Approximately 700,000 strokes occur in the United States annually.
Stroke, or brain attack, is a disease that involves the blood vessels that supply blood to the brain. A stroke occurs when a blood vessel that brings oxygen to the brain gets blocked by a blood clot most commonly. With the oxygen supply to the brain being cut off, brain cells of the brain stop working and die within minutes.
When nerve cells stop working, the area of the body they control can’t work either, and this shows up as leg or arm weakness, slurred speech, or facial droop.
TIA are transient ischemic attacks or mini-strokes that occur when the inadequate blood supply to the brain is recovered within 24 hours of an occlusion of a vessel. They represent warning signs of more serious or permanent strokes, similarly to how angina heralds a major heart attack.
Causes of stroke and TIA include wandering clots (an embolus) from the heart, fatty buildups (atherosclerotic lesions) on the aortic arch or the vessels of the neck or brain, stenosis or narrowing of the arteries of the neck and the brain, or rarely, primary diseases affecting the arteries of the central nervous system known as
vasculitis.
Factors associated with strokes include smoking, diabetes, high blood pressure, high cholesterol, carotid disease, atrial fibrillation (irregular heartbeat) or other heart disease, history of TIAs (mini-strokes), sickle cell anemia, obesity, and other family members with history of strokes.
Symptoms
- Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
- Sudden confusion, difficulties speaking or understanding
- Sudden loss of vision in one or both eyes
- Sudden gait troubles, dizziness or loss of balance and or coordination
The treatment of strokes requires rapid interventions, including use of medications for dissolving clots or endovascular mechanical removal of the clot, and use of neuroprotectants and close critical care monitoring.
Patients at risk of stroke or with TIAs can be treated with medications to thin their blood, reduction of risk factors, and correction of the cause of the clots or vascular occlusion.
Carotid stenosis can be treated with surgery to remove the fatty buildups or with applications of angioplasty and stents. Intracranial narrowing of the vessels can be treated with angioplasty and stenting or extracranial to intracranial bypass surgery
Inadequate blood supply, due to diseases like moyamoya, is treated with revascularization techniques including bypass surgery and EDAS.
BIO: Dr. Aparajita is a fellowship-trained vascular and endovascular surgeon. She is a co-author of 20-plus journal articles and publications and was recently nominated for an Inspiration Award by the American Medical Association.
This column is sponsored by KSC Cardiology, and the opinions expressed herein may not reflect those of CFHN or its advertisers.