Stroke is third most common cause of death. Stroke also known as cerebrovascular accident (CVA), is the rapid loss of brain function due to interruption in the blood supply to the brain. This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a haemorrhage (bleeding). As a result, the affected area of the brain cannot function, which might result in an inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or an inability to see one side of the visual field. Stroke is a medical emergency since it can cause permanent neurological damage and death.
The risk factors for stroke include old age, high blood pressure, previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, tobacco smoking, alcohol and atrial fibrillation.
The diagnosis and the pathology of stroke is established by clinical symptoms and by brain scan (CT and MRI scan).
An ischemic stroke is treated in the hospital with Thrombolysis (also known as a “clot buster”). Acute stroke (infarct) if detected within 3 hours can be treated with Thrombolytic (clot bursting) therapy and it improves the outcome of stroke significantly. Large strokes may also be benefited by surgery, Hemorrhagic strokes benefit from Neurosurgery. The procedure done by us reduces the pressure in the brain by draining the brain fluid (CSF) or craniotomy and removal of the clot.
Treatment to recover any lost function is termed as stroke rehabilitation, ideally done in a stroke unit and it involves health professionals and a multidisciplinary approach which includes speech and language therapy, physical therapy and occupational therapy.
Prevention of recurrence may involve the administration of antiplatelet drugs such as aspirin, clopidogrel and dipyridamole, control and reduction of high blood pressure, and the use of cholesterol lowering drugs. Selected patients may benefit from carotid endarterectomy and carotid bypass surgery.