“Causes and prevention of stroke” that everyone must know.

Definition: Stroke is the sudden loss of neurological function caused by a temporary or permanent cut of the blood supply to any part of the brain. Knowledge about the causes and prevention of stroke is essential to grapple with stroke.

Cerebrovascular accident is the 4th leading cause of death and the leading cause of disability.

The most common problem is the motor deficit. Other neurological deficits are visual, perceptual, sensory, communication, swallowing.

CAUSE OF STROKE:

We can broadly classify the cause of stroke in Ischemic or occlusive (85%) and hemorrhagic(15%). Unfortunately, there is not a quick and easy laboratory or clinical test to determine for sure that the patient lying in front of you is having a stroke. So knowing about the Causes and prevention of stroke is important.

1. Atherosclerotic (thrombotic) : 

Atherosclerosis is a major contributory factor in cerebrovascular disease. Atherosclerosis is the narrowing of arteries by plaque. The accumulation of lipid, fibrin, complex carbohydrate, and calcium cause plaque formation. Plaque may lead to progressive narrowing of blood vessels. Commonly carotid artery, middle cerebral artery, the vertebral artery is affected.

2.The non-atheromatous disease of vessels wall :

• Systemic autoimmune collagen disease. (Rheumatoid arthritis, systemic lupus erythematosus ).

• Inflammation in your blood vessels(Vasculitis). Polyarteritis nodosa.

• Granulomatous vasculitis. Example – Wegener’s granulomatosis.

3. Embolism : 

Embolism induces stroke. An embolism occurs when clots migrate from the source to the distal site. Block more distal cerebral arteries causing cessation of blood flow leads to ischemia. The Source of emboli can be cardiac, aortic, arterial, from a venous origin in the pelvis or lower limbs, fracture site. A common source of embolus is the cardiovascular system.

4. The disease of blood:

Coagulopathies – (Coagulation abnormalities may be genetic or acquired). This is a cause of ischemic stroke. 

5. Cerebral venous thrombosis:

Combine oral contraceptive or estrogen excess give rise to thrombosis of the cerebral vein.

6. Decreased cerebral perfusion:

Hypotension, cardiac arrhythmia, too much bleeding can cause the inadequate blood supply to the affected area.  

7. Hemorrhagic stroke :

Hemorrhagic stroke is mainly two types (according to the site of bleeding) –

• parenchymal hemorrhage into the functional tissue of the brain (15%).

• Subarachnoid space –hemorrhage between the arachnoid membrane and pia mater (5%). 

Cause of hemorrhage –

• Hypertension.
• Amyloid protein builds up in the wall of the artery called Cerebral amyloid angiopathy(CAA).
• Aneurysm.
• Hemophilia (bleeding disorder).
• Drug abuse. Abuse of Cocaine may cause vasospasm, cerebral vasculitis, enhanced platelet aggregation, cardioembolism, and hypertensive surges.
• Trauma can cause an intracerebral hemorrhage.

PREVENTION OF STROKE:

• F- Face Drooping.
• A-Arm Weakness.
• S-Speech Difficulty. 
• T-Time to call.

1. CONTROL HYPERTENSION : 

There is a direct relationship between blood pressure levels and the risk of any stroke. Lowering the blood pressure in hypertensive patients, reducing the risk of stroke. Recurrence of stroke in an individual prevented by control BP. Systolic blood pressure (SBP) 130–139 mm Hg and diastolic blood pressure (DBP) 80–89 mm Hg is shown to reduce stroke occurrence.

You can control hypertension by:

• Check blood pressure at regular intervals if you have hypertension. Keep DIGITAL BP MONITOR in the home. 
• Proper medication.
• Physical activity- 50 to 60-minute rhythmic exercise like brisk walking, cycling, swimming. (Regular exercise help to reduce the risk of coronary artery disease and decrease blood pressure)
• A person who practices yoga with breathing and relaxation exercises daily. This may lower blood pressure.
• Avoid smoking.
• Meditation helps to reduce stress.
• Diet – Reduce sodium intake ( tips: read the food label, processed food, one teaspoon is equal to 2300 mg Na, take less processed food ).
• Maintain proper weight.
• Dark chocolate– Shown to reduce blood pressure.
• Proper sleep.
• Coffee- Caffeine can raise blood pressure to 10 mmHg. 

2. LOWERING YOUR BLOOD CHOLESTEROL:

High-level cholesterol has no noticeable symptoms. After 40 you need to check the cholesterol level. If you have overweight, hypertension, diabetes, and a history of heart disease due to cholesterol. Hypothyroidism is the cause of an increased level of LDL cholesterol. 

You can control cholesterol by:

• Proper diet- Increase consume soluble fibre-rich food (beans, legumes, whole grains, flax, apples, and citrus). Avoid artificial trans fat (Cake, popcorn, hydrogenated vegetable oil, donuts, cheeseburger). Less sugar intake. Take many seasonal fruit-vegetables and Indian spices (garlic, turmeric, ginger, clove have a profound effect on reducing cholesterol. This spice contains vitamins, minerals, and antioxidants). Drink green tea.
• Daily exercise.
• Yoga. 
• Maintain a healthy weight.

3. MANAGE YOUR DIABETES :

About 10% of newly diagnosed type 2 diabetes mellitus patients have suffered in stroke within five years of diagnosis.

You can control your diabetes by-

• Diet control-Vegetable (carrot, cabbage, tomato, beans, etc.), Fruit (berry, orange, melon, apple), Whole grains, Less fat dairy product, Stop sugar intake, Vitamin C-rich food.
• Daily exercise- Average 150 minutes of exercise in a week.
• Proper medication.
• Quit smoking.
• Reduce stress- by meditation.
• Yoga.

4.MENTAL STRESS:

Chronic emotional stress, anxiety can lead to stroke. Exercise daily, Get proper sleep, eat healthy food, Coffee, induce stress, Spent time with friends and family, Practice mindfulness, Yoga, Deep breathing.

5. STOP TAKING COMBINED ORAL CONTRACEPTIVES:

Use alternative of OCP. For example -paraGard (IUD), withdrawal method, the sponge, male Female condom, cervical cap.

6.STOP SMOKING:

Nicotine replacement therapy, avoid alcohol and other triggers, healthy lifestyle helps to quit smoking.

CONCLUSION:

Stroke is the most common neurological emergency. Treatment must be started as soon as possible to prevent death and disabilities. Seizures, syncope, hypoglycemia, metabolic encephalopathy, central nervous system tumor also produce similar symptoms like stroke. Knowing about the “Causes and prevention of stroke” helps us to cope up with this condition.

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