Stroke : The Causes of Hemiplegia and Paralysis

 

 

 

     Stroke, often perceived as a rare and difficult disease, is the second leading cause of death after cancer, accounting for an average of 7.4% of the Thai population. It ranks third globally in terms of incidence. This condition combines the causes of hemiplegia, paralysis, and permanent disability. Delayed treatment can lead to irreversible consequences.

 

Understanding Stroke

     Stroke occurs when certain brain cells become damaged due to a ruptured, narrowed, or blocked blood vessel. It can lead to symptoms such as facial drooping, hemiplegia, vision problems, severe headaches, and sudden weaknesses.

 

 

 

 

Types of Stroke

Stroke is divided into two main types:

• Ischemic Stroke accounts for 80% of all strokes. It occurs when a clot or plaque forms in a blood vessel, obstructing blood flow and depriving brain cells of oxygen, resulting in severe damage.
• Hemorrhagic Stroke makes up around 20% of strokes and occurs when a weakened blood vessel bursts or leaks, causing pressure that damages brain cells. In some cases, it can be due to congenital vascular malformations.

 

The Risk Factors

     The risk can arise from various factors, including certain underlying health conditions such as arrhythmias, obesity, and conditions that increase the likelihood of blood clots forming in the heart's left atrium, which may then travel to block a blood vessel in the brain. In Addition, lifestyle choices that pose risks for developing diseases can contribute to subsequent hypertension.

 

 

 

B.E.F.A.S.T.

• B – Balance Is there an unusual loss of balance? Do you often feel dizzy or unsteady while walking?
• E – Eye Is there sudden vision loss or any abnormal changes in your field of vision?
• F – Face Smile or show your teeth. Is there drooping on one side of the face or is the smile uneven?
• A - Arm Raise both arms for 10 seconds. Does one arm drift down or cannot be lifted?
• S – Speech Try repeating a simple phrase. Is the speech unclear, or slurred, or is there difficulty speaking?
• T – Time If you notice any abnormal symptoms, seek medical help as soon as possible.

 

 

     When the brain is deprived of blood or experiences bleeding, brain cells begin to die. Timely treatment is crucial because the quicker the intervention, the better the chances for helping patients return to normal or near-normal function.

 

 

 

 

The Diagnosis of Stroke

• CT Scan uses computer X-ray imaging techniques to differentiate between hemorrhagic strokes, providing sufficient information to consider administering thrombolytic medication via intravenous route.
• CTA Brain offers better detail in identifying cerebral aneurysms. However, CTA has limitations in patients with kidney disease.
• MRI Scan allows visualization of blood vessels without the need for contrast dye, providing better detail in cases of ischemic strokes or the unknown duration of symptoms.
• Carotid Duplex examines the carotid arteries' condition with ultrasound techniques, such as the vessel wall thickness.
• TCD (Transcranial Doppler) assesses blood flow, especially in cases where patients are unable to undergo MRI or CTA.

 

 

 

Traditional Stroke Treatment

     Traditional treatment for stroke is primarily supportive. This includes administering intravenous fluids or antiplatelet medications to prevent recurrence, but it does not address the underlying blockage in the blood vessels.

 

Current Stroke Treatment

     The current stroke treatment is on rapid intervention. The diagnoses are performed using a CT scan of the brain to determine appropriate treatments, addressing the blood clot obstruction, including.

 

• Thrombolytic Medication dissolves the blood clot obstructing the cerebral vessels within 3 to 4.5 hours, restoring normal blood flow.
• Endovascular Thrombectomy involves catheterization and the use of a stent to remove the clot within 6 to 24 hours, depending on the case.
• Biplane DSA (Digital Subtraction Angiography) provides 3D highly effective imaging in two planes, allowing for rapid diagnosis while reducing side effects associated with treatment.

 

 

 

 

 

 

Stroke: The Prevention

• Preventive Medications take medications or follow your doctor's recommendations to prevent disease.
• Regular Health Examinations have annual health check-ups to assess your current physical condition and reduce risk factors promptly.
• Lifestyle Changes adjust your lifestyle by eating more fruits and vegetables, reducing saturated fats, quitting smoking, avoiding alcohol, and exercising regularly.
• Manage Underlying Conditions treat and control conditions that contribute to stroke risk, such as diabetes and high blood pressure.
• Ongoing Heart Care if you have heart conditions, such as arrhythmias, ensure you receive continuous treatment.
• Monitor Blood Pressure if your blood pressure is above 140/90 mmHg, consult a doctor for treatment.

 

Brain Center: Overcoming Together

     The Brain and Neurology Center, Ramkhamhaeng Hospital is here to support you throughout your treatment journey. Even during times of risk, you can feel reassured by early stroke assessments. Quick results help mitigate risks, as every second counts when facing a stroke. We are ready to assist in your recovery under the care of specialized neurologists and medical staff who are available for 24 hours.