|
Stroke
A stroke is a sudden happening in the brain. It is
usually due to a stopped up artery that stops blood and oxygen getting
to a part of the brain, causing weakness and numbness most commonly
on only one side of the body. That is called an ischemic (not enough
blood) stroke. Usually there isn’t a headache. It can be diagnosed
best acutely with an MRI head scan. For more information, see: The other type of stroke is the hemorrhagic stroke. That means a blood vessel has burst, leaking blood out into the brain and causing damage. They usually occur in hypertensives. Sometimes, depending on how deep the clot is, surgery is indicated to remove the blood clot and reduce pressure on the brain. A type of ischemic stroke is the subarachnoid hemorrhage.
This usually results from leakage of a berry aneurysm. Aneurysms are
ballooned out spots on an artery and if they burst or lead, can raise
the pressure inside the head and make a person pass out. A small leakage
may only cause headache and a stiff neck. Most leaking aneurysms need
to be occluded to prevent re-bleeding, either with open surgery or with
balloon catheters inserted via the parent artery. Management of unruptured
aneurysms is a challenge – see: Patients on blood thinners such as Coumadin can bleed in or around the brain. If bleeding is around the brain, it may need to be relieved with surgery. The brain doesn’t tolerate loss of oxygen for very long. Strokes are an emergency. Treatments for ischemic stroke are now possible with clot busting drugs given IV. A small
stroke that clears up fairly promptly is called a transient ischemic
attack or TIA. TIAs may come from cholesterol placques in the arteries
in the neck breaking off and temporarily stopping up smaller arteries
in the brain. The ophthalmic artery to the eye is one of the first branches
inside the head. The symptom complex of transient loss of vision in
one eye and loss of strength or sensation in the other half of the body
is almost diagnostic of impending stroke from carotid artery disease. |