Table of Contents
Definition2
General Information3
Types
Ischemic Stroke4
Hemorrhagic Stroke5
Stroke Warning Signs.6
Risk Factors
Treatable Risk Factors7
How a CVA is Diagnosed8
Medical Treatment
Emergency and Rehabilitation.
9
Prevention and Prognosis10
Effects of Stroke11
Common Problems and Complications12
Statistics13
Cost Of Stroke to the United States14
Final Data for 200014
Key Terms15
Definition
A cerebrovascular accident more commonly known as a stroke or brain attack is the term used to describe the sudden death of brain cells in a localized area due to inadequate blood flow. In order to woke the brain needs a constant supply of oxygen and nutrients. This supply is carried to the brain by blood through the arteries. If part of the brain is deprived of blood for longer than a few seconds brain cells can die.
A stroke causes loss of function, sometimes permanently, in the part of the body that is controlled by the damaged part of the brain.
General Information
A stroke occurs when blood vessels in the brain burst spilling blood into the space surrounding brain cells, or when the blood supply to part of the brain is blocked thus a stroke is known as a cerebrovascular accident (cerebro refers to a part of the brain vascular refers to the blood vessels and arteries.) In the same way that a person suffering a loss of blood flow to the heart is said to be having a heart attack, a person with a loss of blood flow to the brain or sudden bleeding in the brain can be said to be having a brain attack.
Blood flow to the brain tissue can be hampered in two ways, one the vessel ruptures, causing blood to leak into the brain. Hemorrhagic is the term used to describe bleeding into the brain or the spaces surrounding the brain.
In the second the vessel clogs within Ischemic is the term used to describe the blockage of blood flow and loss of oxygen and nutrients for brain cells.
Blood clots are the most common cause of artery blockage. The process of clotting is necessary and beneficial through out the body because it stops bleeding and allows repair of damaged areas of arteries or veins. However when blood clots develop in the wrong place within the artery they can cause devastating injury by interfering with the normal flow of blood. Clots most often form due to Atherosclerosis. In Atherosclerosis cholesterol containing fatty deposits (plaques) build up over time on the inside of the artery walls.
This accumulation narrows, hardens, and roughens the inside surface of the arteries. Turbulent blood flow around deposits of plaques trigger clot development.Ischemic Strokes
A Ischemic stroke occurs when a blood clot blocks an artery either in the brain itself or in the neck. These blockages stem from three conditions; the formation of a clot within a blood vessel of the brain or neck, called Thrombotic; The movement of a clot from another part of the body such as the heart to the neck or brain called embolism; or a severe narrowing of an artery in or leading to the brain, called stenosis.
Thrombotic stroke occurs when a blood clot forms in one of the cerebral arteries that stays attached to the artery wall until it grows large enough to block blood flow.Cerebral Thrombus occurs most often at night, or early in the morning. In most instancies the underlying cause is Atherosclerosis. Cerebral thrombosis is often preceded by a transient ischemic attack, or TIA, sometimes called a mini-stroke. In a TIA, blood flow is temporarily interrupted, causing short lived stroke like symptoms.This kind of Ischemic stroke accounts for 60% of a stroke cases.
Embolic stroke is another common form of Ischemic stroke. It can occur when a clot, or small piece of plaque formed elsewhere in the circulatory system breaks free.This free roaming clot travels through the bloodstream until it reaches vessels too small to let it pass. This kind of stroke accounts for 20% of all strokes. In most instancies the underlying case is Atrial Fibrillation.
A disorder of the heart beat. The heart doesnt completely empty the blood from the chambers. This stagnant blood forms clots that break off and inter the circulation. Atrial Fibrillation is a factor in about 15% of Embolism stroke.
The risk of a stroke from atrial fibrillation can be dramatically reduced with daily use of anticoagulant medication.Hemorrhagic Strokes
Hemorrhagic stroke occurs when a blood vessels in the brain leaks or ruptures. Bleeding from the ruptured brain artery can either go into the substance of the brain or into the various spaces surrounding the brain. The two types of hemorrhagic stroke are Intracerebral and Subarachnoid hemorrhagic.
Intracerebral hemorrhagic stroke occurs when vessels within the brain leaks blood into the brain itself. It often happens without warning. This type of stroke represents about 10% of all strokes. The most common cause is uncontrolled high blood pressure or (Hypertension.
) Hypertension can cause small arteries inside the brain to become brittle and susceptible to cracking and rupture. Less often it may result from a blood vessel defect present since birth.
In a subarachnoid hemorrhage, bleeding occurs within the space between the brain and the skull. This type of stroke accounts for about 7% of all strokes.
