What is a stroke?
A stroke is a medical emergency that happens when the blood flow to your brain is interrupted. Without blood, your brain cells start to die. This can cause serious symptoms, lasting disability, and even death.
There’s more than one kind of stroke.
What are the different types of strokes?
There are three main types of stroke: transient ischaemic attack, ischaemic, and haemorrhagic.
Transient ischaemic attack
Doctors also call a transient ischemic attack (TIA) a warning or ministroke. A clot that temporarily blocks blood flow to your brain causes a TIA. The blood clot and TIA symptoms last for a short period of time.
An ischemic stroke occurs when a blood clot keeps blood from flowing to your brain. The blood clot is often due to Atherosclerosis, which is a build up of fatty deposits on the inner lining of a blood vessel. A portion of these fatty deposits can break off and block blood flow in your brain. The concept is similar to that of a heart attack, where a blood clot blocks blood flow to a portion of your heart.
An ischemic stroke can be embolic, meaning the blood clot travels from another part of your body to your brain. A number of ischemic strokes are due to a condition called atrial-fibrillation, where your heart beats irregularly.
A thrombotic stroke is an ischemic stroke caused by a clot forming in a blood vessel in your brain.
Unlike a TIA, the blood clot that causes an ischemic stroke won’t go away without treatment.
A haemorrhagic stroke results when a blood vessel in your brain ruptures or breaks, spilling blood into the surrounding tissues.
There are two types of haemorrhagic strokes: The first is an Aneurysm, which causes a portion of the weakened blood vessel to balloon outward and sometimes rupture. The other is an arteriovenous-malformations which involves abnormally formed blood vessels. If such a blood vessel ruptures, it can cause a haemorrhagic stroke.
What are the symptoms of a stroke?
The different stroke types cause similar symptoms because each affects blood flow in your brain. The only way to determine what type of stroke you may be having is to seek medical attention. A doctor will order imaging tests to view your brain.
The Stroke foundation recommends the FAST method to help identify the warning signs of a stroke:
- Face:When you smile, does one side of your face droop?
- Arms:When you raise both arms, does one arm drift down?
- Speech:Is your speech slurred? Are you having trouble talking?
- Time:If you experience any of these symptoms, call 111 immediately.
Additional symptoms that don’t fit in the FAST description include:
- sudden confusion, such as difficulty understanding what a person is saying
- difficulty walking, sudden dizziness, or loss of coordination
- sudden, severe headache that doesn’t have any other known cause
- difficulty seeing in one or both eyes
A TIA will cause these symptoms for a short amount of time, usually anywhere from one to five minutes. However, you shouldn’t ignore stroke symptoms, even if they go away quickly.
What complications can a stroke cause?
A stroke is a medical emergency for a reason — it can have life-threatening consequences. The brain controls the major functions of human life. Without blood flow, your brain can’t manage breathing, blood pressure, and much more. Complications can vary according to the stroke type and if you are able to successfully receive treatment. Examples of complications include:
Behaviour changes: Having a stroke can contribute to depression or anxiety. You also may experience changes in your behaviour, such as being more impulsive or more withdrawn from socializing with others.
Speech difficulties: A stroke can impact areas of your brain having to do with speech and swallowing. As a result, you may have difficulty reading, writing, or understanding other people when they’re speaking.
Numbness or pain: A stroke can cause numbness and decreased sensation in parts of your body. This can be painful. Sometimes injury to the brain can also affect your ability to sense temperature. This condition is known as central stroke pain and can be difficult to treat.
Paralysis: Because of the way your brain works to direct movement, a stroke in the right side of your brain can affect movement on the left side of your body and vice-versa. Those who’ve had a stroke may not be able to use facial muscles or move an arm on one side.
You may be able to regain lost motor function, speech, or swallowing abilities after a stroke through rehabilitation. However, these can take time to regain. For treatment of symptoms during the rehabilitation phase or to aid residual side effects both Physiotherapy and Orthotic treatment plans can help. These may consist of upper and lower limb therapies, consisting of strengthening programs, re-education, neuroplasticity techniques and biomechanical and gait training and re-education. All of this use both physiotherapist and Orthotists to achieve a recovery, and the earlier the intervention usually the better the outcomes.
Orthoses such as Ankle foot orthotics, FES systems, combined neurological knee supports (such as the Neurexa ottobock range of products,) neurological insoles, and upper limb orthoses such as hand wrist splints, elbow and shoulder subluxation orthoses to achieve these goals and outcomes. Both physiotherapy and the orthotist work together to achieve the best outcome possible, with rehabilitation programs and the best designed orthoses possible.
How are strokes treated?
Treatments for stroke depend on many factors. These include what kind it is and how long it lasted. The sooner you can seek help after a stroke, the more likely you’ll have a better recovery.
Treatments for TIA include taking medicines that will help prevent future strokes. These medicines include anticoagulant-and-antiplatelet-drugs.
Antiplatelet reduce the likelihood that components of your blood called platelets will stick together and cause a clot.
Anticoagulants are medicines that reduce the build-up of clotting proteins.
A doctor may also recommend a surgery called a carotid endarterectomy. This removes plaque build-up in the carotid artery of your neck, which is a major cause of stroke.
The ischemic stroke treatments you receive depend on how quickly you get to a hospital. They also depend on your individual medical history.
If you seek treatment within three hours for this type of stroke, your doctor may be able to give you a medicine known as tissue plasminogen activator (TPA). This medicine, which is delivered through an IV, can dissolve the clot. However, not all people can receive TPA due to risks for bleeding. Your doctor should carefully consider your medical history before administering TPA.
Doctors can use procedures to physically remove the clot or deliver clot-busting medications to your brain. These treatments aren’t always beneficial, as your medical history may put you at risk for certain side effects.
Haemorrhagic stroke treatments involve trying to stop bleeding in your brain and reduce the side effects associated with brain bleeding. Side effects may include increased-intracranial-pressure. Surgical procedures include surgical clipping or coiling. These are designed to keep the blood vessel from bleeding further.
You may be given medications to reduce intracranial pressure. You may also need blood transfusions to increase the amount of blood-clotting materials in your blood to try to stop bleeding.
What is the outlook for each stroke type?
A number of people who experience a TIA will go on to have a full-blown ischemic stroke within a year. Seeking treatment reduces the chances of this happening.
If a person has had a stroke, they’re at an increased risk to have another. It’s estimated one-fourth of people who’ve had a stroke will have another within five years.
There are many lifestyle changes you can adopt to reduce your risks for ever having a stroke or a reoccurrence. Examples include:
- increasing physical activity
- eating a healthy diet to maintain a normal weight for your height and build
- reducing binge drinking and limiting drinks to no more than one per day for women and one to two per day for men
- taking medications as prescribed to reduce blood pressure and encourage blood glucose control
- wearing a continuous positive airway pressure mask if you have sleep apneato reduce the demands on your heart
How can OLAB help?
Orthotic Consultation for treatment of a stroke may include measurement / fitting of appropriate upper or lower limb orthoses allowing improved function and mobility. This can be arranged by our trained clinical team – Contact us for more information on what is available or to book.