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Stroke Definition

Type of Stroke 

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Signs and Symptoms of Stroke

Causes of the Stroke

Risk factors of Stroke

Diagnosis of Stroke 

Treatment & Prevention of

Statistics of stroke according
to Global Burden of Disease, 2016

A stroke occasionally called a
“brain attack”, and it happened when blood circulation interrupted or stopped
at any part of brain, that lead to brain tissue 
damage or death, resulting from lack of 
oxygenation and nutrients into brain tissue. So, it must be treated as
fast as possible to increasing survival rate.

There are tow main category of

” Ischemic stroke”

It occur resulting of clots in
blood vessels in brain or in sometimes, it travel from anywhere in the body to
brain. “Ischemic Stroke” also happened when much “plaque” ( fatty deposits
tissue) obstruct blood vessels in the brain.

Approximately 80% of all stroke
that occur in the world are ischemic.

According to American Stroke
Association (TIAs) is loss of blood flow (ischemia) in the brain tissue without
death, because it occur for brief episode of neurological deficit.

TIAs consider “wearning stroke”
that happened before major stroke. So, it need immediate medical intervention.

TIAs sign & symptoms appear
for short time but more similar to people who have full-mature stroke.

Cerebral thrombosis indicate to a thrombus
(blood clot) or fatty deposit tissue that develops at the blocked part of the
blood vessel.

 Cerebral embolism happen when gathering
substance together such as a clots or fatty dispose tissue ( Plaque) that form
at any part of body and carried to the brain tissue. Mostly  clot form large arteries of the upper chest
and neck.

“Hemorrhagic stroke”

Occurred when spontaneous rupture or break for small blood
vessels resulting from a weakling in the arterial wall “aneurysm”, lead to ooze
blood into brain tissue and bring spoilage to brain cells.

About 15-20% of cases is hemorrhagic stroke.

 “Aneurysm” is a bloat of a weakened area
of a blood vessel. If leave without treatment, the aneurysm will continues
to weaken till it split and bleeds into the brain. 

 “Arteriovenous malformation” (AVM) is a
cluster of abnormally formation of blood vessels. Any one at any time  of these blood vessels can tear or rupture
and lead to bleeding into the brain. 

For every minute a stroke goes untreated and blood flow to
the brain continues to be blocked, a person loses about 1.9 million neurons.
Warning sign of the stroke summarized as FAST

Most current causes of stroke:

Stroke resulting from thrombosis.

 Stroke resulting from embolism

Cerebral hemorrhage

Defined as bleeding resulting from rupture a blood vessel in
the brain that lead to death or damage in brain tissue


Subarachnoid hemorrhage

Occur when blood seeps into the area between tow of the
layers that  farming the brain. Mostly
caused via a ruptured. Also, can cause fetal stroke.


a situation in which the blood vessels become inflamed
causing lack or decreased blood flow to region and agitated of the brain

Migraine headache

Some migraine headache episodes as a transient ischemic
attack. However, the symptoms disappear as the headache resolves

Common risk factor that can be treated or changed

High blood pressure.

This is the most important risk factor for stroke. It make
blood vessels most of time constricted and decrease blood flow in the brain
tissue  than may lead to ischemia .


Smoking spoilage blood vessels. Result from blockages within
those blood vessels in the brain tissue, causing a stroke.


If the patient has diabetes, will be more than doubles risk
of stroke.


High cholesterol.

High cholesterol rise the risk of and formation of plaque
and   blocked arteries. Even so, lack of
physical inactivity and obesity also increasing risk factor of heart disease
and stroke.

Carotid or other artery

Transient ischemic attacks (TIAs).

Atrial fibrillation (AFib) or
other heart disease.

occur when heart chamber at unorganized way that lead to
blood to pool and clot, increasing the risk of stroke.

Excessive alcohol consumption.

If women drink in average more than tow cup per day and man
in average more than one cup per day. This is raise blood pressure. Binge
drinking consider high risk and  can lead
to stroke.

Increasing age. Stroke can be affects
all people in different ages. But the older people are higher risk for the
stroke risk because a blood vessels become fragile with aging .

 Gender. Women 
consider a high risk of stroke than men. Because most of the women take
of birth control pills and pregnancy formation, this is consider private risks
factor for women.

Heredity and race. African have a
higher risk of death and inability from stroke than other people. Usually have
high blood pressure more than white. some people have genetics disease like,
Sickle Cells Disease which most of time causes stroke. 

Previous stroke: anyone who has
had a stroke consider high risk to have another one.

Family history: people who have
families with a history of stroke are higher risk for stroke, especially if
still live at same environmental condition that family live it.

When anyone has shown 
sign & symptoms of a stroke or develop TIA for brief time (transient
ischemic attack), a professional of medical team will gather information and
make a diagnosis through:


Full medical history

Physical and neurological reflexes

Confirmed laboratory (blood) tests
such as: D-Dimer

CT scan for definite diagnosis and
MRI scan to detect affected part in the brain.

Angiography: provide a view of the
blood flow through the vessels. This permit the professionals  to detect size and location of blockages or
clots formation.

EEG: Electrical tests record the
electrical impulses of the brain. Usually used after stroke happened .

80% of all strokes can be  prevented with healthy  behaviors

Long-term effects of a stroke  may be minimized with  immediate treatment

More people are surviving and  beating stroke


Antiplatelet drugs

These medications work as reduce
platelets to stick together to prevent blood clots. Antiplatelet drugs like :


These medications work as prevent
blood clots by attack proteins that resulting from blood clot formation ,
rather than attack the platelets. Anticoagulants drugs Like: warfarin

Invasive carotid intervention

A carotid arteries catheterization


Craniotomy to evacuated for blood
clots or bleeding

Considered the gold standard,
(tissue plasminogen
activator or Alteplase IV r-tPA)  is the only FDA-approved treatment just
for ischemic strokes.

When administer at correct time,
it can save lives and reduce the long-term effects of stroke.

Alteplase is given through an IV
in the arm, and works through dissolving the clot and enhancing  blood flow. to the part of the brain that
deny from blood oxygenation .

Alteplase should be used within three
hours of having a stroke or up to 4.5 hours in certain qualified patients.

Much people don’t arrive at the
hospital in time for Alteplase treatment. So, they miss the key  of a brain-saving treatment which is why
it’s so important to identify a stroke  sign and give treatment as soon as possible to
get best chance at a full recovery

“The NINDS (National Institute of
Neurological  Disorders and Stroke, 2015) make pivotal trial and conduct
that 30% more patients had favorable outcomes with Alteplase at 3 months”.

“There was an 11% to 13% absolute
increase in favorable outcomes at 3 months for patients treated with Alteplase
vs patients given placebo”

Primary Prevention

The main aim by it is to avoid all
risk factors that associated with disease by :High blood pressure is the main
big factors for stroke, we can lower blood pressure by:

style itself (lower salt diet and low fat diet, exercise) blood pressure
blood pressure can reduce the chance of patient to has stroke to 52%
according to AHA study journal


 Lose weight
exercise can reduce the risk of stroke up to 30%

Treat atrial fibrillation (it is
irregular heartbeat that causes clot that form in the heart and then can travel
through blood circulation to brain) and other heart disease (treat atrial
fibrillation can reduce the incidence of stroke (15)%

Control diabetes which can reduce
risk of stroke up to 30 %

Treatment of dyslipidemia reduces
the risk of stroke up to 10 %

Decrease or stop smoking

Secondary Prevention

Secondary prevention is aimed to
decline the risk of recurrence after a first stroke or transient ischemic
attack happened. However, If the patient fallow secondary prevention protocol
can reduce the risk of second stroke up to 69% according to “stroke: AHA
journal, 2016”. We can summarize it by (A, B, C, D, and E)


Antiaggregants like ASA, anticoagulants such as warfarin
blood pressure lowering medication
cholesterol lowering medication, cigarette smoking stopping
E: exercise

Tertiary Prevention

It is associated with secondary
prevention the aim from it is to prevent a second or third stroke and to
minimize disability through patient rehabilitation in order to establish
partial or complete independence and increase quality of patient life.





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