A subarachnoid hemorrhage is often signaled by a sudden thunderclap headache thats more severe than any you have ever felt. About half of all people who experience a subarachnoid hemorrhage die. Half of those who survive are left permanently disabled. In fact, subarachnoid hemorrhage is the most deadly of all strokes. The most common cause of subarachnoid hemorrhages is a ruptured aneurysms.
A less common cause is the rupture of an arteriovenous malformation. An arteriovenous malformation is a cluster of abnormally formed blood vessels. The vessels most likely to break are those with preexisting defects.Stroke Warning Signs
Some people do have symptoms without having a completed stroke. These people experience temporary symptoms of a stroke that cause no permanent damage.
These symptoms are warning signs of impending disaster. Usually the symptoms come on suddenly, but they can come on during sleep so that you wake up with them. Symptoms may vary depending on which part of the brain is affected and the size of the damaged area. In general, many people have more than one of these problems.
Most of them are sometimes linked with nausea, or vomiting, and disorientation., Sudden muscle weakness of the face, arm, or leg
Muscle weakness can affect any part of the body but most commonly affect the hand or arm, leg or face. The entire half of the body can even be affected.
, Sudden confusion, trouble speaking or understanding
Sometimes people will have difficulties in finding the words or slurred speech. They also might have problems reading and writing.
Some people have difficulties understanding speech and find it is almost like listening to a foreign language., Sudden trouble seeing in one of both eyes
Some people will have double vision while others only loss vision in one eye. It is not uncommon to have a loss of vision to one side so that the person cannot see anything to the left or right side. Most will experience a fog, haze, scum, or cloud maybe even blindness in one or both eyes., Sudden trouble walking, dizziness, loss of balance or coordination
Muscle weakness can cause trouble walking, loss of balance, or coordination.Often linked with a feeling of spinning called vertigo.
Difficulties with muscle movement such as swallowing may also occur., Sudden localized numbness
Some people find that the feeling in part of their body is altered, with numbness, pins and needles, and tingling., Sudden changes in personality, involuntary laughing or crying
The person will most likely have frequent changes of emotion, frustration or depression accompanied by difficulties with attention, concentration, judgment, and behavior. Its not uncommon to have feelings of anxiety, stress, and tension., Sudden headache
Some people complain of severe headache with no known cause often associated with nausea and vomiting and light and noise intolerance..
, Loss of consciousness
People may become drowsy or even unconscious, so that they are not aware of their surroundings
Risk Factors
Some people are at higher risk for stroke than others. The more risk factors you have the higher your chances are to have a stroke Several factors identify people who have the highest risk for a stroke. There is nothing that can be done about some of the risk factors, such as the ones that follow;
, Age
The leading unmodifiable factor is age., especially if your older than 65., Gender
If your a man, your risk of stroke is higher than a womens
, Race
Blacks are at a greater risk of stroke than other ethnic groups.
This is partly due to a higher prevalence of high blood pressure and diabetes., Family history.Your risk of stroke is slightly greater if one of your parents or a brother or sister has had a stroke.
However, other risk factors likely can be controlled if the individual believes it is worth the effort.
The most important treatable risk factors are;
, Hypertension
Of all the risk factors that contribute to stroke, The most powerful is high blood pressure. People with hypertension have a risk for stroke that is 4 to 6 times higher than the risk for those without hypertension., Cardiovascular Disease
This terms refers to several heart conditions that can increase your risk of a stroke., Diabetes
Diabetes is a major risk for stroke, and it interferes with your bodies ability to break down blood clots.
Blood clots is the number one cause of stroke., Obesity
Being overweight increases your chances of developing high blood pressure, heart disease, and diabetes., Tabacco Use
Cigarette smoking is a major, preventable risk factor for stroke. Smoking contributes to plaques in your arteries. Also, nicotine raises blood pressure.
, Excessive Alcohol
Drinking an average of one alcoholic drink a day for women or two a day for men will lower your risk for stroke
, Use Of Birth Control Pills
The risk of stroke is higher among women who take birth control pills, especially among smokers, and women older than 35
How a Stroke is Diagnosed
Medical Treatment
Emergency
For many years, both the public and the medical community considered stroke as a disease that could not be treated Those opinion are changing, as new treatment of proven usefulness are available. However for success, many of these interventions must be given as soon as possible after the onset of stroke In order to convey the urgency of stroke treatment, the term brain attack is being used. The message is to treat acute stroke (brain attack) in the same way as acute myocardial infarction (heart attack)
A stroke is a medical emergency requiring immediate treatment. Treatment is based on the severity of the stroke. Intensive care treatment is necessary for severe strokes. Pain medications to treat the severe headaches.
