Stroke

Stroke damage in the brain can affect the entire body — resulting in mild to severe disabilities. These include paralysis, problems with thinking, problems with speaking, emotional problems and pain.

Transient ischemic attacks, or TIAs, occur when the warning signs of a stroke last only a few moments and then disappear. These brief episodes are also sometimes called "mini-strokes." Although brief, they identify an underlying serious condition that isn't going away without medical help. Unfortunately, since they clear up, many people ignore them. Don't ignore them. Heeding them can save your life.

Yes. Stroke is preventable. A better understanding of the causes of stroke has helped people make lifestyle changes that have cut the stroke death rate nearly in half in the last two decades.

While a family history of stroke plays a role in your risk, there are many risk factors you can control:

• If you have high blood pressure, work with your doctor to get it under control. Managing your high blood pressure is the most important thing you can do to avoid stroke.
• If you smoke, quit.
• If you have diabetes, learn how to manage it. Many people do not realize they have diabetes, which is a major risk factor for heart disease and stroke.
• If you are overweight, start maintaining a healthy diet and exercising regularly.
• If you have high cholesterol, work with your doctor to lower it. A high level of total cholesterol in the blood is a major risk factor for heart disease, which raises your risk of stroke.

Source: National Institutes of Health

Doctors have several techniques and imaging tools to help diagnose stroke quickly and accurately. The first step in diagnosis is a short neurological examination or an evaluation of the nervous system.

When a possible stroke patient arrives at a hospital, a health care professional, usually a doctor or nurse, will ask the patient or a companion what happened and when the symptoms began. Blood tests, an electrocardiogram and a brain scan such as computed tomography (CT) or magnetic resonance imaging (MRI) will often be done.

CT Scan

The most commonly used imaging procedure is the computed tomography or CT scan, also known as a “CAT” scan. A CT scan is comprised of a series of cross-sectional images of the head and brain. Because it is readily available at all hours at most major hospitals, produces images quickly and is good for ruling out hemorrhage prior to starting thrombolytic therapy, CT is the most widely used diagnostic imaging technique for acute stroke.

A CT scan may show evidence of early ischemia – an area of tissue that is dead or dying due to a loss of blood supply. Ischemic strokes generally show up on a CT scan about six to eight hours after the start of stroke symptoms.

MRI

Another imaging technique used for stroke patients is magnetic resonance imaging or MRI scan. MRI uses magnetic fields to detect a variety of changes in the brain and blood vessels caused by a stroke.

One effect of ischemic stroke is the slowing of water movement through the injured brain tissue. An MRI can show this type of damage very soon after the stroke symptoms start.

MRI and CT are equally accurate for determining when hemorrhage is present. The benefit of MRI over a CT scan is a more accurate and earlier diagnosis of ischemic stroke, especially for smaller strokes and transient ischemic attacks (TIAs). Also, MRI can be more sensitive than CT for detecting other types of neurologic disorders that mimic the symptoms of a stroke. However, MRI cannot be performed in patients with certain types of metallic or electronic implants, such as pacemakers for the heart.

Although increasingly used in the emergency diagnosis of stroke, MRI is not immediately available at all hours in most hospitals, where CT is used for acute stroke diagnosis. Also, MRI typically takes longer to perform than CT, and therefore may not be the first choice when minutes count.

For most stroke patients, rehabilitation mainly involves physical therapy. The aim of physical therapy is to have the stroke patient relearn simple motor activities such as walking, sitting, standing, lying down and the process of switching from one type of movement to another.

Another type of therapy to help patients relearn daily activities is occupational therapy. This type of therapy also involves exercise and training. Its goal is to help the stroke patient relearn everyday activities such as eating, drinking and swallowing, dressing, bathing, cooking, reading and writing and toileting.

Speech therapy helps stroke patients relearn language and speaking skills, or learn other forms of communication. It is appropriate for patients who have no deficits in cognition or thinking but have problems understanding speech or written words, or problems forming speech.

Talk therapy, along with the right medication, can help ease some of the mental and emotional problems that result from stroke.