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Stroke occurs when the blood supply to the brain is interrupted or when the blood vessel in the brain bursts,spilling blood into the spaces surrounding brain cells. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain.

Your risk for stroke increase with age. But a stroke can strike anyone, anytime. In fact, the rate of stroke among the age group between 18 and 65 is on the rise. The fact is younger people ignore stroke symptoms

Common Risk Factors Of Stroke 

1. Advancing Age
2. Smoking
3. High Blood Pressure
4. Diabetes Mellitus
5. High Cholesterol levels
6. Irregular Heart Rhythm (Atrial Fibrillation/Atrial Flutter)
7. Ischaemic Heart disease (Angina or Heart attack)
8. Chronic Kidney disease

Risk factors for Stroke in Younger Adult (Age <45 years) will include some of the risk factors as above. But not all of them are relevant in this age group. Stroke is not uncommon in this age group, but the causes are different and hence investigations to find them needs to be different.

Additional Risk Factors of Stroke 

1. Vasculitis or swelling of brain blood vessels (can happen in isolation or in conjunction to disease in other systems like Rheumatoid arthritis, Crohn’s disease, SLE etc.)
2. Infective Vasculopathy – permanent change in blood vessel wall in relation to infections like HIV, Hepatitis B & C, Syphilis, Herpes Simplex or Varicella Zoster viruses.
3. Toxic Vasculopathy – permanent change in blood vessel wall in relation to use of recreational drugs particularly cannabis and cocaine
4. Reversible Cerebral Vasospasm (RCVS) – transient spasm in blood vessel wall in relation to recreational drugs (Cociane/Cannabis), infections or medicines (nasal decongestants are a common offender)
5. Fibromuscular Dysplasia – Change is blood vessel wall causing them to be narrower and stiffer, so far cause is unknown. Usually associated with similar change in kidney blood vessels and this needs to be screened and scented if found.
6. Dissection – Commonest cause of Stroke in young adults. A small tear occurs in the blood vessel wall due to trivial or non trivial trauma and this leads to blood clots forming around the tear. Common places are neck blood vessels (Carotid and vertebral arteries). Prognosis is very good. Usually the blood vessel remodels itself and completely reanalyses in 90-95% of cases.
7. Atrial Fibrillation – irregular heart rhythm
8. Obstructive Sleep Apnoea – screen for snoring.
9. Patent Foramen Pvale – hole in the heart. Current evidence suggests closing the hole if found is better than medical treatment.
10. Congenital Thrombophilia – Certain abnormal blood proteins which are present from birth which makes blood more sticky and therefore more prone to clot. These can be tested through blood samples and treated.
11. Acquired Thrombophilia – Certain abnormal blood proteins which are acquired through life which makes blood more sticky and more prone to clot. They are often associated with disease in other systems like Rheumatoid Arthritis, SLE etc.
12. COVID Infection – A form of acquired thrombophilia is reported with COVID infections with presence of Antiphosphoplipid antibodies (Abnormal blood protein) transiently which makes blood more prone to clot. Usually dissapears in 3 months.
13. COVID Vaccination – Certain COVID vaccines, in particular AstraZeneca (Covishield) and Johnson & Johnson (Jansen), have been reported to cause an immune reaction (bodies defence mechanism malfunctions and attacks blood cells) where they deplete platelets (Vaccine induced thrombocytopenia, ViTT) which causes clotting all over the body.

Diabetes is not only a serious condition itself but is also responsible for increasing the vulnerability for many health conditions, stroke being one of them. Studies indicate that people suffering from diabetes have around 1.5 times greater chances of having a stroke, than people who do not have it. According to World Health Organisation (WHO), total number of people with diabetes is projected to increase to 366 million in 2030 from 171 million in 2000.

Diabetes affects the capabilities of the body to create insulin or put it to best uses. Insulin plays a very important role in filtering out the glucose from the bloodstream into the cells. People who suffer from diabetes, do not have this mechanism working quite efficiently, thus they are often left with extreme amounts of sugar in their blood. As time passes by, this extra sugar leads to the building up of clots or deposits of fat inside the vessels that are responsible for supplying blood to the brain and the neck. This is nothing but the process of atherosclerosis.

