Ischemic stroke

Stroke ( cerebrovascular disease ) is the death of brain tissue ( cerebral infarction ) happens because of reduced blood flow and oxygen to the brain .

Strokes can be ischemic or bleeding ( hemorrhagic ) .
In ischemic stroke , the blood flow to the brain stops because of atherosclerosis or a blood clot that has clogged the arteries.
In hemorrhagic stroke , a blood vessel rupture thereby inhibiting normal blood flow and blood seeps into the region in the brain and damage it .

stroke

CAUSE

In ischemic stroke , blockage can occur along the artery leading to the brain .
For example, an atheroma (fatty deposits ) may form in the carotid artery , causing reduced blood
flow . This situation is very serious because each carotid artery in normal circumstances giving blood to most of the brain .
Fatty deposits can also be detached from the walls of arteries and blood flow , then the smaller arteries clog .

Carotid artery and the vertebral artery and its branches can also clog due to blood clots that originate from elsewhere , for example, of a heart or a valve .
This kind of stroke called cerebral embolism , which most often occurs in patients who had undergone cardiac surgery and patients with abnormalities of the heart valves or heart rhythm disorders ( especially atrial fibrillation ) .

Netting fat embolism causing stroke .
Fat embolism is formed when fat from the bone marrow yan gpecah released into the blood stream and eventually joined in an artery .

Stroke can also occur when an infection causes inflammation or narrowing of the blood vessels leading to the brain .
Drugs ( eg cocaine and amphetamines ) can also narrow the blood vessels in the brain and cause a stroke .

The decrease in blood pressure could suddenly reduces blood flow to the brain , which usually causes a person to pass out .
Stroke can occur if blood pressure is very severe and chronic lower .
This occurs when a person experiences a lot of blood loss due to injury or surgery , heart attack or abnormal heart rhythms .

SYMPTOMS

Most cases occur suddenly , very quickly and cause brain damage within a few minutes (completed stroke ) .

Stroke can be worse in a few hours to 1-2 days due to the increased extent of brain tissue death ( stroke in evolution ) .
Disease progression usually go ( but not always ) interspersed with periods of stable , where the expansion of dead tissue or a pause occurs some improvement .

Symptoms that occur depending on the area of the brain affected :
- Loss of taste or abnormal sensation in the arm or leg or one side of the body
- Weakness or paralysis of an arm or leg or one side of the body
- Partial loss of vision or hearing
- Double vision
- Dizziness
- Slurred speech ( rero )
- It's hard to think or say the right words
- Not being able to recognize parts of the body
- Unusual Movement
- Loss of control over bladder
- Imbalance and falls
- Fainting .

Neurological disorder that occurs heavier , wider , associated with coma or stupor and sedentary nature .
In addition , a stroke can cause depression or inability to control emotions .

Stroke can cause edema or swelling of the brain .
This is dangerous because the very limited space in the skull . This tension could further damage the brain tissue and worsen neurological disorder , although the stroke itself is not expanding .

Diagnosis
Diagnosis is usually made based on the course of disease and the results of physical examination .
The physical examination helps determine the location of the brain damage .

To confirm the diagnosis is usually performed a CT scan or MRI .
Both of these checks could also help determine the cause of the stroke , whether bleeding or brain tumor .

Sometimes performed angiography .

TREATMENT

Usually given oxygen and intravenous fitted to include fluids and nutrients .

At a stroke in evolution given anticoagulants ( eg, heparin ) , but these drugs are not given if there has been a completed stroke .
Anticoagulants are also not usually given to people with high blood pressure and was never supplied to patients with brain hemorrhage because it will increase the risk of bleeding into the brain .

Recent research shows that paralysis and other symptoms can be prevented or reversed if certain drugs that function destroys blood clots ( eg, streptokinase or tissue plasminogen ) given within 3 hours after stroke onset .
Immediate examination to determine that the cause was a blood clot and not bleeding , which can not be overcome with medication destroyer blood clot .

In the completed stroke , some dead brain tissue to improve blood flow to the daerh will not be able to function. Because it usually does not do surgery .
But the removal of the blockage after a minor stroke or transient ischemic attack , can reduce the risk of stroke in the future .

To reduce swelling and pressure in the brain in patients with acute stroke , usually given mannitol or corticosteroids .
Patients with very severe stroke may require a respirator to maintain adequate respiration .

Given special attention to the function of the bladder , digestive tract and skin ( to prevent cuts in the skin due to the emphasis ) .
Abnormalities that accompany stroke ( eg, heart failure , irregular heart rhythms , high blood pressure and lung infections ) should be treated .

After a stroke , usually a change in mood ( particularly depression ) , which can be treated with medication or psychological therapy .

REHABILITATION

Intensive rehabilitation can help people to learn to overcome the paralysis / partial disability due to dysfunction of the brain tissue .
Other parts of the brain can sometimes replace functions previously carried out by the brain damage .

Rehabilitation begins immediately after the blood pressure , pulse and respiratory stable patients .
Do exercises to maintain muscle strength , prevent injury due to muscle contraction and suppression ( due to lying too long ) and practice walking and talking .

Prognosis

Many patients who experience healing and re-run the normal functions .
Other patients experience physical and menatal paralysis and unable to move , speak or eat normally .

Approximately 50 % of patients who experienced a half body paralysis and other severe symptoms , can basically meet the needs of their own back .
They are able to think clearly and running well , although the use of the affected arm or leg rather limited .

Approximately 20 % of patients died in the hospital .
Dangerous is that stroke is accompanied by loss of consciousness and respiratory or cardiac dysfunction .

Neurological abnormalities that persist after 6 months is likely to continue to persist , although some undergo repairs .