What Is a Stroke, What Causes It and First Aid

I lost already one person due to a stroke, and considering that only in the US one person dies of stroke every 4 minutes, by the time I will finish writing this post unfortunately several more people will have died. The reason why I decided to write this post is to help other people recognize the early symptoms of strokes and giving them a chance to call for help in a timely manner. Even a few minutes can greatly increase the chances of survival, so if you know somebody with high risk for a stroke please read carefully.

Let's start by answering to the question: what is a stroke?

It is defined as an interruption or reduction of the blood supply to the brain. This, deprives the brain cells with nutrients and oxygen. Considering that brain cells are high oxygen and nutrients consumers, they can't withstand long deprivation of blood supply with consequent cell death. This is a horrible way to die because as we will discuss later it can be very painful and even when people survive to a stroke they can be disabled for the rest of their life.

What are the causes of a stroke?

Strokes can originate as a consequence of 3 different classes of events:

• A blocked artery (ischemic stroke)
• A leaking blood vessel (hemorrhagic stroke)
• A temporary disruption of the blood flow (transient ischemic stroke)

Ischemic Stroke

When arteries become narrowed or blocked, the amount of blood that reach the brain can diminish drastically causing an ischemic stroke which accounts for 85% of all strokes. Normally with aging there is a build up of fatty deposits in the arteries, causing them to narrow and consequently increasing the chances for blood clot formation, when this happens we have a thrombotic stroke. However, ischemic strokes can also be caused by cardiovascular problems. In this case, the blood clot forms away from the brain, commonly in the heart. How is that possible? As you know the heart is composed of 4 chambers that gets filled with blood coming from the veins and pump it in arteries. Sometimes the heart contraction is not complete and this can result with the formation of pockets in the chambers in which some blood is stagnating. If not treated most likely the formation of small blood clots will occur. Those will grow in size until will be swept through the bloodstream. The chance of this small blood clot to lodge in narrowed brain arteries is quite high, and can give origin to an embolus (Embolic Stroke).

Hemorrhagic Stroke:

But, not all strokes originate from an embolus or an occlusion of the brain arteries. In fact, some strokes originate from haemorrhages (Hemorrhagic Stroke). There are several conditions that can cause a haemorrhage and these are:

• High blood pressure (hypertension)
• Weak spots in your blood vessels walls (Aneurysms)
• Rupture of thin walled blood vessels (this is less common)

However, it must be said that not all strokes are permanent. There are also cases in which there is a temporary decrease of blood supply to the brain. This event is known as a Transient Ischemic Attack (or Ministroke) which results with similar symptoms to stroke but the blockage is only temporary.

What are the risks factors for a stroke?

Most risk factors for a stroke encompass our lifestyle. From one point of view this is good news, because it's something that with a bit of discipline we can control. These factors are:

• Obesity
• Physical activity
• Excessive drinking
• Use of drugs

So living with a bit of common sense should help prolonging our life. I know it's easy to fall in the temptation of laziness and it's hard to find time for some physical activity during our "busy life" but I think the main issue is that often our health is not seen as a priority. We tend to give importance to it only when we have a problem (which is often too late). The truth is, to stay healthy we need to put a bit of effort, eat less fries and burgers and cycle to work instead of taking a car. Another important aspect is to monitor as often as we can the status of our health. To help you understand what I mean here there is another list of treatable stroke-risk factors (what we need to monitor carefully):

• High blood pressure (higher than 120/80 mmHg)
• Cigarette smoking or second hand smoking
• High cholesterol
• Diabetes
• Obstructive sleep apnea (the oxygen level intermittently drops during the night)
• Cardiovascular disease

However, as for many other diseases, there is also a genetic predisposition to strokes, for this reason if somebody in our family had a stroke, we need to do a health check more frequently and be aware of the early symptoms (discussed below) of a stroke to be able to act quickly. Our race is also a predisposing factor (African-American have higher risks) as well as our gender (males have higher risks of strokes than females). But as also common sense suggests our age is strongly correlated with the possibility of a stroke, from 55 years old and above, there is a dramatic increase in the likelihood of having a stroke.

But what are the symptoms of a stroke?

The longer a stroke goes untreated, the greater the potential for damage. For this reason I think it's very important to pay attention to this list:

• Trouble with walking - sudden dizziness, loss of balance or loss of coordination
• Trouble with speaking and understanding - experience confusion
• Paralysis or numbness of the face, arm or leg - try to raise both arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Or if one side of your mouth is dropping while you smile.

• Trouble with seeing in one or both eyes - blurred or blackened vision or see double
• Headache - sudden severe headache accompanied by vomiting, dizziness and altered consciousness.

To better remember what to check in case of an attack remember the acronym FAST:

F. Face
A. Arms
S. Speech
T. Time to call help

I hope none of you will ever find himself in this situation. And even if you are healthy it should not be an excuse to overlook your lifestyle. What is sure is that some prevention and a few health checks cannot do any harm.