As a result of these deposits growing, the blood vessels often narrow down or can even get blocked completely. When the blood flow to the brain stops, there are chances of occurrence of a stroke.

What is a stroke and what are the types of it?

For the definition of a stroke, in a layman’s terms, stroke is a condition in which the blood vessels of the brain are damaged. A number of factors characterize the occurrence of a stroke, like the place in the brain where the blood vessels have been damaged, the size of the damaged blood vessel and the event responsible for the damage. Following are the types of strokes:

• Ischaemic stroke: This is the most common type of stroke and occurs when the artery supplying oxygen-rich blood to the brain, gets blocked. Most often the bran gets blocked due to a blood clot.

• Hemorrhagic stroke: This stroke happens when the artery in the brain ruptures or leaks blood. This is a very serious kind of stroke and is responsible for 40 per cent of deaths related to strokes.

• Transient ischaemic attack: Also known as TIA, this condition is often known as a mini-stroke as the blood flow to the brain gets blocked for a certain amount of time. This stroke does not result in a permanent neurological damage. TIA may last from a minute to many hours, till the clogged artery opens back. Often referred to as a warning stroke the symptoms should not be ignored.

What are the warning signs of stroke?

1. Weakness or numbness on one side of the body
2. Sudden confusion or trouble understanding
3. Trouble talking
4. Dizziness, loss of balance, or trouble walking
5. Double vision
6. Severe Headache

As the signs develop suddenly and as STROKE is a life-threatening disease, it is important to contact the emergency department as getting treatment as soon as possible after a stroke can help prevent permanent damage to your brain

A deep connection between stroke and diabetes

As we have already understood, diabetes increases the chances of stroke. To add to this, diabetes also makes it hard for the body to respond to stroke. When the oxygen supply gets cut off, the other arteries can normalise the situation by acting as a bypass. In case, a person suffering a stroke already has diabetes, the vessels may remain clogged or hardened with plaque, a condition which is known as atherosclerosis. Thus, the brain finds it hard to receive the supply of the blood.

With the passage of time, the high blood sugar levels can damage the nerves and the blood vessels.  If the condition is not brought under control in time, a person with diabetes can suffer a stroke anytime. People suffering from diabetes are also vulnerable to suffer from other conditions that can increase the risks of having heart disease and stroke.

The American Heart Association have indicated in their findings that 16 % of the adults above 65 years and with diabetes, die from a stroke and 68 % die from other heart diseases. They have also warned that diabetes is one of the seven controllable risk factors for various kinds of cardiovascular diseases.

How to reduce the occurrence of a stroke in people who have diabetes?

While stroke is a disease of the blood vessels, diabetes affects blood vessels in addition to other organs. So, if diabetes can be controlled, its timely control and other sorts of precaution can lessen the risks of a stroke resulting from it.

• People need to take proper medications to lower associated risks.
• A dietary change is also beneficial for the prevention of strokes.
• Exercising regularly, at least for 2 hours and 30 minutes is of great help.
• The diet should include lots of vegetables.
• Quitting smoking would be really great.
• Maintaining good cholesterol levels is a very important preventive measure.
• A healthy weight should also be maintained.

If you have any health queries related to Stroke Medicine, Geriatric Medicine, Neurological Diseases in the Elderly and General Medicine, and need medical advice/second opinion, contact us on  [email protected]

References:

• https://www.healthline.com/health/diabetes/diabetes-and-stroke
• https://www.webmd.com/diabetes/type-2-diabetes-guide/diabetes-stroke#1
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543806/

A stroke may be frightening to both the survivor and the family. Immediately after stroke it’s not unusual to feel overwhelmed, uncertain, about your newly added role as a caregiver. The common question that comes to the mind as a caregiver “Will My Loved Ones Recover from STROKE?”

