A stroke is a medical emergency, and prompt treatment is very important. Early detection & action can reduce brain damage and other complications leading to permanent disability or uncommon death.

What is Stroke?

Stroke is a cerebrovascular disease. This means that it affects the blood vessels that feed the brain oxygen. If the brain does not receive enough oxygen, damage may start to occur.

A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes.

Although many strokes are treatable, some can lead to disability or death.

Remember “Be Fast”  when you spot a stroke:

• Sudden Loss of Balance
• Loss of vision in one or both Eyes
• Face drooping
• Arm weakness
• Speech difficulty
• Time to call  medical emergency

Risk factors:

Risk factors for narrowed blood vessels in the brain are the same as those that cause narrowing blood vessels in the heart and heart attack  these includes:

• High blood pressure/Hypertension
• High cholesterol
• Diabetes & Smoking

Symptoms:

The sooner a person having a stroke gets care, the better their outcome is likely to be. For this reason, it’s helpful to know the signs of a stroke so you can act quickly. Stroke symptoms can include:

• Confusion, including difficulty speaking and understanding speech
• A Head ache, possibly with altered consciousness or vomiting
• Numbness or an inability to move parts of the face, arm, or leg, particularly on one side of the body
• Vision problems in one or both eyes
• Difficulty walking, including dizziness and a lack of coordination.

What are the different types of strokes?

There are three main types of stroke:

• transient ischemic attack
• ischemic stroke
• hemorrhagic stroke.

Transient ischemic attack (TIA):

Doctors also call a transient ischemic attack (TIA) a warning or ministroke. Anything that temporarily blocks blood flow to your brain causes a TIA. The blood clot and TIA symptoms last for a short period of time.

Ischemic stroke

An ischemic stroke occurs when a blood clot keeps blood from flowing to your brain. The blood clot is often due to atherosclerosis, which is a buildup of fatty deposits on the inner lining of a blood vessel. A portion of these fatty deposits can break off and block blood flow in your brain. The concept is similar to that of a heart attack, where a blood clot blocks blood flow to a portion of your heart.

An ischemic stroke can be embolic, meaning the blood clot travels from another part of your body to your brain. An estimated 15 percent of embolic strokes are due to a condition called atrial fibrillation, where your heart beats irregularly.

A thrombotic stroke is an ischemic stroke caused by a clot forming in a blood vessel in your brain.

Unlike a TIA, the blood clot that causes an ischemic stroke won’t go away without treatment.

Hemorrhagic stroke

A hemorrhagic stroke results when a blood vessel in your brain ruptures or breaks, spilling blood into the surrounding tissues.

There are three main types of hemorrhagic strokes: The first is an aneurysm, which causes a portion of the weakened blood vessel to balloon outward and sometimes rupture. The other is an arteriovenous malformation, which involves abnormally formed blood vessels. If such a blood vessel ruptures, it can cause a hemorrhagic stroke. Lastly, very high blood pressure can cause weakening of the small blood vessels in the brain and result in bleeding into the brain as well.

Your doctor will ask you or a family member about your symptoms and what you were doing when they arose. They’ll take your medical history to find out your stroke risk factors. They’ll also:

• ask what medications you take
• check your blood pressure
• listen to your heart

You’ll also have a physical exam, during which the doctor will evaluate you for:

• balance
• coordination
• weakness
• numbness in your arms, face, or legs
• signs of confusion
• vision issues.

Treatment:

Proper medical evaluation and prompt treatment are vital to recovering from a stroke.

You may go through various tests to further help your doctor determine if you’ve had a stroke, or to rule out another condition. These tests include:

Blood tests

Your doctor might draw blood for several blood tests. Blood tests can determine:

• your blood sugar levels
• if you have an infection
• your platelet levels
• how fast your blood clots

MRI and CT scan

You may undergo either or both a magnetic resonance imaging (MRI) scan and a computerized tomography (CT) scan.

The MRI will help see if any brain tissue or brain cells have been damaged. A CT scan will provide a detailed and clear picture of your brain that shows any bleeding or damage in the brain. It may also show other brain conditions that could be causing your symptoms.

EKG

Your doctor may order an electrocardiogram (EKG), too. This simple test records the electrical activity in the heart, measuring its rhythm and recording how fast it beats. It can determine if you have any heart conditions that may have led to stroke, such as a prior heart attack or atrial fibrillation.

