How to Recognize a Warning Sign of Stroke?

Introduction

Stroke is the third leading cause of death today. There are many complications associated with a stroke, which will disturb the day-to-day activities of a person or family members. Every person must be aware of the signs and symptoms of stroke to save the patient's life. For better protection, a person should know the risk factors of stroke, how to identify the warning signs, and managing the same. This article discusses the warning signs of stroke and how to recognize the signs.

What Is Stroke?

Stroke is also referred to as a cerebrovascular accident (CVA) or brain attack. It means that there is an insult or interruption or reduction of the blood supply to the brain, which leads to neurological function loss. A stroke may cause permanent disability to one or two or all four extremities.

Complications with stroke are abnormalities found with vision, paralysis (inability to move the limb or complete flaccidity) or paraparesis that is, weakness of muscles in one or more extremities, difficulties in speech such as difficulties found in formulation and understanding, gait abnormalities, severe headache, confusion, sudden loss of balance, etc. A common consequence of stroke is hemiplegia (paralysis of one side of the body). Post-stroke disability is the major complication of stroke.

What Are the Types of Stroke?

Hemorrhage (bleeding due to injury) and ischemia (lack of blood supply) are the major causes of the disturbance of blood supply in the brain.

• Ischemic Stroke: Ischemic stroke occurs mainly due to the blockage of any major artery which supplies any part of the brain. This blockage prevents blood flow to the brain, and it is responsible for major permanent damage to brain tissue, which in turn will lead to neurological insult. Ischemic stroke affects 80 % of individuals with stroke. Due to blockage, the brain would become deprived of necessary oxygen and nutrients.

• Hemorrhagic Stroke: Hemorrhagic stroke refers to bleeding from blood vessels of the brain inside or outside the brain. When blood vessels rupture it will cause extravasation of blood causing sudden neurological dysfunction and deterioration of consciousness.

What Are the Signs and Symptoms of Stroke?

Signs and symptoms of stroke depend upon the area of the brain affected. The most common areas involved in developing stroke are the areas of the brain supplied by the anterior cerebral artery, middle cerebral artery, internal carotid artery, posterior cerebral artery (lacunar syndrome), vertebrobasilar artery, etc. In stroke, many focal deficits are present namely changes in the consciousness levels and abnormal motor, sensory, cognitive, perceptual, and language functions, numbness in the face or extremities, or difficulty walking or lifting hands up.

What About Heat Stroke?

Heat stroke is the most deadly heat-related condition. It happens when the body loses the ability to regulate its temperature, causing the body's temperature to increase quickly, the sweating system to malfunction, and the body to be unable to cool down. Within 10 to 15 minutes after the onset of heat stroke, the body temperature can reach 106°F or more. Additionally, the symptoms might include clammy, chilly skin, profuse perspiration, lightheadedness, and cramping. Immersing oneself in the cold once one notices the warning signs is an effective treatment strategy to reduce the temperature and thereby prevent heat stroke and complications.

What are the Risk Factors for Stroke?

Risk factors that predispose an individual to suffer a stroke are as below:

1. High blood pressure.

2. High cholesterol.

   Related Topics

   ---

   I have high blood pressure and feel chest pain. Please help.

   I had two episodes of high BP and fall. Am I at the risk of stroke?

   I had high blood pressure and low heart rate. Is my ECG showing infarction?

3. Age of above 55 years.

4. Positive family history.

5. Diabetes mellitus.

6. Cardiovascular diseases.

7. Obesity.

8. Atrial fibrillation.

9. Congestive heart failure.

10. Peripheral vascular disease.

11. Surgery.

12. Excess alcohol consumption.

13. Lack of exercise.

14. Tobacco smoking.

What Are the Warning Signs of Stroke and How to Recognize Them?

Early warning signs given by the National Stroke Association are as follows:

1) Transient Ischemic Attack (TIA):

• Sometimes stroke occurs without any symptoms, but sometimes with some early signs which are referred to as transient ischemic attack. It is also known as mini-strokes. However, it is a major warning sign of a major stroke happening in the near future.

• The signs and symptoms of TIA are

  • Drooping eyes on one side.

  • Dropped face and mouth on one side.

  • Inability to smile on the one side.

