Saturday, June 23, 2012

DIABETES AND STROKE

Diabetes and Stroke

Stroke
 occurred when blood stream to the brain is insufficient. It is considered as an emergency case that should seek for immediate help. There are two types of stroke. The first one is ischemic stroke due to a clot or blockage of blood and oxygen supply to the brain. The second one is hemorraghic stroke or bleeding stroke caused by a rupture of a brain aneurysm or leak of tiny weakened or inflamed blood vessel in the brain.


About 75% of stroke cases are clot stroke. The blockage is caused by either a thrombus or an embolus. A thrombus is a static clot in the blood vessel, while if it is loosing itself and moves following blood stream it is called an embolus. An embolus may fix in another smaller vessel causing the obstruction.

Clot stroke may be preceded by a condition called by transient ischemic attacks or TIA. This a kind of mild stroke indicated by sudden physical weakness, inability to talk, double vision and dizziness. In TIA the recovery of blood circulation is quite fast so that serious neurological damage can be avoided. The survival rate of clot stroke is generally high.

In the bleeding type, as blood flows into the brain it increases the pressure in the brain that may directly kill brain cells. The increased tension may also block blood circulation and destroy brain cells. This condition is reflected as severe headache which is sometimes followed by unconsciousness. Unlike the clot stroke, mortality of massive bleeding is around 80% of the cases.

Cause

The cause of a clot stroke is related to cardiovascular diseases, e.g. atherosclerosis or heart attack. Atherosclerosis is responsible in the formation of a thrombus or embolus that causes the obstruction. After a heart attack the blood flow becomes slower. This creates the possibility to form blood clots.

A bleeding stroke may result from a brain aneurysm rupture. It can also caused by a weakening blood vessel due to consistent strain of high blood pressure. A rare condition is the leaking of arteriovenous malformation, a congenital disease in the brain.

Signs and Symptoms

Stroke symptoms are; sudden loss of vision, strength, sensation and coordination, ability to speak or to understand speech. Impairment may occur to one side of the body, like lack of sensation at one side of the face or one-eye blindness. The patient may also experience a sudden loss of balance followed by nausea and vomiting, hiccup or trouble when swallowing. If the patient shows sudden and severe headache followed by unconsciousness it is the symptoms of bleeding stroke.

Risk factors

Factors that are considered as condition or illness that can lead to stroke are; age over 60’s, gender, high blood pressure, high cholesterol especially Low Density Lipoproteins, diabetes, obesity, smoking, drug abuse, use of birth control pills and stress.

Diagnosis and Treatment

A neurologist should confirm all the stroke symptoms that appear. In addition, the neurologist should conduct a thorough and quick exam to identify the type of stroke, the location of the lesion and the extent of the affected brain area to be able to provide the right treatment. A standard exam like to assist the diagnosis like the examination of blood vessels in the eye, looking for possible unusual noise in the heart and carotid artery of the neck, measuring blood pressure and pulse rate, and test to assess sensation and neurological reflexes. A critical test for stroke includes a CT scan and MRI scan.

Stroke patients are best treated in a hospital to provide the necessary treatment to avoid further brain damage. In clot stroke the conventional medicine is an anti-coagulant like heparin. While in bleeding stroke a surgical operation may be necessary to drain the accumulating blood and clip the ruptured vessel.

After passing the critical condition, the patient should stay in the hospital until the condition is stable. When released from the hospital the patient should be guided by a recovery program to prevent future strokes. The program may include diet and lifestyle changes, drug treatment, and paralysis rehabilitation. A neurologist may also consider a surgical operation there is an indication of critical brain artery narrowing.

Prevention of future stroke

Patients with bleeding stroke should keep their blood pressure at a low level. In clot stroke, anti coagulant like aspirin should be taken. Aspirin is strongly prohibited for patient with bleeding stroke. Be sure to see your doctor regularly and follow his instruction and guidance. Try to run a healthy lifestyle which includes low fat, salt and cholesterol food, exercise regularly, control weight, monitor blood pressure and cholesterol levels.

On the Alert

You should call you doctor if you or someone else is experiencing the following symptoms:
  • Sudden loss of vision, strength, sensation and coordination, ability to speak or understand speech.
  • Impairment may occur to one side of the body, like lack of sensation at one side of the face or one-eye blindness.
  • Sudden loss of balance followed by nausea and vomiting, hiccup or trouble when swallowing.
  • Sudden and severe headache followed by unconsciousness which is the symptoms of bleeding stroke
If the symptoms passed quickly, you may experience TIA or transient ischemic attack in the brain. Do not neglect it, report to your doctor to seek immediate medical intervention.