Cerebral angiogram

Another test your doctor may order to determine if you’ve had a stroke is a cerebral angiogram. This offers a detailed look at the arteries in your neck and brain. The test can show blockages or clots that may have caused symptoms.

Carotid ultrasound

A carotid ultrasound, also called a carotid duplex scan, can show fatty deposits (plaque) in your carotid arteries, which supply the blood to your face, neck, and brain. It can also show whether your carotid arteries have been narrowed or blocked.

Echocardiogram

An echocardiogram can find sources of clots in your heart. These clots may have traveled to your brain and caused a stroke.

These stroke types are caused by a blood clot or other blockage in the brain. For that reason, they’re largely treated with similar techniques, which include:

Antiplatelet and anticoagulants

Over-the-counter aspirin is often a first line of defense against stroke damage. Anticoagulant and antiplatelet drugs should be taken within 24 to 48 hours after stroke symptoms begin.

Clot-breaking drugs

Thrombolytic drugs can break up blood clots in your brain’s arteries, which still stop the stroke and reduce damage to the brain.

One such drug, tissue plasminogen activator (tPA), or Alteplase IV r-tPA, is considered the gold standard in ischemic stroke treatment. It works by dissolving blood clots quickly, if delivered within the first 3 to 4.5 hours after symptoms of your stroke began. People who receive a tPA injection are more likely to recover from a stroke, and less likely to have any lasting disability as a result of the stroke.

Mechanical thrombectomy

During this procedure, the doctor inserts a catheter into a large blood vessel inside your head. They then use a device to pull the clot out of the vessel. This surgery is most successful if it’s performed 6 to 24 hours after the stroke begins.

Stents

If your doctor finds where artery walls have weakened, they may perform a procedure to inflate the narrowed artery and support the walls of the artery with a stent.

Surgery

In the rare instances that other treatments don’t work, your doctor may perform surgery to remove a blood clot and plaques from your arteries. This may be done with a catheter, or if the clot is especially large, your doctor may open an artery to remove the blockage.

Hemorrhagic stroke

Strokes caused by bleeds or leaks in the brain require different treatment strategies. Treatments for hemorrhagic stroke include:

Medications

Unlike with an ischemic stroke, if you’re having a hemorrhagic stroke, the treatment goal is to make your blood clot. Therefore, you may be given medication to counteract any blood thinners you take.

You may also be prescribed drugs that can reduce blood pressure, lower the pressure in your brain, prevent seizures, and prevent blood vessel constriction.

Coiling

During this procedure, your doctor guides a long tube to the area of hemorrhage or weakened blood vessel. They then install a coil-like device in the area where the artery wall is weak. This blocks blood flow to the area, reducing bleeding.

Clamping

During imaging tests, your doctor may discover an aneurysm that hasn’t started bleeding yet or has stopped. To prevent additional bleeding, a surgeon may place a tiny clamp at the base of the aneurysm. This cuts off blood supply and prevents a possible broken blood vessel or new bleeding.

Surgery

If your doctor sees that an aneurysm has burst, they may do surgery to clip the aneurysm and prevent additional bleeding. Likewise, a craniotomy may be needed to relieve the pressure on the brain after a large stroke.

Recovery And  Rehabilitation:

It’s important that recovery and rehabilitation from a stroke start as soon as possible. In fact, stroke recovery should begin in the hospital. There, a care team can stabilize your condition, assess the effects of the stroke, identify underlying factors, and begin therapy to help you regain some of your affected skills.

Stroke recovery focuses on four main areas:

Speech therapy

A stroke can cause speech and language impairment. A speech and language therapist will work with you to relearn how to speak. Or, if you find verbal communication difficult after a stroke, they’ll help you find new ways of communication.

Cognitive therapy

After a stroke, many survivors have changes to their thinking and reasoning skills. This can cause behavioral and mood changes. An occupational therapist can help you work to regain your former patterns of thinking and behavior and to control your emotional responses.

Relearning sensory skills

If the part of your brain that relays sensory signals is affected during the stroke, you may find that your senses are “dulled” or no longer working. That may mean that you don’t feel things well, such as temperature, pressure, or pain. A therapist can help you learn to adjust to this lack of sensation.

Physical therapy

Muscle tone and strength may be weakened by a stroke, and you may find you’re unable to move your body as well as you could before. A physical therapist will work with you to regain your strength and balance, and find ways to adjust to any limitations.

