Management and Prevention of Stroke

In medical parlance a stroke is also referred to as cerebrovascular accident or CVA. A stroke occurs
due to a dysfunction or disturbance in the flow of blood to the brain. When this happens
the brain cells are starved of oxygen and as a result get damaged or die. This in turn
causes havoc to the blood flow making it ripe for a stroke. Causes of a stroke

• Lack of blood supply or Ischemic stroke
• Hemorrhagic stroke

Ischemic stroke

Most of the strokes that occur are ischemic strokes. And these occur when the blood
carrying veins /arteries to the brain are narrowed or blocked, causing totally reduced or
no blood flow at all. The common ischemic strokes that occur are:

Thrombotic stroke- When a blood clot or thrombus forms in one of the arteries that
supplies blood to the brain, the stroke that follows this blockage is called thrombotic
stroke. This cause for the clot in the arteries may be due to fat deposits that build up in
the arteries causing strain in flow of blood called atherosclerosis or due to other
debilitating conditions.

Embolic stroke- Another kind of ischemic stroke is an embolic stroke. This occurs when a
blood clot or blockages or debris forms elsewhere in the body, away from the brain, but
gets carried to the brain through the bloodstream and lodges in the brain’s arteries. The
stroke that occurs is called embolic in nature.
Hemorrhagic stroke

This occurs when a blood vessel in the brain leaks or ruptures. Brain haemorrhages
occur as a result of many conditions such as high blood pressure and presence of weak
spots in the vessel walls or aneurysms as they are called. Another less common cause of
haemorrhage could be due to the rupture of blood veins that have got entangled. This is
mainly seen in very rare cases among babies at birth and called arteriovenous
malformation (AVM).

Hemorrhagic stroke in turn could include intracerebral haemorrhage, when the blood
vessel in the brain bursts and spills into the surrounding brain tissue and subarachnoid
haemorrhage that occurs due to the rupture of a small sack-shaped or berry-shaped
pouch on an artery in the brain.

Risk Factors of a Stroke

Many factors increase the chances of a stroke and these include-

High Blood Pressure
Smoking
High Cholesterol
Diabetes
Obesity
Physical inactivity
Sleep apnea
Cardiovascular diseases
Usage of some birth control pills
Addiction to drinking
Severe drug abuse
Personal or family history
Old age
Gender and
Racial factors

Management of Stroke

The goal for emergency medicine physicians, neurologists and other physicians is to
provide stroke care within the first 24 to 48 hours of hospitalization. It is imperative that
people who are having symptoms of a stroke are rushed to a hospital or seek urgent
medical care at its first signs.

At the hospital physicians and emergency medicine specialists need to address the
diagnosis and emergent treatment of an acute ischemic stroke in addition to the
management of its acute and sub-acute medical complications arsing thereof.
The steps to management include-

1. Evaluation and affirmation to confirm that the patient’s impairments are due to
ischemic stroke
2. If the stroke is due to a blood clot a clot busting drug to be administered
3. Medicine to control the symptoms of high blood pressure
4. Special surgery to prevent the occurrence of further strokes
5. Nutrients and fluids
6. The evaluation in turn would help in determining the next steps of treatment
7. Diagnostic studies to screen out neurological complications of stroke
8. Lastly historical data to assess or provide clues regarding the pathopysiological and
etiological implications of the stroke.

Prevention of Stroke

Patients who have had previous experience of stroke are at a greater risk of a
recurrence. Preventive measures are essential to reduce the risk. These include-
1. Quit smoking
2. Healthy eating
3. At least 30 minutes of exercise daily
4. Maintenance of healthy weight
5. Limited consumption of alcohol and
6. Regular health checkups