Ischemic Stroke Essays

Ischemic Stroke Essays Ischemic Stroke Essay Ischemic Stroke Essay A stroke occurs when the blood supply to part of the brain is partially or completely reduced, depriving the brain of necessary blood and oxygen and ultimately causing brain damage. There are two main types of stroke, ischemic and hemorrhagic, but for the purpose of this paper, the focus will be on ischemic stroke. Ischemic strokes account for approximately 87% of all stoke cases and occur as the result of an obstruction within a blood vessel that supplies blood to the brain. The obstruction can either be a cerebral thrombosis or a cerebral embolism. An ischemic stroke would be classified as thrombotic if the clot forms in an artery that is already very narrow. In contrast, a stroke would be classified as embolic when a clot forms in another part of the circulatory system and then proceeds to travel to brain and causes a blockage in smaller vessels. The underlying cause of ischemic strokes is atherosclerosis, which is defined the buildup of fatty deposits inside the vessel walls and it is the buildup of these fatty deposits that leads to blockages, and ultimately stroke. There are many different factors that contribute to an individual’s risk of experiencing a stroke. Some risk factors can be reduced, treated, and changed, but others are more permanent and serve as lifelong risks. For instance, an example of a long term effect would be that the risk of suffering from a stroke increases with age and approximately doubles each decade after an individual reaches the age of 55. Stroke is also more common among men than women and the risk for experiencing a stroke increases if there is a family history of it as well. In contrast, factors such as poor diet, smoking cigarettes, and a lack of physical activity are risk factors for stroke that can be controlled and reduced. High blood pressure is also one of the leading causes of stroke, as well as high blood cholesterol and heart disease. These risks are typically considered high risk and are associated with less healthy lifestyles, but do have the potential to be overcome given a proper diet and exercise plan. Symptoms Identifying the symptoms of stroke is essential to recovery, since the longer it goes untreated, the greater the chance of severe brain damage and disability. One of the common symptoms of stroke is lack of coordination. Individuals may face difficulties walking, experience dizziness, or be prone to lose balance and stumble. Another common symptom of stroke is difficulty speaking. Individuals experiencing a stroke may slur their words and some may have difficulty understanding speech as well. In addition, another symptom of stroke is paralysis or numbness of the face, arms, or legs. When this occurs, it is important to note that paralysis is most often is present on one side of the body, but can be seen in both sides as well. Difficulty with one’s vision is also a symptom of stroke and can be present in either one or both eyes. The sudden appearance of a severe headache is additionally a symptom and is often accompanied by dizziness and vomiting. All symptoms of stroke need to be taken seriously and individual’s displaying them should be rushed to a hospital as soon as possible. Treatment and Recovery As mentioned earlier, the longer a stroke goes undiagnosed, the greater the probability of severe brain damage and disability. Furthermore, treatment of stroke is most effective in the early stages, specifically within the first three hours. This section will look at the different treatment and recovery options for individuals suffering from ischemic strokes. Treatment In regards to treatment of an ischemic stroke, doctors typically first rely on thrombolytic medication to help break down the clot and restore blood flow to the brain. Aspirin is typically given after an ischemic stroke to prevent the formation of additional clots and reduce the likelihood of another stroke. Heparin is another blood thinning agent that may be used in the case of an ischemic stroke, however it is far less common since its effectiveness in emergency settings has yet to be fully determined. The use of an injection of tissue plasminogen activator, TPA, is a technique used by doctors to treat ischemic stroke, but it is only effective within the first three to four hours after the symptoms first began. TPA is administered through a vein in the arm and works to help dissolve the blood clot and reduce the effects of stroke. However, the drug does increase the chance of a brain bleed, and the majority of people admitted to the hospital for an ischemic stroke come in too late to receive the medication. In addition to the use of medication to combat ischemic strokes, doctors may also resort to emergency procedures as well. For instance doctors may make the decision to directly input TPA into the brain through the use of a catheter that is inserted into an artery in the groin area and maneuvered to the area of the brain where the stroke is occurring. This treatment option is more invasive, but gives doctors a greater window of treatment and requires smaller amounts of the drug which reduces the risk of bleeding. Doctors may also elect to use mechanical clot removal to treat an ischemic stroke. This procedural entails a doctor inserting a catheter with a mechanical device on the end and maneuvering it inside the brain to physically remove the clot. However, if the clot is not visible, this mechanical