Rehabilitation may take place in a rehabilitation clinic, a skilled nursing home, or your own home.

Preventive Measures:

In addition to emergency treatment,Recovery and Rehab  healthcare providers will also advise you on ways to prevent future strokes.

• Quit smoking.
• Consume alcohol in moderation.
• Keep weight in check
• Regular Checkups

Taking all these measures will help put you in better shape to prevent stroke.

Conclusion/ Take away

If you suspect or experiencing symptoms of a stroke, it’s crucial  you seek emergency medical treatment. Clot-busting medication can only be provided in the first hours after the signs of a stroke begin, (i.e, first 3hrs- 4.5hrs are said to be golden period) and early treatment is one of the most effective ways to reduce your risk for long-term complications and disability.

Prevention is possible, whether you’re preventing a first stroke or trying to prevent a second. Medications can help reduce the risk of blood clots, which lead to strokes. Speakup with your doctor to find a prevention strategy that works for you, including medical intervention and lifestyle changes.

 

 

Alzheimer’s disease is a neurological disorder in which the death of brain cells causes memory loss and cognitive decline.Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that disrupts a person’s ability to function independently.

The disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).

These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. Many other complex brain changes are thought to play a role in Alzheimer’s, too.

This damage initially appears to take place in the hippocampus, the part of the brain essential in forming memories. As neurons die, additional parts of the brain are affected. By the final stage of Alzheimer’s, damage is widespread, and brain tissue has shrunk significantly.

Understanding Alzheimer’s and dementia

Alzheimer’s is the most common cause of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 60 percent to 80 percent of dementia cases.Learn more about dimentia

Sign & Symptoms of Alzheimer

The most common early symptom of Alzheimer’s is difficulty remembering newly learned information.

the person must have experienced a decline in cognitive or behavioral function and performance compared with how they were previously. This decline must interfere with their ability to function at work or in usual activities.

Reduced ability to take in and remember new information, which can lead, for example,

• repetitive questions or conversations
• misplacing personal belongings
• forgetting events or appointments
• getting lost on a familiar route

Impairments to reasoning, complex tasking, and exercising judgment, for example:

• poor understanding of safety risks
• inability to manage finances
• poor decision-making ability
• inability to plan complex or sequential activities

If symptoms begin or worsen over the course of hours or days, you should seek immediate medical attention, as this could indicate an acute illness.

Alzheimer’s is most likely when memory loss is a prominent symptom, especially in the area of learning and recalling new information.

Language problems can also be a key early symptom, for example, struggling to find the right words.

If visualization deficits are most prominent, these would include:

inability to recognize objects and faces
difficulty comprehending separate parts of a scene at once
difficulty with reading text, known as alexia
The most prominent deficits in executive dysfunction would be to do with reasoning, judgment, and problem-solving.

Causes
Scientists believe that for most people, Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time.

The exact causes of Alzheimer’s disease aren’t fully understood, but at its core are problems with brain proteins that fail to function normally, disrupt the work of brain cells (neurons) and unleash a series of toxic events. Neurons are damaged, lose connections to each other and eventually die.

The damage most often starts in the region of the brain that controls memory, but the process begins years before the first symptoms. The loss of neurons spreads in a somewhat predictable pattern to other regions of the brains. By the late stage of the disease, the brain has shrunk significantly.

Researchers are focused on the role of two proteins:

Plaques. Beta-amyloid is a leftover fragment of a larger protein. When these fragments cluster together, they appear to have a toxic effect on neurons and to disrupt cell-to-cell communication. These clusters form larger deposits called amyloid plaques, which also include other cellular debris.
Tangles. Tau proteins play a part in a neuron’s internal support and transport system to carry nutrients and other essential materials. In Alzheimer’s disease, tau proteins change shape and organize themselves into structures called neurofibrillary tangles. The tangles disrupt the transport system and are toxic to cells.

Stages
The progression of Alzheimer’s can be broken down into three main stages:

Alzheimer’s disease typically progresses slowly in three general stages — mild (early stage), moderate (middle stage), and severe (late stage). Since Alzheimer’s affects people in different ways, the timing and severity of dementia symptoms varies as each person progresses through the stages of Alzheimer’s differently.

Mild Alzheimer’s disease (early stage)
In the early stage of Alzheimer’s, a person may function independently. He or she may still drive, work and be part of social activities. Despite this, the person may feel as if he or she is having memory lapses, such as forgetting familiar words or the location of everyday objects.

