Saturday, May 7, 2011

What are the signs of stroke and what should you do?

Major stroke:
The most common symptom of a stroke is sudden weakness of the face, arm or leg, most often on one side of the body. Other symptoms include sudden onset of:

• numbness of the face, arm, or leg, especially on one side of the body;
• confusion, diffi culty speaking or understanding speech;
• diffi culty seeing with one or both eyes;
• diffi culty walking, dizziness, loss of balance or coordination;
• severe headache with no known cause;
• fainting or unconsciousness.

The effects of a stroke depend on which part of the brain is injured and how severely it is affected. A stroke may affect just one part of the body, such as the face, an arm or a leg. It can also completely paralyse one side of the body. A very severe stroke can cause sudden death.

Minor stroke:
A minor stroke is also called a transient ischaemic attack or TIA. The features of minor strokes may be similar to those of major strokes, but they are milder and last only a short time, usually less than an hour. Often, the person recovers without treatment. These “mini-strokes” are warning signs; most people who have had one or more minor strokes will later have a major stroke.

What to do in the case of a stroke?
If you see someone showing signs of a stroke, call a doctor or ambulance right away, or take the person to the emergency room of the nearest hospital. Do this even if the symptoms are not very severe, because a stroke can progress. You should also do this in the case of a minor stroke. If there is no hospital or health centre near you, call a doctor immediately.

Treating stroke
The level of medical care you will receive can vary from place to place. The amount of care you will need depends on how severe the stroke was.

If you arrive at a hospital within 3 hours after the fi rst sign of a stroke, the doctor there may give you a thrombolytic medicine right away, to dissolve any blood clots in your arteries. However the choice of treatment will depend on the exact cause of the stroke.

To diagnose what type of stroke you have had, doctors will take your medical history, examine you, and perform tests such as computerized tomography (CT) and magnetic resonance imaging (MRI). These tests will show whether you have had an ischaemic stroke (caused by a blockage) or an intracerebral haemorrhage (caused by a burst blood vessel in the brain).

The doctor will probably prescribe medicines to help relieve your symptoms and prevent future strokes, and give you advice on changing your lifestyle to lower your risk. If you take this advice, you will get the best possible results. Listen carefully to your doctor’s instructions and ask questions if you need to.

For some patients, special surgical procedures to open up the blockage of neck arteries, such as carotid endarterectomy or stenting, can help prevent future strokes.

Rehabilitation and long-term care
Patients who become paralysed following a stroke need special care in hospital to help them recover and to avoid complications and long-term disability. Most patients who have a stroke are left with some physical disability and may need long-term care at home. A large part of stroke rehabilitation involves teaching patients how to exercise safely. It also includes:

• helping to improve walking, eating, dressing, bathing, cooking, reading, writing and going to the toilet;
• speech therapy;
• checking to make sure that patients can live safely at home;
• helping to organize medical and rehabilitative care and schedules;
• counselling patients and families, including advice about managing money, legal, and business affairs;
• occupational therapy to help patients stay active and involved;
• physiotherapy to help get back movement.

Medicines used to treat and manage stroke patients
Medicines often used to treat stroke include:
• antiplatelet agents, such as aspirin;
• anticoagulants or blood thinners, such as warfarin;
• medicines to control blood pressure, such as calcium-channel blockers, and angiotensin converting enzyme inhibitors;
• medicines to lower blood fats.
These medicines must be used under a doctor’s supervision. You can read more about stroke medicines and their side effects in Annex.

Treatment of intracerebral haemorrhage
About 10–15% of all strokes are caused by bleeding into the brain due to rupture of a blood vessel. In many cases this is associated with high blood pressure. When strokes due to intracerebral haemorrhage occur, the diagnosis is usually made on a CT or MRI scan. The management is then usually as
described above, including stroke rehabilitation, except that blood-thinning medicines, such as anticoagulants and antiplatelet agents, are not given. Blood pressure control is very important for this type of stroke and management in a stroke unit is also desirable as for other forms of strokes. Occasionally, surgical procedure may be required depending on the patient’s condition.

Can a person recover from a stroke?

Yes, but the amount of long-term disability depends on how much lasting brain damage the stroke caused. Many stroke survivors are left with mental and physical disabilities. They need support from family members and friends to help them cope.

How can I avoid having another stroke?

It is important to maintain a healthy lifestyle and to follow carefully your medical treatment, such as taking aspirin and medicine to lower your blood pressure. People who have had one stroke are more likely to have another. If you have an irregular heart beat (atrial fi brillation), it is also important to recognize it and seek medical care to prevent future strokes. Consult your doctor about this. You can avoid a repeat stroke by
adopting a healthy life style and taking medications.

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