Stroke

A stroke is a medical condition in which poor blood flow to the brain results in cell death. There are two main types: ischaemic (due to lack of blood flow) and haemorrhagic (due to bleeding).

• A leading cause of disability and death worldwide.
• Risk increases with age, but strokes can occur at any age.

• Ischaemic Stroke:

• • Accounts for about 85% of strokes.
  • Caused by interruption of blood flow due to a blood clot (thrombosis) or embolism.
  • Results in cerebral infarction.

• Haemorrhagic Stroke:

• • Accounts for about 15% of strokes.
  • Caused by bleeding either within the brain (intracerebral) or into the subarachnoid space (subarachnoid haemorrhage).

• Hypertension
• Diabetes
• Smoking
• Obesity
• High cholesterol
• Atrial fibrillation
• Previous stroke or transient ischaemic attack (TIA)
• Family history
• Age

• Sudden onset of neurological deficit, such as weakness or numbness on one side of the body, difficulty speaking or understanding speech, vision problems, dizziness, and loss of balance.
• FAST (Face drooping, Arm weakness, Speech difficulties, Time to call emergency services) is a quick tool to recognize stroke symptoms.

• Clinical assessment using the National Institutes of Health Stroke Scale (NIHSS).
• Imaging: CT scan or MRI to differentiate between ischaemic and haemorrhagic stroke.
• Additional tests: Carotid ultrasound, echocardiogram, blood tests.

• Ischaemic Stroke: Thrombolysis (e.g., IV alteplase), mechanical thrombectomy.
• Haemorrhagic Stroke: Control of blood pressure, surgery or endovascular procedures to control bleeding.
• Secondary prevention: Antiplatelets (e.g., aspirin), anticoagulants (for atrial fibrillation), control of risk factors.

• Physical, occupational, and speech therapy.
• Multidisciplinary approach to help regain as much function as possible.

• Depends on stroke type, severity, rapidity of treatment, and presence of comorbid conditions.
• Early treatment improves outcomes significantly.