Friends, family or others close to the individual begin to notice difficulties. During a detailed medical interview, doctors may be able to detect problems in memory or concentration. Common difficulties include:

Problems coming up with the right word or name
Trouble remembering names when introduced to new people
Challenges performing tasks in social or work settings.
Forgetting material that one has just read
Losing or misplacing a valuable object
Increasing trouble with planning or organizing

Moderate Alzheimer’s disease (middle stage)
Moderate Alzheimer’s is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer’s will require a greater level of care.

During the moderate stage of Alzheimer’s, the dementia symptoms are more pronounced. A person may have greater difficulty performing tasks, such as paying bills, but they may still remember significant details about their life.

You may notice the person with Alzheimer’s confusing words, getting frustrated or angry, or acting in unexpected ways, such as refusing to bathe. Damage to nerve cells in the brain can make it difficult to express thoughts and perform routine tasks.
At this point, symptoms will be noticeable to others and may include:

Forgetfulness of events or about one’s own personal history

Feeling moody or withdrawn, especially in socially or mentally challenging situations

Being unable to recall their own address or telephone number or the high school or college from which they graduated

Confusion about where they are or what day it is

The need for help choosing proper clothing for the season or the occasion

Trouble controlling bladder and bowels in some individuals

Changes in sleep patterns, such as sleeping during the day and becoming restless at night

An increased risk of wandering and becoming lost

Personality and behavioral changes, including suspiciousness and delusions or compulsive, repetitive behavior like hand-wringing or tissue shredding

Severe Alzheimer’s disease (Final stage)

In the final stage of this disease, dementia symptoms are severe. Individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult. As memory and cognitive skills continue to worsen, significant personality changes may take place and individuals need extensive help with daily activities.

Diagnosis
There is no single test for Alzheimer’s disease, so doctors will look at the signs and symptoms, take a medical history, and rule out other conditions before making a diagnosis.

They may also check the person’s neurological function, for example, by testing their balance, senses, and reflexes.

Other assessments may include a blood or urine test, a CT or MRI scan of the brain, and screening for depression.

Sometimes the symptoms of dementia are related to an inherited disorder such as Huntington’s disease, so genetic testing may be done.

After ruling out other possible conditions, the doctor will carry out cognitive and memory tests, to assess the person’s ability to think and remember.

Risk factors

• Age
• Family History
• Genetics
• Down syndrome
• Sex
• life style & heart health
• Past Head Trauma
• poor sleep patterns

Treatment
There is no known cure for Alzheimer’s. The death of brain cells cannot be reversed.

However, there are therapeutic interventions that can make it easier for people to live with the disease.

According to the Alzheimer’s Association, the following are important elements of dementia care:

effective management of any conditions occurring alongside the Alzheimer’s
activities and day-care programs
involvement of support groups and services
Drug therapy
No disease-modifying drugs are available for Alzheimer’s disease, but some options may reduce the symptoms and help improve quality of life.

Prevention
Alzheimer’s disease is not a preventable condition. However, a number of lifestyle risk factors for Alzheimer’s can be modified. Evidence suggests that changes in diet, exercise and habits — steps to reduce the risk of cardiovascular disease — may also lower your risk of developing Alzheimer’s disease and other disorders that cause dementia. Heart-healthy lifestyle choices that may reduce the risk of Alzheimer’s include the following:

Exercise regularly
Eat a diet of fresh produce, healthy oils and foods low in saturated fat
Follow treatment guidelines to manage high blood pressure, diabetes and high cholesterol
If you smoke, ask your doctor for help to quit smoking
Studies have shown that preserved thinking skills later in life and a reduced risk of Alzheimer’s disease are associated with participating in social events, reading, dancing, playing board games, creating art, playing an instrument, and other activities that require mental and social engagement.

How Long Can a Person Live with Alzheimer’s Disease?
The time from diagnosis to death varies—as little as 3 or 4 years if the person is older than 80 when diagnosed, to as long as 10 or more years if the person is younger.Although treatment can help manage symptoms in some people, currently there is no cure for this devastating disease.

 

We’re sure, you now have a fair idea of what Alzheimer’s disease is is all about and the way it could impact your life. Please feel free to contact us  query@gtsmeditour.com if you’d like to take a second opinion on your condition or undergo treatment for the same.