Understanding Stroke: Symptoms, Causes, Diagnosis, and Effective Treatment

Stroke is a significant health problem globally. It is the third leading cause of death in Malaysia. A stroke happens when blood flow to the brain is suddenly disrupted.

Blood is carried to the brain by blood vessels called arteries. When a stroke happens, blood flow may stop moving through the artery either because a blood clot or plaque blocks the artery or because the artery breaks or burst. When blood stops flowing, the brain does not get the oxygen it needs, causing brain cells in the blocked area to die, which may lead to permanent brain damage.

Some strokes are fatal, while others cause permanent or temporary disability. It is important to understand that stroke can be prevented.

What is a Stroke?

A stroke is a medical emergency that occurs when the blood flow to part of the brain is interrupted, leading to brain cell damage. This can happen in two main ways:

1. Ischemic stroke: Caused by a blockage in a blood vessel, which prevents blood flow to the brain.
2. Hemorrhagic stroke: Occurs when a blood vessel in the brain ruptures, causing bleeding.

Both types of stroke disrupt brain function, potentially causing brain cell death and leading to long-term disability or death if not treated promptly.

What are the Risk Factors for Stroke?

Understanding the risk factors for stroke is crucial for prevention, as certain conditions and lifestyle choices can significantly increase the likelihood of experiencing a stroke.

• Old age
• Family history of stroke
• Prior history of stroke, health attack, or transient ischemic attacks (TIA)
• High blood pressure
• Smoking
• Diabetes
• High cholesterol
• Poor diet
• Physical inactivity
• Obesity
• Excessive alcohol consumption
• Drug abuse
• Having sickle cell anaemia
• Having heart diseases

By recognising and managing these risk factors, you can significantly reduce your chances of having a stroke and mitigate the risk of serious complications, leading to better long-term health outcomes.

What are the Symptoms of Stroke?

The main symptoms of a stroke occur suddenly and can vary widely. Recognising these symptoms quickly is crucial for effective intervention.

The acronym FAST is a simple way to remember the key symptoms:

• Face: Is there drooping on one side of the face? One side of the face may often droop, making it difficult to smile.
• Arms: Can both arms be lifted? You might find it impossible to lift and hold both arms due to weakness or numbness in one arm.
• Speech: Is speech slurred during conversation? Speech may become slurred or sound confused; this is a critical symptom to note.
• Time: Time is critical. Call emergency services immediately if any of these symptoms are present.

Additional Stroke Symptoms

• Numbness or Weakness: Sudden loss of strength or numbness on one side of the body.
• Vision Problems: Blurring or loss of vision in one or both eyes.
• Confusion: Trouble speaking or thinking clearly, which may come with memory issues.
• Physical Disorientation: Dizziness, loss of balance, or an unexplained fall.
• Severe Headache: A sudden, intense headache without a known cause.
• Nausea or Vomiting: These may also occur as less common signs of a stroke.
• Reduced Conscious Level

Symptoms of a stroke might cease temporarily, leading some to believe the danger has passed. However, even transient symptoms demand immediate medical attention as they can signify a looming major stroke. 

How is Stroke Diagnosed?

If a doctor suspects you have had a stroke, they will perform several tests to determine the type and severity of the stroke. The diagnostic process typically includes:

• Clinical examination by a doctor
• Blood tests: To check for underlying health issues that may have contributed to the stroke, such as clotting disorders or infections.
• CT scan: A CT scan (computed tomography) of the brain helps detect bleeding or brain damage caused by a hemorrhagic stroke or ischemic stroke.
• MRI scan: An MRI scan provides more detailed images of the brain to identify location of the stroke
• Echocardiogram: A test to check for heart-related causes of stroke, as blood clots from the heart can travel to the brain.
• Cerebral angiogram: This test involves injecting a dye into the blood vessels and taking X-rays to identify blockages, aneurysms, or other abnormalities in the brain's blood vessels.

Types of Stroke Diagnosed

• Ischemic Stroke: Caused by a blood clot or plague blocking blood flow to the brain, this is the most common type of stroke.
• Hemorrhagic Stroke: Occurs when a blood vessel in the brain ruptures, leading to bleeding in the brain.
• Transient Ischemic Attack (TIA): Often called a mini-stroke, a TIA involves temporary stroke symptoms that last less than 24 hours. Although the symptoms resolve, a TIA is a medical emergency as it significantly increases the risk of a full-blown stroke.

A TIA should be treated immediately, as prompt care can help prevent a major stroke.

What are the Treatment Options for Stroke?

Treatment for a stroke varies depending on the type and severity of the stroke. The first 24 hours are crucial for recovery, and immediate treatments may include:

• Thrombolysis: Medications to dissolve blood clots and restore blood flow to the brain in the case of an ischemic stroke.
• Surgical Procedures: For a hemorrhagic stroke, surgery may be required to repair a ruptured blood vessel, remove the blood clot, or drain excess fluid from the brain to reduce pressure or to remove a part of the skull.

After the initial treatment phase, long-term therapies may include:

• Anticoagulants: Blood-thinning medications to prevent further blood clots from forming.
• Blood Pressure Medications: To help manage high blood pressure, a key risk factor for stroke.
• Statins: Medications to lower cholesterol and prevent additional strokes or heart attacks.

While in the hospital, a team of doctors, specialists, and therapists will help you begin your recovery and rehabilitation, guiding you through physical, cognitive, and emotional recovery.

Stroke Recovery: What to Expect and How to Support Your Rehabilitation

Recovery from a stroke varies widely. For some, recovery may take days or weeks, while for others, it could take months or even years, requiring lifestyle changes. These may include adapting your home for easier mobility and taking time off work.

Factors that Affect Recovery

• The severity of the stroke affects recovery time and progress.
• A personalised rehabilitation plan involving exercises, therapy, and activities to help regain strength and function.

Rehabilitation and Support

After hospital discharge, your healthcare team will support your recovery with necessary equipment, technical support and a home plan that may include: 

• Physiotherapy to help with movement and numbness.
• Cognitive rehabilitation with activities to improve memory, concentration, and mood.
• Speech and swallowing exercises to address speech, swallowing, and vision problems.
• Mental health support through cognitive behavioral therapy (CBT) for anxiety, depression, and fatigue.
• Bowel and bladder support through advice and exercises to manage these issues.

Progress Review

Regular reviews by a treating physician will be scheduled to assess and update condition, and adjust recovery plan. Start your stroke recovery at Gleneagles Hospital Penang!

Recovering from a stroke can be challenging, but with the right support, therapy, and personalised care, you can make significant progress. At Gleneagles Hospital Penang, our dedicated healthcare team, including the best neurosurgeons and neurologists, will work with you to develop a tailored recovery plan that suits your needs. Contact us today to begin your rehabilitation.