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Complete Guide About Stroke Diagnosis. How Can we Prevent Stroke?

Explore our guide on stroke prevention, symptoms, and diagnosis.

Imagine waking up one morning with numbness in your arm and a slur in your speech. You feel confused and nervous, and you wonder what is wrong. This scenario, which is sometimes neglected, might be the first indicator of a stroke, a medical emergency that demands quick treatment. This post will look at the most significant components of stroke: prevention, symptoms, and the road to recovery.

How Stroke Occurs?

The words “stroke” and “cerebrovascular accident (CVA)” create the perception of an instantaneous occurrence, similar to the sudden start of symptoms associated with a stroke. This name aptly reflects the rapid and unexpected way a stroke manifests.

Like other bodily components, the brain obtains its oxygen supply from the blood. When a portion of the brain experiences an interruption or reduction in blood supply either by a clot (a lump of blood cells stuck together) or bursts. This can hinder the delivery of oxygen and nutrients to brain tissue. These circumstances can lead to the death of brain cells in just a few minutes, making it crucial to seek medical help immediately.

According to the World Health Organization (WHO), over 15 million people worldwide have a stroke.

A stroke occurs when blood flow is interrupted to a region of the brain, which is similar to a heart attack in the body.

Types of Strokes

There are varieties of CVAs, each distinguished by its own set of causes and characteristics.

types of strokes

Ischemic stroke

An ischemic stroke occurs when a blood clot obstructs a portion of the brain’s blood supply. They are the most common ones, which are further divided into two kinds:

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  • Thrombic Type: Atherosclerosis, or a blood clot (thrombus) blocking an artery, is the primary cause of ischemic stroke, which accounts for 87% of all cases. In atherosclerosis, cholesterol plaques narrow the arteries by accumulating within their walls.  As arteries narrow, blood flow to the brain decreases, and blood pressure rises. Plaque deposits roughen the artery’s inner wall, causing clots to develop. These clots typically form in the larger blood vessels in the neck and the brain’s base.
  • Embolic type: An embolic stroke occurs when a clot breaks away from an artery wall, becoming an embolus that travels and blocks a smaller artery. These emboli often originate from the heart, where various diseases can lead to clot formation.

When blood supply is briefly interrupted in a region of the brain, symptoms like transient ischemic attacks (TIAs)—also known as mini-strokes—may appear, including a momentary difficulty in speaking. They account for around 30% of all strokes. In most cases, TIAs go away within a minute or two.
However, one or more TIAs can occur days, weeks, or even months before a CVA.  But like other types, they are also a medical emergencies.

Risk Factors

A CVA is more likely to occur if you have specific risk factors. According to the National Heart, Lung, and Blood Institute, there are several factors that increase the risk of having a stroke:

  • Diet: It has been found that an unbalanced diet high in trans lipids, sodium, saturated fats, and cholesterol can increase stroke susceptibility.
  • Alcohol use: Excessive alcohol consumption is also associated with an elevated risk of CVA. It has been studied to raise triglyceride and cholesterol levels, which can cause arterial constriction from plaque buildup.
  • Tobacco Use: Tobacco use in any form increases the risk of cerebrovascular accidents due to the injury it causes to the heart and blood vessels. Nicotine increases blood pressure as well.
  • Physical Inactivity: A lack of activity or exercise can increase the risk of stroke.
  • High BP and Diabetes: High blood pressure is the primary cause of stroke, typically defined as a reading of 140/90 mm Hg or higher.  Because there are frequently no symptoms or early warning signs, regular blood pressure monitoring is critical for early detection and prevention.
  • Prior stroke or heart attack: Research suggests that having experienced a stroke significantly increases the likelihood of another occurrence. Similarly, a history of heart attacks raises the risk of suffering a stroke.
  • Atrial Fibrillation: One form of arrhythmia, or abnormal heartbeat, is atrial fibrillation, AF, or Afib. A greater likelihood of strokes and blood clots is associated with atrial fibrillation, with up to 1.9% of strokes each year. 

