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Overview for Dietary and Lifestyle or Treatment info
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A stroke occurs when there
has been a sudden interruption of blood supply to an area of the brain.
This can occur when a blood clot forms in an artery, occluding that
artery thereby depriving that area of its blood supply. An embolism
can have the same affect.
An embolism is either a 'travelling clot of blood', an air bubble or
a fragment of tissue which travels through the blood stream. It will
deprive an area of its blood when it becomes lodged in an artery. Rupture
of the actual blood vessel can cause a local haemorrhage with the same
effect.
Stroke is one of the major causes of death worldwide; it is the third
most common cause in the UK. The incidence rises steeply with age and
is uncommon under the age of 40 years. There are degrees of stroke.
A minor stroke is one in which recovery of the patient occurs within
a 24 hour period leaving no neurological defit.
A Transient Ischaemic Attack (TIA) is a focal deficit lasting less than
24 hours, following which there is a full recovery. Unfortunately, these
attacks can occur at any time. Secondary causes have to be considered.
There may be an underlying abnormality which directly causes the circulatory
problem causing the stroke. Into that category come "space occupying
lesions", a tumour or abscess.
In young adults about one fifth of strokes are caused by a dissection
(split in the wall) of a major artery as the result of trauma or manipulation
of the neck. For those patients who suffer from Hypertension, Diabetes,
Obesity and who smoke, their risk of developing a stroke is much greater
than most.
The clinical features of a stroke are that the signs and symptoms occur
in a few minutes and develop over a period of several hours. It is not
possible to accurately determine the precise cause in that time. A cerebral
haemorrhage is, however accompanied by a severe headache. The situation
of the haemorrhage can be localised as the part affected will indicate
the area of the brain in which the "accident" took place.
The main purpose of the investigation is to differentiate between haemorrhage
and infarction and to identify future (or present) risk factors which
can be dealt with. CT or magnetic resonance imaging is indicated in
most patients. This will demonstrate the site of the accident and give
information as to whether it was haemorrhage or infarction and can possibly
demonstrate any existing problem which could have precipitated the stroke.
eg Neoplasm (Ca).
General investigations of blood and urine can also be of use in this
line. eg. Clycosuvia (Diabetes), Raised Hb (Polycythermia), Raised ESR
(Sedimentation rate - arteritis and vasculitis.
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