method is not viable. Recovery After the initial emergency treatment of an ischemic stroke, the focus shifts to the recovery process which involves helping patients recover their strength and regain as much function and sense of independence as possible. Rehabilitation typically begins in the hospital and continues at home or in an outpatient facility after the patient is discharged. No two rehabilitation programs are exactly the same, and in order for them to be most effective, they must be tailored to meet the patient’s needs. Some of the common issues addressed within stroke rehabilitation include: vision problems, difficulty sleeping, seizures, incontinence, paralysis, dysphagia, hemiparesis, spasticity, foot drop, aphasia and memory problems, and fatigue. As mentioned earlier, treatment plans are typically customized based on the needs of the patient, but we will look at a few treatment options that are commonly used for stroke victims. One of the most common impairments associated with stroke is paralysis. Hemiparesis, which is weakness or partial paralysis of one side of the body, is the form of paralysis most common amongst stroke victims. This can cause a loss of balance for the individual as well as muscle fatigue, a lack of coordination, and difficulty walking and grasping objects. There are various treatment methods to combat hemiparesis, but one of the most common methods is modified constraint-induced therapy. This involves forcing the patient to use their weak side to perform certain tasks by restricting the use of the less affected side of the body. Electrical stimulation and cortical stimulation are two other treatments options that can be used through the use of electrodes to stimulate the weakened body part or the brain in the hopes of the patient regaining their mobility. These treatment methods can also be applied to other forms of paralysis associated with stroke such as spasticity and foot drop. Spasticity and foot drop can also be treated through the use of stretching exercises that help improve range of motion and flexibility while also reducing pain and discomfort. Furthermore, an additional form of paralysis associated with stroke is dysphagia, which is paralysis of the throat muscles. This can lead to problems swallowing, eating, drinking, and breathing. There are a variety of rehabilitation methods to help lesson symptoms, including swallow therapy, special exercises, medication, and surgery. Surgery is the most extensive option and is typically reserved for severe cases, but has shown to be effective in the past. Swallow therapy and exercises are often used as well and involve the use of electric stimulation to improve swallowing and exercises to strengthen throat muscles. All of these rehabilitation techniques can be coupled with medications such as muscle relaxers in order to increase the effectiveness of the therapies being used on the individual. Incontinence is also another common result of stroke and affects approximately 40-60% of stroke victims. Treatment can involve a variety of methods including but not limited to medication, bladder and bowel training, surgery, the use of a catheter, and behavioral and physical therapies. In addition to incontinence, seizures are also a side effect associated with ischemic stroke but is far less common. Antiepileptic drugs are the most common treatment method for stroke, however, they need to be carefully administered given the that they can sometimes have a negative impact on overall stroke recovery. To combat seizures due to stroke, surgery is sometimes presented as an option, as well as the implementation of a vagus nerve stimulator to help prevent future seizures, but these treatment methods are more invasive and come with a higher risk. Aphasia and memory problems are two cognitive effects of stroke that impact a multitude of individuals. Aphasia is a communication disorder that affects an individual’s ability to both comprehend and use language. Aphasia is often treated using melodic intonation therapy, art therapy, visual speech perception therapy, constraint-induced language therapy, and group therapy. However, the most common treatment for aphasia is speech therapy, which uses special exercises and techniques to improve the patient’s ability to speak. In order to combat memory problems, neuropsychological rehabilitation, cognitive rehabilitation and cognitive training are used to help improve alertness, attention to detail, recall, and the ability to function independently. Treatment in these two areas is highly important and successful rehabilitation can provide stroke victims with a better quality of life and sense of independence. Conclusion The outlook for victims of strokes varies on a case to case basis, but if caught early, there is a greater chance of a more effective recovery. The type of stroke also greatly impacts survival rates, with individuals with ischemic strokes having more positive outlooks than individuals who suffer a hemorrhagic stroke. In emergency treatment of a stroke, doctors will initially attempt acute treatment methods in the hopes of breaking up and dissolving the clot, however the most effective treatments have a limited time frame of use. Post stroke rehabilitation varies from patient to patient and is customized to fit a patient’s needs. It is often a lengthy process but in the end the results have the potential to be very positive and most patients see an improvement in their overall quality of life.