As mentioned above, all these risks are modifiable, and by switching to better options, we can reduce the risk of stroke. But there are certain non-modifiable risk factors, such as:

  • Age: A person is susceptible to suffering a stroke at any stage of life, from infancy to adulthood. But the chances of getting it increase with age. It is found to be more common after the age of >65.
  • Gender: Although strokes can occur in either sex, the CDC reports that women experience them at higher rates than men do across all age categories.
  • Race: It is more common among people of African American, Native American, and American Indian descent than among people of other races.
  • Family history: Some families have a higher risk of getting a CVA than others due to hereditary health conditions, such as high blood pressure.
  • Personal Medical History: Conditions such as high cholesterol levels, obesity, heart disease, abnormal heart rhythms, abnormal heart valves, enlarged heart chambers, diabetes, sickle cell disease, and blood clotting problems increase the risk of stroke.

Signs and Symptoms

An individual undergoing a stroke might exhibit one or more of the subsequent symptoms:

  • Sudden paralysis or numbness, particularly in the arm, limb, or face, affects one side of the body.
  • They experience sudden confusion, difficulty talking verbally, or trouble processing what is said.
  • Sudden visual impairment affects one or both eyes.
  • Unexpected difficulty walking, vertigo, loss of balance, or sudden stumbling.
  • Sudden severe headache with no known cause.

The effects of a stroke vary depending on the degree and location of the injury in the brain. They can produce abrupt weakness, numbness, or difficulties speaking, seeing, or walking. Because various portions of the brain govern different regions and functions, the area immediately around the CVA is frequently impacted.

Up to 50% of strokes are avoidable. Before difficulties arise, several risk factors may be managed. 

A quick and easy approach to recalling the critical signs is the FAST test, such as

  • F — Face: Ask the person to smile. Does one side of the face 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 the speech slurred or strange?
  • T — Time: If you see any of these signs, call 9–1–1 immediately. Don’t wait!

A newer version has been proposed as BEFAST

Letter Symptom Description
B Sudden loss of balance Be watchful for a sudden loss of balance or coordination.
E Sudden loss of vision Keep an eye out for sudden vision loss in one or both eyes, including double vision.
F Facial drooping Ask the person to smile. Look for a droop on one or both sides of their face, indicating muscle weakness or paralysis.
A Arm weakness Check for muscle weakness. Ask them to raise their arms. If one arm sags or drops, it indicates one-sided weakness.
S Speech difficulties Strokes can impair speech. The person might slur their speech or struggle to find the right words.
T Time to call emergency services Time is critical. Note when symptoms start and seek immediate medical help. The onset time is crucial for treatment.

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Diagnosis and Tests

A stroke initiates suddenly. A person should seek medical attention at a hospital within three hours of the onset of their symptoms for optimal results.
  • Physical Examination: An evaluation of the patient’s medical history and a physical examination make up the initial phase in diagnosing a stroke. Symptoms that physicians search for include paralysis, numbness, speech difficulties, and other abrupt changes. In addition, risk factors such as hypertension, cardiovascular disease, and diabetes are evaluated, along with lifestyle choices, including tobacco use and diet.
  • Neurological Examination: A neurological examination is carried out to evaluate brain function. It may involve evaluating the patient’s sensation, vision, strength, coordination, and reflexes. Additionally, the physician may assess cognitive functions and speech.
  • Blood Tests: A physician may also conduct blood tests in which specific substances (e.g., coagulation factors). They may also access infections.
  • Imaging Tests: Imaging tests are essential in diagnosing a CVA’s nature and place. Standard imaging tests include:
  1. CT Scan: Brain computed tomography (CT) scans are often performed as an initial diagnostic procedure. It may indicate cerebral hemorrhage, an ischemic stroke, or additional medical conditions.
  2. Magnetic Resonance Imaging (MRI):  This type of imaging can detect changes in brain tissue caused by an ischemic attack or brain hemorrhage and provides a more detailed image of the brain than a CT scan.
  • Carotid Ultrasound: This test uses sound waves to create detailed images of the inside of the carotid arteries in your neck. It helps to reveal the presence of plaque or other issues with blood flow that could have caused stroke symptoms.
  • Carotid Angiogram: The test is used to see obstruction inside the brain’s blood vessels and provide a detailed image of vessels in the brain and neck. This is accomplished by injecting a dye into the cranial blood vessels to render them visible via X-ray imaging.
  • Echocardiogram: An echocardiogram uses sound waves to create images of the heart’s chambers and valves, detecting if a blood clot caused a stroke.

To learn all about the treatment procedures and extend the recovery. Please refer to our detailed article for it.

