What is a stroke?

According to the American Stroke Association, “A stroke is a disease of arteries leading to and within the brain. It occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot (ischemic stroke) or bursts (hemorrhagic stroke). When that happens, part of the brain cannot get the blood and oxygen it needs, so it starts to die.”

The brain is an extremely complex organ that controls most body functions. If a stroke occurs and blood flow can’t reach the region that controls a particular body function, that part of the body won’t work as it should.

Strokes can happen suddenly and thus require immediate medical attention. Treatment within 60 minutes of the first symptoms often leads to a good prognosis. If deprived of oxygen for more than a few minutes, brain cells begin to die. The longer the stroke lasts, the greater damage to the brain.

Symptoms of stroke
Sudden onset of any of the following warning signs of a stroke warrants emergency medical attention:

• Numbness or weakness in one leg, arm or side of the face
• Difficulty walking or keeping balance, or extreme dizziness
• Confusion or difficulty talking or understanding others
• Double vision
• Sudden and extremely severe headache

Transient ischemic attacks (TIAs) are a form of mini-stroke. The symptoms are the same as for a full-blown stroke, but theydon’t last as long—often only a few minutes to an hour. TIAs are warning signs that a bigger stroke could follow.

When someone has shown symptoms of a stroke or a TIA, a doctor will gather information and make a diagnosis. He or she will review the events that have occurred and will:

• Get a medical history
• Do a physical and neurological examination
• Have certain laboratory (blood) tests done
• Get a CT or MRI scan

Why are people with diabetes at risk for stroke?
A person with diabetes is at higher risk than others for stroke and other cardiovascular diseases. As with many of the health problems associated with diabetes, high blood glucose is a contributory risk factor.

Persistently elevated blood glucose levels contribute to the buildup of plaque in blood vessels. Plaque—a collection of cholesterol, calcium, cellular waste and protein—sticks to the walls of blood vessels and can interfere with blood flow. This impaired blood flow can lead to a stroke.

Treatment of stroke
The most promising treatment for ischemic stroke is the FDA-approved clot-busting drug tPA (tissue plasminogen activator), which must be administered within a three-hour window from the onset of symptoms to work best. Administering tPA or other clot-dissolving agents is complex and is done through an intravenous (IV) line in the arm by hospital personnel. If given promptly, tPA can significantly reduce the effects of stroke and reduce permanent disability. Generally, only 3-5 percent of those who suffer a stroke reach the hospital in time to be considered for this treatment.

For hemorrhagic stroke (specifically for a subarachnoid hemorrhage), surgical treatment is often recommended to either place a metal clip at the base, called the neck, of the aneurysm or to remove the abnormal vessels comprising an arteriovenous malformation (AVM).Endovascular procedures are less invasive and involve the use of a catheter introduced through a major artery in the leg or arm, guided to the aneurysm or AVM where it deposits a mechanical agent, such as a coil, to prevent rupture.

Preventing Stroke
Talk to a healthcare professional and follow these guidelines:

Control blood pressure (hypertension)
High blood pressure is a major stroke risk factor if left untreated.

Identify atrial fibrillation (Afib) Afib is an abnormal
heartbeat that can increase stroke risk by 500 percent. Afib can cause blood to pool in the heart and may form a clot and cause a stroke. Preventing the blood clot will prevent a stroke.

Stop smoking
Smoking doubles the risk of stroke. It damages blood vessel walls, speeds up artery clogging, raises blood pressure and makes the heart work harder.

Control alcohol use
Alcohol use has been linked to stroke in many studies. Most doctors recommend not drinking or drinking only in moderation -no more than two drinks each day.

Know cholesterol levels
High cholesterol levels can clog arteries and cause a stroke, therefore should be treated.

Control diabetes
Many people with diabetes have health problems that are also stroke risk factors. Sugar levels should be well-controlled.

Manage exercise/diet
Excess weight strains the circulatory system. Exercise five times a week. Maintain a diet low in calories, salt, saturated and trans fats and cholesterol. Eat five servings of fruits and vegetables daily.

Treat circulation problems
Fatty deposits can block arteries carrying blood to the brain and lead to a stroke. Other problems such as sickle cell disease or severe anemia should be treated.

Transient Ischemic Attack (TIA)
A TIA is a temporary episode of stroke-like symptoms that can last a few minutes to 24 hours but usually causes no permanent damage or disability. TIA and stroke symptoms are the same. Recognizing and treating a TIA can reduce stroke risk. Up to 40 percent of people who experience a TIA may have a stroke.

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• why diabetes warrants no tpa in stroke victums

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