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Lisa Thomas, LCSW, LMFT, DAACS
A stroke occurs when the brains oxygen and blood supply are temporarily reduced or completely stopped. When brain tissue is deprived of these two important things, the tissue will die, and cannot function (Clinical Reference Systems, 1994). Blood may be prevented from reaching the brain many ways. Their could be a block in a blood vessel that would make it difficult for blood to squeeze through. Or a blood vessel can burst within the brain, causing a hemorrhage (Clinical Reference Systems, 1994). Strokes occur most often after age 65 (Stroke, 1995).
Their are several names of different kinds of strokes that may occur. For example their may be a thrombotic stroke, or when fatty deposits begin to collect within the walls of an artery, called arteriosclerosis, and blood flow becomes blocked.
Or, an embolic stroke may occur when a blood clot is formed in another area of the body, breaks off, and travels through the bloodstream up, and into the brain. The clot then blocks and artery to the brain. Blood clots may consist of blood clot fragments, clumps of platelets, fibrin, cholesterol or fat. (Clinical Reference Systems, 1994).
A third kind of stroke called a lacunar stroke can result when a blockage forms within certain small blood vessels leading from the brain.
Or finally, a cerebrovascular hemorrhage may take place when an artery in the brain ruptures suddenly. A hemorrhage happens suddenly and usually without warning. This specific type of problem is thought to have been from a possible defect in a blood vessel that a person may have lived with since birth (Clinical Reference Systems, 1994). The presence of blood may result in severe headache, lethargy or coma. When blood ruptures primarily into the spaces around the brain, the stroke is termed a subarachnoid hemorrhage. Rupture into the brain substance itself is termed an interacerebral hemorrhage. A blood vessel may burst as a result of high blood pressure, or a rupture of an aneurysm, a thin walled and ballooned like pocket that forms at a weak spot in the wall of a cerebral artery (Stroke, 1995).
There are many general warnings signs of having a stroke. These can include weakness of the face, arms and legs on one side of the body, inability to walk, not being able to speak or trouble with speech, problems understanding language, visual complaints, confusion, personality changes, loss of bowl or bladder control, judgment problems and difficulty with motor skills, such as getting dressed (Clinical Reference Systems, 1994).
However, most stroke symptoms will depend on the artery involved and the brain area which is being deprived of blood and oxygen. Strokes in the brain area supplied by the carotid artery commonly effect vision, cause aphasia, partial blindness, paralysis or loss of sensation. The paralysis and sensory disturbances will happen on the opposite side of the body of which the brain is affected. Strokes that involve the vertebral circulation may produce some combination of double vision, slurred speech, loss of coordination, difficulty swallowing, and weakness or sensory loss (Stroke, 1995).
Risk factors that may increase your risk of having a stroke include heart disease, high blood pressure, diabetes, high cholesterol levels, smoking, excessive alcohol drinking, and family history of stroke or obesity (Clinical Reference Systems, 1994).
When a patient complains of stroke symptoms, it is important for the doctors to act quickly to prevent further damage. Tests are done to determine what part of the brain is damaged and what the cause of the stroke might be. Doctors may choose to order a CT scan or an x- ray to be able to view probable cause (Clinical Reference Systems, 1994). The CT scan is the preferred imaging technique for detecting small amounts of bleeding quickly. Other diagnostic steps taken may include evaluation of heart function, blood tests for coagulation disorders and inflammatory diseases, and a follow up CT or MRI test to compare previous results with (Stroke, 1995).
Treatment of strokes includes medications. Drugs can help thin blood clots, or minimize platelet clumps forming in narrow blood vessels. Aspirin is known and used to help thin out blood, and coumadin and heparin are used as the prescription anticoagulants (Stroke, 1995).
In a study published in 1997, research found that aspirin at 300 mg is effective in reducing the risk of having a second stroke. But it was also noted that their is a significant extracerebral hemorrhage risk, or bleeding within the skull. Heparin was noted to reduce the risk of recurrent ischemic strokes, though it increased the risk of hemmorragic strokes. Furthermore, it was noted in the Lancet study that low dose heparin was
However, a new drug has recently hit the news and is being called a miracle drug. TPA, or Tissue Plasminogen Activator, is a drug that for many years was used to treat heart attack patients (Newsweek,1997) TPA, if administered within a three hour window after having a stroke, can dramatically reduce the damage that the stroke may cause
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