Stroke

The symptoms of stroke happen suddenly and include: 

Numbness or weakness especially in one side of the body, this may happen in the face, arm, or leg  

Confusion or trouble speaking 

Trouble seeing in one or both eyes 

Trouble walking, dizziness, or loss of balance 

Severe headache with no known cause 

 If you or anyone with you experienced any of these symptoms, go to the emergency department immediately or call the ambulance, then the patient should follow up with a Cardiologist and Neurologist afterwards 

Many risk factors may lead to stroke such as: 

• High blood pressure 
• Diabetes mellitus 
• High cholesterol 
• Obesity 
• Heart disease 
• Previous stroke 
• Smoking 
• Alcohol 
• Sedentary lifestyle 
• Genetic cause 

Many tests are used in addition to the symptoms and physical examination. 

• Computed tomography scan “CT” (an imaging technique to obtain a detailed picture of the brain and rule out hemorrhagic stroke). 
• Magnetic resonance imaging “MRI” (a type of scan that uses magnetic fields to obtain a detailed picture of the brain). 
• Electrocardiogram (a simple test to examine the rhythm and electrical activity of the heart using skin-attached sensors to detect the electrical signals produced by the heart during each beat).  
• Echocardiogram (a type of ultrasound scan that is used to examine the heart valves and how it pumps blood to the body to know if there’s structural heart disease). 
• Laboratory tests (a blood sample is used for routine tests to assess the general health of the patient and to know the reason for the stroke). 

The treatment depends on the type of stroke and the timing at which the symptoms. 

Ischemic stroke: 

• Medications: 
• Intravenous Alteplase is given to patients who have the symptoms for less than 4.5 hours. 
• Aspirin and Clopidogrel may be started after 24 hours. 
• Surgery:  
• A minor surgery is done by using a catheter to remove the thrombus which blocks the blood supply to the brain. 
• The medication “Alteplase” may be directed to the brain directly in patients who have contraindications for its intravenous administration. 

Hemorrhagic stroke: 

• Medications: 
• High blood pressure should be lowered by using medications such as Labetalol, Esmolol, Enalapril, Nicardipine, Hydralazine. 
• The pressure inside the brain should be lowered by using Mannitol 
• Vitamin K should be used in some cases when the reason for the hemorrhage is using blood thinners such as Warfarin. 
• Surgery: Different types of surgeries can be done to stop the bleeding.