Blood pressure medication may be given to reduce high blood pressure. Treatment of stroke from a blood clot is aimed at dissolving the clot with medication. Emergency treatment of hemorrhagic stroke is aimed at controlling intracranial pressure. Surgery for hemorrhagic due to aneurysm may be performed if the aneurysm is close enough to the cranial surface to allow access. Ruptured vessels are closed off to prevent rebleeding.
Rehabilitation
Rehabilitation refers to a comprehensive program designed to regain functions as much as possible. Rehabilitation is coordinated by a team of medical professional. This team may include the services of a neurologist, a physician who specializes in rehabilitation medicine, a physical therapist, an occupational therapist, a speech-language pathologist, a nutritionist, and a social worker. The rehabilitation program is based on the patients individual deficits and strengths. Rehabilitation begins with the prevention of stroke recurrence and other medical complications.
Physical therapy is used to maintain and restore rang of motion and strength in affected limbs.
Occupational therapy improves self-care skills such as feeding, bathing, and dressing. A speech-language pathologist focuses on communication and swallowing skills. Mental health professionals may be involved in the treatment of depression or loss of thinking. A social worker may help coordinate services and ease the transition out of the hospital back into the home. Support groups can provide an important source of information for stroke patients and for caregivers.
Prevention
Damage from strokes may be significantly reduced through emergency treatment. Measures to control your treatable risk factors can lower the risk of stroke. These measures include diet, changes in lifestyle, and medications.
, Screening For Aneurysms May Be Effective Preventive Measure In Those With A Family History Of Aneurysms.
, If You Smoke Quit, Especially Women Over 35 That Are On Birth Control Pills., Control High Blood Pressure, Cholesterol, Diabetes, And Heart Disease
, Find Out If You Have Heart Rhythm Problems, Especially Atrial Fibrillation
, Limit The Amount Of Alcohol You Drink And Do Not Use Illegal Intravenous Drugs., Keep Body Weight Down. Exercise Daily For 30 Minutes Or More
, Eat Foods Low In Fat And Cholesterol.
And Use Less Salt In Your Foods
, Daily Comsumption Of Green-Yellow Vegetables, And High Fruit Intake
, Get Regular Checkups, And Follow The Doctors Advice
, Learn To Relax And Avoid Stress In Your Life.
Prognosis
Stroke is fatal for about 27% of white males, 52% of black males, 23% of whit females, and 40% of black females. Stroke survivors may be left with significant deficits. Emergency treatment and comprehensive rehabilitation can significantly improve both survival and recover. How long it takes to recover and how much recovery occurs depends on the extent of brain damage.
Recovery usually begins within 1 to 2 weeks. Most people have some permanent loss of function following a stroke. Most of the recovery that is possible will occur within 6 months, but some functions may be regained as long as a year afterwards.Common Problems After A Sever Stroke
, Urinary Incontinence
It is quit common for people to have a problem with controlling their urine after a stroke.
This usually improves after a few weeks. Occasionally after a severe stroke a permanent urinary catheter will be needed
, Constipation
This often occurs because of immobility and inadequate intake of foods and fluids. Usually drug treatment will improve this condition.
, Swallowing Difficulties
Quit commonly after a severe stroke people have difficulties with swallowing. This will usually go away after a few days or weeks.
, Depression
Not surprisingly, some people, particularly those with sever strokes, suffer depression. Others feel anxious or have difficulty controlling their emotions.
, Pain
Although strokes rarely cause pain other than a headache which usually disappears within the first few days, people may complain of other pains during their recovery. This can be caused by stress and strain on joints and muscles, especially in the back and shoulders.
Complications after a stroke
, Pressure sores
, Pneumonia
, Bladder infections
, Blood clots in the legs
, Permanent loss of movement
, Bone fractures
, Joint contractures
, Muscle spasticity
, Disruption of communication
, Decreased ability to function, or care for self
, Decreased life span
, Side effects of medications
Stroke Statistics
Cost of Stroke to the United States.
Total cost of stroke to the United States; estimated at about $43 Billion a year.
Direct cost for medical care and therapy; estimated at bout $28 Billion a year
Indirect cost from lost productivity and other factors; estimated at about $15 Million a year.
Average cost of care for a patient up to 90 days after a stroke $15,000*
For 10% of patients, cost of care for the first 90 days after a stroke $35,000*
Percentage of direct cost of care for the first 90 days
, Initial Hospitalization 43%
, Rehabilitation 16%
, Physician cost 14%
, Medication and other expenses 13%
Americans will pay about $51 Billion in 2003 for stroke related medical costs and disability.
Causes Of Death For All Americans In The United States
Year 2000 Final Data