Stroke recovery varies from person to person and is nearly impossible to predict. Some people can recover completely, some survivors require long-term care because of the severity of the impairments, some soon die after a stroke. Recovery from a stroke can vary from few days to months to years. It is determined by where in the brain the stroke occurred. For example, in which portion of the brain the stroke occurred. How much of the brain is affected, the survivor’s motivation, caregiver support, the quantity and quality of rehabilitation and the survivor’s health before the stroke.

What You Need To Know As a Caregiver

• Educate Yourselves:

1. • The first thing you should do as a caregiver is to ask questions for example What type of stroke did your loved one have? What side of the brain was affected? What caused the stroke? How can another stroke be prevented?
   • Build a network with other stroke survivors and caregivers.

• Avoid Falls: Falls after stroke is common. So, the first thing as a caregiver one should take into consideration is to make the home safer to avoid falls. For example, if there is a way the patient can avoid stairs, is there a way to put grab bars and seats in the bathroom and shower.

• Reduce the risks of having another stroke: Survivors are at a higher risk for a second stroke, so it’s important to help minimize that risk. Along with it, is also important to recognise the signs of Stroke.The risk of having another stroke goes up with the older age, high blood pressure, high cholesterol, diabetes, obesity, heart disease, cigarette smoking, use of alcohol and drug use. Though some of these risk factors cannot be controlled for example age, gender but some of these could be reduced through use of prescribed medicines by doctor or change of lifestyle.

• Focus on a healthy life style: After a stroke it is crucial to get all the nutrients your brain needs for a fast recovery from stroke. Neurogenesis helps to regenerate new cells and compensate for the damage from Stroke. It is crucial to have diet that is rich in neurogenesis for example blueberries, omega-3 fatty acids, green tea and curcumin. Along with proper diet, regular exercise, taking medicines on time as prescribed by the doctors and visits to the healthcare provider on time is crucial towards lowering the risk of having another stroke.

Stroke Complications That You Need To Be Aware Of

• Swallowing: Post Stroke, the survivor may have problem in swallowing. If the survivor face such problems, get some help from a speech therapist who can help you to relearn how to swallow and eat normally again. Dietitian can help you to find nutritious food that are easier to eat and swallow.

• Bladder And Bowel Control: Frequent urination, trouble urinating, ability to identify the need to go for urinating can be some of the problems a survivor may face. It is advisable to seek help from a bladder or bowel specialist if such problem persists.

• Be aware of the Physiological Problems A Stroke Patient May Face: Post Stroke, depression & anxiety are some of the common psychological problems noticed among the survivor. Signs of such emotions might interfere with your loved one’s recovery. In such cases, if you notice your loved one is having hard time controlling emotions, it is important to seek advice from your healthcare provider.

• Be aware of the Disrupted Cognitive Functions: One or more of the cognitive functions can be disrupted by a stroke. This includes communication, memory, and concentration, the ability to carry out skilled activities such as getting dressed or making a cup of tea. Though most of the communications skills can be recovered through speech and language therapy over time, but you may find that they don’t return to the way they were before.

The role of a caregiver can be stressful. So, as a caregiver it is important that you look after yourself. The more you look after yourself both physically and emotionally, the more you can care your loved ones. It is also crucial to take time for yourself. This shouldn’t be ignored. It contributes to your loved ones’ healing process.

If your loved ones had a stroke and you have questions about your loved ones recovery, it is best to ask a stroke specialist online

References:

• https://www.stroke.org/en/help-and-support/for-family-caregivers/15-things-caregivers-should-know-after-a-loved-one-has-had-a-stroke
• https://www.healthline.com/health/stroke/recovery#complications

In our daily lives, we often hear our relatives or other acquaintances suffering a stroke. A stroke connotes a situation when there is a sudden disruption in the blood supply to the brain. Most strokes result from a sudden blockage of the arteries which lead to the brain. This condition has a better medical term. It is also known as an Ischemic Stroke. Some other kinds of strokes are caused by the bleeding tissues in the brain due to the sudden bursting of the blood vessels. This condition is known as the haemorrhagic stroke. Now, whatever be the medical situation, prompting the stroke, we have to opt for certain lifestyle changes to prevent or reduce the rates of occurrence.

