Stroke

A stroke occurs when a part of the brain dies after its blood supply is cut off. Its blood supply can be interrupted in two different ways. First, a blood clot or piece of plaque can break off from a distant site in the body and block a blood vessel. A blood vessel can also narrow or close down. This would kill off any brain tissue that was being fed by that blood vessel. Second, a blood vessel can burst and clot-off, causing death of the surrounding brain tissue.

There are certain diseases or conditions that place people at risk of developing a stroke. High blood pressure (hypertension) and are the leading causes of stroke in the US. Also, diseases or conditions that cause a hardening of the arteries (athlerosclerosis) can cause very fragile blood vessels that can be easily clotted or ruptured. Much in the way your rusted-out home plumbing can burst if the pressure in the system is too high, a blood vessel in the brain can rupture under the same conditions.

The major risk factors for the development of athlerosclerosis and therefore stroke include: high blood pressure, diabetes, high cholesterol, smoking, and a family history of stroke or heart attack. Some people with certain heart conditions are at high risk for stroke. Abnormal or turbulent flow within the heart can lead to the formation of blood clots that can break off, travel to the brain, and cause stroke. These conditions include chronic atrial fibrillation (persistent fluttering of the heart), ventricular aneurysm (a dilation of the major heart chamber), or dilated cardiomyopathy (a dilation of the entire heart). These persons should probably be placed on Warfarin, a strong blood-thinning medication. Warfarin must be prescribed by a doctor and monitored with special blood tests.

Symptoms

The symptoms of stroke, when there are any, come in many forms depending on the size and area of the brain that is affected. Strokes that affect the back of the brain may lead to loss of vision, while strokes in the front of the brain can cause personality or behavioral changes. One unifying characteristic of a stroke is that the neurological defect arises suddenly. It is important to recognize the signs and symptoms of a possible stroke when it is happening and seek medical attention immediately. Although rare, in some very modern hospitals, certain drugs or surgical procedures are not only life saving, but they can reverse a stroke before permanent damage is done. The key point to medically reversing a stroke is to get into a hospital within three hours of the onset of symptoms.

In Mexico, hospitals that have been designated 5/5 on the MedToGo rating system should be equipped with the necessary technology for these interventions. Please note that a hospital will diagnose stroke with either magnetic resonance imaging (MRI) or computerized tomography (CAT) scans. A stroke can also happen when an aneurysm (an abnormally dilated blood vessel in the brain) leaks or ruptures. Unfortunately, sometimes there are no warning signs of an aneurysm and they can be the cause of rare sudden death in a young person. A severe, recurrent headache may be the only clue.

Signs of Possible Stroke

• Double vision, blurred vision, or visual loss
• Numbness, heaviness, weakness, or clumsiness of extremities
• Slurred or difficult speech
• Dizziness
• Sudden loss of bowel or bladder function
• Difficulty swallowing
• Blacking out or fainting
• Memory loss, confusion, or sudden behavioral disturbance
• Severe headache
• Change in level of alertness (lethargy, stupor, or coma)

Prevention

Fortunately, with the use of modern medicines, many strokes can be prevented. Medication to lower blood pressure, lower cholesterol, and treat diabetes are available. Persons at high risk may take Warfarin or other blood-thinning medications such as Plavix or low-dose aspirin to help prevent stroke. Also, see Transient Ischemic Attack (TIA).