  • Weakness or numbness in one arm.

  • Slurred speech.

• It might last for a few seconds to a few minutes and not more than 24 hours. It may originate from emboli, reduced cerebral perfusion (less blood circulation in the brain), due to arrhythmias (abnormal cardiac rhythm), reduced cardiac output, hypotension, an overdose of antihypertensive medication, etc.

• About 20 percent of TIA patients may eventually experience a massive stroke within 90 days, and 2 percent may do so within two days.

• It is advised to get medical attention right away and have investigations performed to prevent stroke.

2) High Blood Pressure:

High blood pressure increases four to five times the risk of stroke. Blood pressure above 160/95 mmHg is a warning sign for stroke.

• The person may feel sudden confusion, and difficulties in speaking, pronouncing, and understanding the words. This type of speech is called slurred speech.

• Difficulties found with vision in one or both eyes. The patient may find it difficult while walking and will feel dizzy. The patient cannot maintain balance properly. Coordination of movement also becomes difficult prior to a stroke.

• Severe headaches may appear suddenly, without any known cause. Sometimes the person may feel nausea, vomiting, and fever for some minutes or hours, or several days. Fainting may appear just prior, a few seconds, before developing the stroke.

The above-stated signs may appear before a stroke. A person and his relatives are encouraged to call emergency medical services, even if these symptoms go away quickly and are painless. When one finds these symptoms, please note the time, as this information is very important for doctors.

During a stroke, time is everything. A stroke needs immediate emergency treatment to prevent permanent focal defects in the brain. Morbidity and mortality rates are high with stroke. If treatment is not given as early as possible, the chances for disabilities are more.

How Is Stroke Diagnosed?

• Computed tomography (CT) in the early stage is used to differentiate the type of stroke. It may be an atheroembolic stroke or hemorrhagic stroke.

• Magnetic resonance imaging (MRI) is also useful to diagnose stroke.

How Can Stroke in Its Early Stages with Warning Signs Be Managed?

• First Aid for Stroke:

  • Call the medical emergency

  • Note the signs and symptoms. Right-sided strokes affect the left side of the body, and left-sided strokes affect the right side of the body.

  • If the patient is not breathing and is unconscious, start CPR while waiting for the emergency services to arrive.

• Tissue Plasminogen Activator: If a patient gets a stroke due to atherothrombotic reasons, then they may be advised to take a clot-dissolving enzyme such as Tissue plasminogen activator (tPA) 50 - 100 mg once daily or Urokinase or Prourokinase within three hours of the onset of stroke symptoms. It must be used in atherothrombotic stroke. It is strongly contraindicated in hemorrhagic stroke because it may increase blood loss. Researchers have proved that a person who was treated with tissue plasminogen did not get any disability or minimum disability as compared to those who did not receive the treatment.

• Oxygen: Improvement in cerebral perfusion is established by proper circulation and oxygenation. It can be delivered by a mask or cannula.

• Blood Pressure: Maintenance of blood pressure is established by an antihypertensive drug of 10 mg once a day after breakfast.

• Electrolytes: Electrolyte balance and restoring fluid is an integral part of management.

• Blood Thinners: Anticoagulant therapy is initiated with Heparin or Coumadin (5000 units SC q8-12 hour or 7500 units SC q12 hour) to improve circulation and to reduce the risk of developing embolus. A low dose of 2 mg of Heparin once a day is used for this purpose. Antiplatelet therapy with Aspirin (50 to 325 mg orally once a day) is initiated as soon as possible. A low dose is used to prevent a second attack. A high dose of 5 mg may be used to treat atrial fibrillation. Ticlopidine (250 mg twice daily with food) or Clopidogrel bisulfate (75 mg orally once daily) is another agent used to prevent recurrent attacks. The above-stated medications are used in emergency treatment.

Conclusion:

It is imperative to receive prompt medical care if one experiences any warning signs of stroke. Seeking therapy as soon as feasible is one of the greatest ways to reduce the likelihood of long-term complications and disability. Even though a stroke cannot always be fully avoided, making certain lifestyle adjustments can significantly lower the chance. The chance of blood blockages, which can result in stroke, can also be decreased with the aid of medications. Right recognition, the right decision, and the right treatment at the right time may save an individual’s life!