How to Recognise the Signs of a Stroke?

Though every different people have different symptoms of a stroke, they occur suddenly most of the times. Different parts of our brain are responsible for controlling the different parts of our body and this is the reason why the symptoms are varied. The symptoms depend on the affected parts of the brain as well as the extent of the damage caused. We can take the help of the word FAST to remember the symptoms:

• F stands for face– The face may start dropping on one of the sides and the affected person may not be able to conduct any facial movement. Their mouth or eyes may also start drooping.

• A stands for arms-There might be weakness or numbness in the arms and the affected person may face difficulty in lifting them.

• S stands for speech: The speech starts getting slurred and the person will not be able to talk even if he tries hard. They also start having comprehension problems.

• T stands for time to call for medical help: If the patient shows any of these symptoms, please take him to the hospital immediately. Even if the symptoms goes away, it is advisable to seek emergency medical services immediately.

Some other symptoms might also be attributed to a stroke attack. It includes complete paralysis of any side of the body, confusion, dizziness, problems with coordination and balance, dysphagia, loss of consciousness etc.

Serious Changes in Lifestyle

Many of us may attribute divine intervention or destiny to the occurrence of a stroke in our known people. We may also conclude that nothing could have been done to avoid it. But, are we aware of the fact that a stroke can be prevented by incorporating some healthy changes in our lifestyle?

One of the best ways to prevent a stroke is to make positive changes in our lifestyle. We can start eating a healthy diet, avoid too much drinking and smoking and exercise regularly to avoid getting affected by certain medical ailments. Often life gives a second chance and people might have recovered from a first stroke. Bringing about lifestyle changes is important for them, as well.

• A change in diet: An unhealthy diet is very much responsible for increasing the chances of having a stroke. This is because the unhealthy components can increase the levels of cholesterol as well as blood pressure. The medical practitioners recommend a high-fibre and low-fat diet. This kind of diet usually comprises whole grains, fresh fruits and vegetables. Eating a balanced diet is equally important. Eating too much of a single kind of food is not recommended. This advice works preferably for processed foods and foods high in salt.

• Exercising: Engaging in physical activities, especially exercising is a very good way of maintaining a healthy weight as well as staying away from unnecessary health complications. We should also be aware of the fact that exercising is also good for preventing strokes. Regular exercise can not only help in lowering cholesterol levels but also stabilises high pressure. For most of us, a two and half hour of moderate-intensity aerobic activity every week is quite preferable. Cycling and walking fast are the best aerobic activities, we can indulge in. Exercising also helps in fast recovery of the patients, who have recently suffered a stroke.

• Stop smoking: Smoking is a malicious activity, which increases the risks of having a stroke. This is because smoking narrows down the walls of the arteries and enhances the risks of blood clotting. When we stop smoking, we can reduce the risks of being affected by stroke, besides improving our general health conditions.

• Cutting down on alcohol consumption: When we depend on alcohol consumption, to a great extent, we are building a conducive environment for strokes to occur. Alcohol consumption leads to high blood pressure and prompt atrial fibrillation or irregular heartbeat, the conditions which increase the risks of suffering a stroke. Heavy drinking increases the risks of stroke as alcoholic drinks are high in calories.

• Never provide an excuse to miss your medicines: Often, the doctors prescribe us certain medications to help protect our body from certain impending medical ailments. We should never be so busy in our lives to forget eating these medicines.

Our present-day lifestyle is in a great way responsible for a large number of medical complications we suffer from. When we bring about healthy changes in it, we reduce the risks of suffering from them. Strokes have become quite common and to reduce the chances of them affecting us or our near and dear ones, we should maintain a healthy lifestyle.

If you have any health queries related to Stroke Medicine, Geriatric Medicine, Neurological Diseases in the Elderly and General Medicine, or need medical information, please don’t hesitate to Ask a Doctor Online

References:

https://www.webmd.com/stroke/features/stroke-prevention-lifestyle-tips#2

https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke