Cerebral Stroke: Symptoms, Causes, Treatment and Types

Cerebral Stroke is a condition that occurs when the supply of the blood to the brain, especially in the cerebral region, is blocked. It results in a decreased amount of oxygen in the brain. In addition, the blood vessel that supplies blood to the brain may get blocked due to conditions like atherosclerosis. A cerebral stroke occurs because the cells of the brain begin to die after a shortage of oxygen for some time. It is the condition of a medical emergency, and treatment is required urgently in this case. The early treatments can help prevent the complications of the diseases and may help stabilise the brain.

The symptoms of the stroke may include:

1. Sudden onset of numbness and feeling of weakness in the face, arm, or leg that especially occurs on one side of the body.
2. Difficulty in walking and feeling of dizziness
3. Experiencing blurred or blackened vision in either one or both eyes
4. Loss of balance or coordination
5. Trouble in speaking and understanding the words said by others
6. Sudden severe headache without any known cause
7. Sudden collapse
8. Continuous headache

The cause of stroke mainly depends upon the type of stroke you have developed. These are classified into the following categories:

1. Ischemic Stroke: It is a common type of stroke that occurs when a major blood vessel in the brain is blocked either by a blood clot or by depositing the fatty substances inside the blood vessels.
2. Hemorrhagic Stroke: It occurs when the blood vessels in the brain burst and the blood spills all around the nearby tissues. In a hemorrhagic stroke, the pressure is increased in the nearby tissues in the brain, and this condition can cause more damage to the brain. 
3. Transient Ischemic Attack: It is also called a ministroke. Although it has the symptoms of a stroke, they last for less than five minutes. It occurs due to a temporary reduction in the blood flow in a part of the brain. It does not cause permanent damage to brain tissues. 

1. High Blood Pressure: Blood pressure 140/90 mm of Hg or higher for a prolonged time can cause damage to the blood vessels. It may obstruct the blood supply to vital parts, including the brain.  
2. Heart Disease: It is a major cause of death in the case of stroke.
3. Diabetes
4. Smoking: Smokers are at a doubled risk of getting affected by stroke.
5. High red blood cell count
6. Cholesterol: due to increased lipid levels in the blood, the blood flow may get disturbed, and thus this may lead to decreased oxygen supply in the brain.
7. Abnormal Heart Rhythm: having heart disease can increase the risk of developing stroke.
8. Other Risk factors: These include race, gender, age, genetics, obesity, inactivity, obstructive sleep apnea, and drug abuse.

To prevent cerebral stroke, you must also know its risk factors to prevent its occurrence.

1. Quit smoking: The persons who smoke are at a higher risk of developing cerebral stroke. So, quitting smoking is the best idea to prevent stroke attacks.
2. Decrease the use of alcohol: Heavy alcohol consumption can increase the chances of getting affected by stroke. Therefore, limiting alcohol consumption can help decrease the risk. In addition, you may take the help of your doctor to quit alcohol.
3. Managing underlying medical conditions: The patients should manage diabetes, maintain blood pressure at acceptable levels, and keep cholesterol within the prescribed limits. 
4. Maintaining weight: Overweight or obese people are at increased risk for developing stroke due to the presence of other stroke risk factors, such as hypertension and cardiovascular disease. 
5. Exercise: Exercise lowers the level of cholesterol, maintains blood pressure and improves heart health.
6. Healthy diet: People should incorporate fruits and vegetables in their diet. 
7. Treating obstructive sleep apnea

Some of the tests that assist in diagnosing the stroke are as follows:

1. A Physical Examination: First, the doctor will do physical tests like checking blood pressure and listening to the heartbeat. 
2. CT scan: This test provides a clear image of the brain using X-rays. It can show the bleeding and damage to the brain.
3. Blood Test: The doctor may also prescribe you some blood tests. These tests may include clotting time, blood sugar, complete blood count, and the presence of infection is also checked in the blood.
4. Echocardiogram: It uses powerful radio waves to create a detailed picture of the brain. It can detect tissue damage in the brain.
5. MRI: Magnetic resonance imaging allows the doctors to determine the damage to the brain tissues due to ischemic stroke or haemorrhage. 
6. Carotid Ultrasound: It helps the doctor in finding the presence of plaque and obstruction in the blood flow in carotid arteries. 
7. Cerebral angiogram: This test is not commonly used. It involves the use of a catheter, which is guided to the carotid artery through an incision in the groin area. An X-ray image of the carotid artery is obtained by injecting a dye. It allows the doctor to have a comprehensive view of the arteries of the neck and head.

How to prepare for doctor consultation?

1. Always try to book an appointment online through the website of the hospital/clinic. It will help you to cut out the time in the queue.
2. Always explain the symptoms that you are experiencing in detail to the doctor. It will help the doctor better diagnose the condition.
3. Prepare a list of questions that you want to ask your doctor, like the medicines routine and the risk associated with treating the stroke etc.

Surgery of ischemic stroke

1. Emergency endovascular procedures: These may prevent the long-term effect of strokes like disabilities. Also, the time duration of this procedure is longer than others.
2. Medicines directly delivered to the brain: The doctor inserts a catheter through the groin and is guided to the brain. The medicine is released into the brain at the site of the stroke. 
3. Removal of the clot by using a tent retriever: in this method, the clot is removed from the brain using a stent. It directly removes the clot from the blood vessels. This process is advised in the case of the presence of large clots where the clots cannot be removed by using medicines. This procedure is done with a combination of clot-dissolving medicines in most cases.

Surgery of Hemorrhagic stroke

1. Surgery: If the bleeding area is large, the doctor may perform the surgery to remove the blood clots and regain brain functions. Surgery may also be used to repair the blood vessels damaged.
2. Clipping: The surgeon may place a tiny clamp to stop the blood supply to the aneurysm. It will prevent the aneurysm from bursting.
3. Surgical AVM removal: If the AVM is located in the reachable area of the brain, then the surgeon may remove it by using surgery. It prevents them from rupturing and reduces the chances of hemorrhagic stroke.
4. Endovascular embolisation: The doctor uses a catheter to place tiny detachable coils in the aneurysm. The catheter is inserted in the artery through the groin area and is guided to the brain using an imaginary system.

The complications can result from either the direct damage to the brain or the disability of the body caused by the stroke. The patient may experience the following types of complications:

1. Loss of muscle movement (Paralysis)
2. Memory loss
3. Change in behaviour of the person
4. Depression
5. Bedsores
6. Loss of bladder or bowel control
7. Shoulder pain
8. Difficulty in talking and swallowing
9. The person may feel it difficult to control his/her emotions.

Progression of disease

Worsening of the stroke in its earlier stages is a common occurrence. It generally occurs within 48 to 72 hours of the onset of the stroke. It has serious short and long-term effects on the patients. Progression increases the chances of death, and the survivor has more serious and permanent neurological defects and disabilities.

When to see a doctor?

You should ask for medical help if you see any signs of a stroke in your friend or relative, even if they appear and go quickly. The symptoms of the stroke can be identified through the acronym FAST, which indicates Face, Arm, Speech, and Time. To confirm, do the following:

1. Face: Ask the person to smile and confirm if there is a droop on one side of the face.
2. Arm: Ask the person to raise both of his arms in the air. Check if he/she is unable to raise both the arms or able to raise one arm but fails to raise the other.
3. Speech: Ask the person to say simple sentences or just generally try to start a casual conversation with them. Check if their speech is slurred.
4. Time: Time is crucial in case a relative, friend or nearby person identifies the above symptoms. The person should immediately call the emergency for assistance.