involving high blood pressure as the major modifiable risk factor for the ailment, with muscle weakness or unilateral paralysis on one side of the body the most common symptom of Strokes, other symptoms of the Number One contributor to adult disabilities in the United States, and the second leading cause of death worldwide, depend on the affected area of the brain and may include speech problems, drooling, tingling in the extremities, difficulty breathing, structural compressions, sensory sensation reductions, facial muscle weaknesses, numbness, cranial nerve deficiencies, hemiplegia, ptosis, drooping eyelids, ocular muscle weaknesses, nystagmus, the inability to rotate the head from side to side, sternocleidomastoid muscle weaknesses, Broca’s area aphasia in the speech production region of the brain, Wernicke’s area asphaia that creates inabilities to understand spoken and written language, motor speech disorders, temporal lobe memory defects, parietal lobe hemineglects, frontal lobe hypersexual gestures, disorganized thinking, confusion, anosognosia, difficulty walking, vertigo, and unconsciousness.

Diagnosis:

Clinical in nature, using imaging techniques that are beneficial in determining the subtype and cause of the Stroke, diagnostic tools available for establishing the ailment include patient and family histories, the National Institutes of Health Stroke Scale that measures the severity of Strokes, MRIs, CT scans, ultrasounds, blood tests, SPECT cerebral blood flow nuclear medicine scans, PET scans with FDG isotops, carotid artery doppler studies, echocardiograms, electrocardiograms, cerebral vasculature angiograms, homocysteinuria blood tests, bleeding diathesis evaluations, and Holter monitors that measure central nervous system electrical activities.

Treatment Options:

The general treatment options for Stroke patients include Warfarin, the mainstay of Stroke prevention, clot busters, thrombectomies, Stroke rehabilitation, physical therapy, occupational therapy, speech and language therapy, antiplatelet medications, Dipyridamole, aspirin, hypertension control, anticoagulants, Thienopyridines ADP Receptors, Plavix, carotid angioplasty surgeries, carotid endarterectomies, folic acid, the Mediterranean Diet, hospitalization in a Stroke Unit, orthotics, controlling blood sugar levels, IV fluids, oxygen therapies, increased blood flow to the brain, Tissue Plasminogen Activator proteins, intra-arterial fibrinolepsis, mechanical embolectomies, nasogastric tubes, precutaneous endoscopic gastrostomy tubes, daily rehabilitation exercises, the Activities of Daily Living Exercises and Training Program, and neurological evaluations to determine and effectively treat the cause of bleeding for hemorrhegic Stroke patients.

National Institutes of Health Stroke Scale:

Used to measure the severity of Strokes the National Institutes of Health Stroke Scale determines the patient’s level of consciousness, their ability to correctly answer questions, their ability to properly perform tasks, their speech, their self recognition, their visual fields, their horizontal eye movements, their facial palsy, the motor abilities of their arms and legs, their muscle movements, sensations of the patient’s face, arms, and legs, their comprehension, and their communication skills.

Ischemic Strokes:

Established reasons ischemic Strokes, the main form of the ailment, may develop are blood supply interruptions, venous thrombosis, embolisms, locally forming blood clots, blood vessel obstructions, shock, decreased blood supplies, systemic hypoperfusion, cytogenic Strokes of undetermined origins, and cerebral infarctions.

Hemorrhegic Strokes:

Most hemorrhegic Strokes display specific symptoms such as blood vessel ruptures, abnormal vascular structures, previous head injuries, and the accumulation of blood within the skull vault, with a distinction being made between extra-atrial hemorrhages of blood inside the skull but not in the brain, which may be subdural hematomas, subarachnoid hemorrhages between the pia mater and the arachnoid mater, epidermal hemorrhages between the skull and the dura mater, and intra-axial hemorrhages of blood inside the brain.

Silent Strokes:

Usually discovered incidentally on MRIs, without the patient’s ability to ever recall feeling any symptoms of the ailment at any time in their lives, Silent Strokes damage brain tissues without causing any symptoms and place patients at a higher risk of future Strokes and mental skill losses.

Mini-Strokes:

Short term interruptions in the flow of blood to the brain, typically during transient ischemic attacks, Mini-Strokes create Stroke symptoms, but do not cause any brain damages, and warn patients they are at an extremely high risk of suffering a full Stroke, therefore immediate medical care is required.

Sources:

This Article was compiled from several websites that provide much more information about Strokes including:

http://www.ninds.nih.gov (the National Institute of Neurological Disorders and Strokes website)
http://www.stroke.org/site/PageNavigator/HOME (the National Stroke Association website)
http://www.strokeassociation.org/STROKEORG/ (the American Stroke Association website)
http://www.mayoclinic.com/health/stroke/DS00150
http://www.medicinenet.com/stroke/article.htm