A stroke of bad luck

A stroke can be such a nice thing. Caressing your partner, petting your dog or cat, making a beautiful painting with brush strokes. Unfortunately, we use the same word for one of the worst things that can happen to you.

Worldwide, almost seven million people die each year due to a brain attack. In the US alone, someone dies of a stroke every three minutes. Stroke is also identified as one of the over fifty causes and diseases that may generate dementia.

Ischemic stroke

Ischemic stroke

A stroke, also known as a cerebrovascular accident (CVA), results from a disturbance in the blood flow to the brain, which causes cell death. The stroke can be due to a lack of blood, caused by blockage of a blood vessel. In this case, it is called an ischemic stroke. If the symptoms of this type of stroke last no more than one or two hours it is a transient ischemic attack, known as TIA.

Hemorrhagic stroke

Hemorrhagic stroke

The other type of stroke is called an hemorrhagic stroke and is the result of a bleeding. Such a bleeding may be caused for instance by a weakness in the wall of an artery or vein, a brain aneurysm.

A cerebrovascular accident almost always happens in only one of the brain halves. Since the left hemisphere in principle governs the right side of the body and the right hemisphere the left side, someone who had a stroke in his left hemisphere could become paralysed in for instance his right arm or leg.

Risk factors
The main risk factor for stroke is high blood pressure. But also smoking, obesity, and diabetes contribute to the risk. Several other factors have been indicated in raising stroke chances. Too low levels of vitamin D for instance raise the risk for stroke. Vitamin B9, better known as folic acid or folate, appears to reduce the risk of stroke. Depression may contribute to occurrence of heart disease and stroke, as do anger and hostility.

Time is essential to limit and repair stroke damage. (© AlienCat – Fotolia.com)

Time is essential to limit and repair stroke damage. (© AlienCat – Fotolia.com)

Stress has many negative consequences to our health. It arises when situations are experienced as threatening. Heart rate increases, but vascular resistance does not decrease. This results in an increase in blood pressure and will cause serious health problems in the long term, such as a heart attack or a stroke.

Whereas an hemorrhagic stroke sometimes needs a surgery, an ischemic stroke can be treated well by administering medication that breaks down the clot within a blood vessel.

Time is a crucial element in treating a brain attack. Clot-busting drugs may stop a stroke in progress and even reverse damage already done. They improve the outcome of a stroke by about thirty percent. The best results are generated when the drugs are administered within three hours of the onset of the stroke. That’s why it is so important to be able to quickly recognise a stroke and seek professional help.

After a brain attack, rehabilitation is directed towards recovering lost function. Improvement is a very real possibility, but a lot of effort will go into it. Our brain retains the ability to rewire itself throughout life, an ability called neuroplasticity. The adult brain not only forms new connections in response to changing environmental conditions, but can also rewire itself after some types of damage.

One of the first persons to discover this was the American brain scientist Paul Bach-y-Rita. His father had suffered a stroke. Despite extensive damage in his brain, with intensive training he succeeded to live a relatively normal life. After his death, autopsy revealed other parts of his brain had taken over the functions of the lost parts.

With the right kind of rehabilitation the brain is able to recover lost function. (© Kzenon – Fotolia.com)

With the right kind of rehabilitation the brain is able to recover lost function. (© Kzenon – Fotolia.com)

The brain’s ability to reorganise is also used in a special rehabilitation program for people who have had a stroke and as a result ended up with a paralysed hand or arm. This paralysis occurs because a small part of the brain responsible for movement has been damaged during the stroke. The neurones in this area are dead or seriously injured. And this damage will spread because the patient is not using the paralysed limb. Neurones that don’t receive signals anymore, because the neighbours are dead, will die as well.

Constraint-induced movement therapy forces the patient to use the affected limb by restricting the unaffected one. This stimulates the growth of new neural pathways. The training uses skills closely related to everyday life. It is done in increments and concentrated into a short period.

At a certain stage of the therapy, patients go out for a meal in a restaurant with their functioning arm or hand disabled in a sling. The staff has been informed of their visit beforehand since eating with hands or arms that don’t function properly, logically results in quite a mess. The other guests look on open-mouthed.

But it does work! Thanks to a very intensive training and tons of perseverance, new connections are made in the damaged brain part that make the use of hand or arm possible again. Of course, this can only happen when after the stroke enough working neurones have been left in the vicinity to take over the job of the deceased neurones. In most cases, the reorganisation and rewiring aren’t perfect, which makes the movements a bit clumsy, but the improvement is substantial in many cases.healthy lifestyle

Stroke used to be an ill accompanying old age, but not anymore. Average age of people having a stroke has lowered to 69 years of age and about twenty percent of strokes happen in people under 55 years of age. It is the number one cause of adult disability.

Treating hypertension can reduce the risk of stroke by up to forty percent. But our most faithful ally is a healthy lifestyle! Most cardiovascular diseases can be prevented by addressing behavioural risk factors, such as tobacco use, drinking too much alcohol, unhealthy diet, and physical inactivity. Protect your brain by choosing a brain-healthy lifestyle!

Classic stroke symptoms

  • Sudden numbness or weakness of the face, arm or leg on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing on one side
  • Sudden, severe difficulty walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

It is important to emphasise the words “sudden” and “severe” and the number “one.” Any of these symptoms can occur in a mild, fleeting way and not be worrisome, but if any one of them comes on suddenly and is quite severe, it could signal the onset of a stroke.

Is someone having a stroke?

  • Ask the person to smile
  • Ask the person to raise both arms above his or her head
  • Ask the person to speak a simple sentence

Making sure your blood pressure is within normal range is an important step to avoid stroke. (© HasanEROGLU – Fotolia.com)

Making sure your blood pressure is within normal range is an important step to avoid stroke. (© HasanEROGLU – Fotolia.com)

To minimise risk of stroke

  • Control your blood pressure either through lifestyle changes or medication if necessary.
  • Exercise. People who exercise consistently have increased cardiovascular health and a lower risk of suffering a stroke.
  • If you smoke, quit. Smoking is the leading preventable risk factor for stroke.
  • Limit alcohol intake. If you drink alcohol, do so only in moderation. Moderate alcohol intake is defined as no more than one drink per day for women and two drinks per day for men.
  • Lower total cholesterol levels into a healthy range by adhering to a healthy diet and exercising regularly.
  • Focus on your diet. Follow an eating plan designed for those with high blood pressure and heart disease – it may be helpful in preventing strokes.

Brush strokes © vizafoto – Fotolia.com
Healthy living © djvstock – Fotolia.com

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