The Story Behind Stroke
Symptoms and diagnosis
By Neurosurgery Singapore
What is a stroke?
A stroke or a brain attack occurs when a blood clot blocks a blood vessel or when a blood vessel bursts, interrupting blood flow to an area of the brain.
An ischemic stroke occurs when the blood vessel is blocked. This is the most common type of stroke.
A hemorrhagic stroke (brain bleed) occurs when a blood vessels breaks. This type of stroke is less common.
What are the most common stroke symptoms?
- Sudden numbness or weakness of face, arm or leg, especially on one side of the body
- Suddenly having confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Suddenly having trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
Other important but less common stroke symptoms
- Suddenly nausea and vomiting
- Brief loss of consciousness or period of decreased consciousness (fainting, confusion, convulsions or coma)
F – Face; ask the person to smile. Does one side droop?
A – Arms; ask the person to raise both arms. Does one arm drift downward?
S – Speech; ask the person to repeat a simple phrase. Is there speech slurred or strange?
T – Time; If you observe any of these signs, call ambulance immediately!
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What types of diagnosis?
Physical examination. Our Neurologist will ask you or a family member what symptoms you’ve been having, when they started and what you were doing when they began. He then will evaluate whether these symptoms are still present.
Our doctor will want to know what medications you take and whether you have experienced any head injuries. You’ll be asked about your personal and family history of heart disease, transient ischemic attack and stroke.
We will also check your blood pressure and use a stethoscope to listen to your heart and to listen for a whooshing sound (bruit) over your neck (carotid) arteries, which may indicate atherosclerosis. He may also use an ophthalmoscope to check for signs of tiny cholesterol crystals or clots in the blood vessels at the back of your eyes.
- Blood tests. You may have several blood tests, which tell us how fast your blood clots. Whether your blood sugar is abnormally high or low, whether critical blood chemicals are out of balance, or whether you may have an infection. Managing your blood’s clotting time and levels of sugar and other key chemicals will be part of your stroke care.
- Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create a detailed image of your brain. It can show a hemorrhage, tumor, stroke and other conditions. Doctors may inject a dye into your bloodstream to view your blood vessels in your neck and brain in greater detail (computerized tomography angiography). There are different types of CT scans that our doctor may use depending on your situation.
- Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and magnets to create a detailed view of your brain. It can detect brain tissue damaged by an ischemic stroke and brain hemorrhages. Our doctor may inject a dye into a blood vessel to view the arteries and veins and highlight blood flow (magnetic resonance angiography, or magnetic resonance venography).
- Carotid ultrasound. In this test, sound waves create detailed images of the inside of the carotid arteries in your neck. This test shows buildup of fatty deposits (plaques) and blood flow in your carotid arteries.
- Cerebral angiogram. Using this test, our doctor inserts a thin, flexible tube (catheter) through a small incision, usually in your groin, and guides it through your major arteries and into your carotid or vertebral artery. Then he injects a dye into your blood vessels to make them visible under X-ray imaging. This procedure gives a detailed view of arteries in your brain and neck.
Echocardiogram. An echocardiogram uses sound waves to create detailed images of your heart. It can find a source of clots in your heart that may have traveled from your heart to your brain and caused your stroke.
You may have a transesophageal echocardiogram. In this test, our doctor inserts a flexible tube with a small device (transducer). It attached into your throat and down into the tube that connects the back of your mouth to your stomach (esophagus). Because your esophagus is directly behind your heart, a transesophageal echocardiogram can create clear, detailed ultrasound images of your heart and any blood clots.
Myth Vs Reality
|Stroke is unpreventable||It is largely preventable|
|Stroke cannot be treated||It requires emergency treatment|
|Stroke only strikes the elderly||It can happen to anyone of any age|
|Stroke happens to the heart||It occurs in the brain|
|recovery only happens for a few months following a stroke||Stroke recovery continues throughout life|