STROKE
Other names are:
o Cerebrovascular accident
o Apoplexy
o Brain Attack
Stroke is sudden impairment or loss of consciousness, sensation, and voluntary motion that results from obstruction or rupture of blood vessel in the brain which leads to blockage of blood supply to the part of the brain affected.
Cutting off of blood supply to a portion of the brain leads to temporary or permanent impairment or loss of function of the part of the body controlled by that portion of the brain.
If unresolved, cutting off blood supply to a part of the brain can lead to damage of that part of the brain with resultant disability. If it involves a large part of the brain the problem can lead to death of the person.

SYMPTOMS
Symptoms may come suddenly or (rarely) gradually, and include:
 Numbness or weakness (paresis) of the body, especially one side of the body.
 Paralysis usually of one half of the body
 Deviation of face to one side
 Dizziness
 Blurred vision
 Headache
 Problem with swallowing
 Slurred speech
 Convulsion
 Unsteady gait
 Confusion
 Problem with communication
 Coma

TYPES OF STROKE
1. Ischaemic (Non-haemorrhagic) Stroke (80%)
This is the more common type of Stroke. This occurs as a result of clogged brain arteries, commonly from cholesterol, or fat, or blood clot. Onset of Stroke, if from thrombosis, is usually gradual and it occurs often at night or while waking up in the morning.
Stroke from blood embolism usually occurs suddenly and it can result from heart disease, bone fractures or cancer cells. Rarer causes are sickle cell blood cell clumping and septicaemia.
2. Haemorrhagic Stroke (20%)
This results from bursting of some weakened artery in the brain, very commonly from high blood pressure. Congenital brain blood vessel aneurysm may burst later in life (even during childhood). This type is less common, but is more deadly. It usually comes suddenly.

3. Transient Ischaemic Attack (TIA), or Mini-stroke
This occurs suddenly. It has all the features of stroke in milder degrees, and usually lasts for only a few minutes to a several hours. Previous TIA predisposes to stroke in future.

RISK FACTORS
 Previous TIA
 Previous stroke
 Heart disease
 High blood pressure
 Diabetes
 Obesity
 Sickle cell disorder
 Illicit drug use
 Alcoholism
 High fat diet
 Bleeding disorders
 Congenital brain blood vessel abnormality
INVESTIGATIONS
 CT scan
 MRI
Laboratory Tests
 Full Blood Count
 Blood Glucose
 ESR
 Coagulation tests
 Lipid cholesterol level
 ECG
 Echocardiography
 Kidney Function Tests

TREATMENT
a) Haemorrhagic Stroke
 Supportive measures
 Correction of bleeding disorder
b) Non-haemorrhagic Stroke
 Treatment of high BP
 Management of unconscious patient
 Thrombolytic treatment- heparin, other anticoagulant
 Treatment of diabetes
 Treatment of cardiac condition
 Vascular surgery for removal of thrombosis
 Supportive measures
 Rehabilitation
 Psychotherapy , including support from relatives

PREVENTION
 Low salt diet
 Low fat diet
 Eat more of fish, vegetables, whole grains, and fruits
 Minimize sugar intake
 Avoid alcohol
 Maintain healthy body weight
 Do not smoke
 Control blood pressure
 Regular exercise
 Treat Diabetes
 Treat heart condition