Preventing Stroke

The research indicates, nevertheless, that nearly 80% of strokes are preventable via lifestyle modifications, risk factor management, and increased awareness.  There are numerous ways in which one can decrease their risk of experiencing a stroke. This does not imply that a stroke can be prevented, but it can reduce the likelihood.

Preventive measures can mitigate the extent of the damage caused by a stroke.

Two-thirds of stroke survivors experience a recurrence of the condition. However, one can mitigate the risk by consulting with a healthcare professional and formulating a preventive strategy.

1. Start Early Prevention

Strokes can also affect youth. 10%–15% of all strokes affect adults younger than 50 years of age. Furthermore, recent studies indicate that the exact causes contributing to strokes in younger adults are also present in older adults: hypertension, obesity, diabetes, and elevated cholesterol levels.

It is recommended that young adults begin monitoring their blood pressure, cholesterol, lipids, and blood sugar levels.

2. Recognize Signs of Mini Stroke

Recognising TIA’s (FAST) signs becomes more critical if you have a family history of CVA. If you suspect you are experiencing a transient ischemic attack (TIA), also known as a mini-stroke, dial 911 without delay. As we all know by now, prompt assessment and intervention are important.  About 20% of individuals who experience a TIA go on to suffer a full stroke within the next three months.

Rapid action can be necessary to preserve lives and reduce the additional complications.

3. Quit Smoking

It is clear that smoking has negative consequences no matter how much you smoke. According to studies, the chance of having a stroke increases by 12% in people who smoke even a small number of cigarettes each day, like five.

If you feel reluctant, then behavioural therapy, counselling, and even medicine or drug substitution therapies can help.

4. Move More

A study published in the JAMA Network Open in 2022 found that the risk of stroke was 44% higher for those who sat for 13 hours or more per day.
But it has also been found that activity can reduce stroke risk by 25-30%. As per many studies, the risk can be decreased with 30 minutes of moderate activity five days a week.

If you’ve been sick or haven’t exercised, you must talk to your doctor before beginning an exercise regimen.

5. Keep Blood Pressure Under Control

Elevated blood pressure correlates with an increased susceptibility to CVA. A substantial contributing factor to elevated blood pressure is identified in 90% of all CVAs.

So managing and keeping track of blood pressure after the 40s becomes important. Adequate blood pressure management incorporates weight loss, consistent physical activity, and salt reduction in the diet. Specific individuals may also require prescription medications to assist in blood vessel relaxation and blood pressure reduction.

Considering these small measures, one can reduce the chance of having a CVA by up to 40%.

6. Maintain Blood Sugar

Like BP, diabetes is responsible for an estimated 20% of mortality among individuals with stroke. This risk can also be reduced by incorporating lifestyle modifications, such as exercise and a low-sugar diet, into diabetes management. Some individuals may also require medication to maintain healthy blood sugar levels.

7. Reduce Stress

Although a little temporary stress isn’t harmful, being in a constant “fight-or-flight” response can cause high blood pressure to remain elevated, which increases the risk of stroke—as we already know. There are many methods to reduce stress, like deep breathing exercises, which might be helpful, but they are not sufficient for effective stress management.

It calls for an all-encompassing evaluation of our daily routines, including our sleep habits, screen usage, and time management restrictions.

8. Healthy Diet and Managing Weight

The risk of having a CVA increases in the people who are overweight with almost 24%, and this risk is further elected up to 64% if the person is obese. Healthy weight management strategies include dieting and moving as much as one can. Those adjustments, however, will not suffice for everybody. Keep your daily caloric intake between 1,500 and 2,000 calories (or lower if your exercise level and body mass index differ).

What constitutes a healthy diet is a topic on which many specialists and medical professionals disagree. To be sure, there are a handful of things we can state. The body benefits significantly from a calorie-controlled diet that is high in whole foods, fibre, and heart-healthy fats. Some combination of macronutrients, time, and calorie restriction is usually a successful technique. However, not everyone reacts identically to a particular diet, and different ways work for different people.

We recommend seeing an expert to determine the most effective course of action if you are having trouble maintaining healthy eating habits.

Though stroke necessitates immediate medical attention, there are numerous other critical health situations that warrant attention as well. For more information, consult our article here.

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Dr Aimen

Being a Doctor by profession, Aimen is passionate about helping people get better health in their lives. Aimen enjoys her research on Prime With Time subjects and strives to create better awareness of the problems and changes related to women's health.
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