A. Causes and risk factors

There are many risk factors that may lead to stroke, such as hypertension, diabetes, high cholesterol, atrial fibrillation, and carotid or other artery disease1.

Source: 1let’s talk about Risk Factors for Stroke https://www.strokeassociation.org/idc/groups/stroke-public/@wcm/@hcm/documents/downloadable/ucm_309713.pd

Among these risk factors, the three major ones: Hypertension, Atrial Fibrillation and Arterial Stiffness, those can be detected by Freescan.

 

Hypertension

It is also called high blood pressure. A chronic increase in arterial blood pressure (systolic blood pressure > 140 mmHg and diastolic blood pressure > 90 mmHg) is defined as hypertension and is the most frequent cardiovascular disease worldwide.

High blood pressure puts a strain on all the blood vessels throughout your body, including the ones leading to the brain. As a result, your heart has to work much harder to keep the blood circulation going. This strain can damage your blood vessels, causing them to become harder and narrower, a condition called atherosclerosis. This makes a blockage more likely to occur, which could cause a stroke or transient ischaemic attack. On rare occasions, this extra strain may cause a blood vessel to weaken and burst inside the brain, causing bleeding into surrounding tissues. This is called a haemorrhagic stroke2. To control blood pressure is a cornerstone to prevent recurrent strokes.

Source: 2Stroke Association – September 2012

 

Atrial Fibrillation

Atrial fibrillation (AF) is the most common arrhythmia for the older people, a type of irregular heartbeat. It causes abnormal atrium and pulmonary vein electrophysiologic activity (when the two upper chambers of the heart beat unpredictably and sometimes rapidly). AF causes abnormal contraction and relaxation function in heart atrium, and even a loss of atrial pumping function. Finally, these irregular heartbeats can cause blood to collect in the heart and potentially form a clot (thrombi), which can travel to a person’s brain and cause an ischemic stroke.

 

B. Diagnosis of strokes

The initial onset of stroke may be massive in its effects, producing widespread paralysis, inability to speak, coma, or death within a short time, usually within several hours or days. On the other hand, the onset may be manifested by a series of transient ischemic attacks during which the patient may experience weakness and numbness of an arm, a leg, or a side of the face. There may be temporary difficulty in speech, confusion, or visual disturbances. Transient ischemic attacks may recur many times, but they are usually followed eventually by more widespread and permanent paralysis.3

Regardless, either atherosclerosis or thrombi, a diagnosis is always needed to evaluate by a physician. Differential diagnosis is carried out by examining the spinal fluid for evidence of blood and by performing diagnostic imaging, such as a brain computed tomography(CT) and MRI. The imaging can indicate a stroke occurring and the exact location in the brain.

Source: 3The Editors of Encyclopædia Britannica, 2-28-2017

 

C. Therapy options for strokes

The urgent treatment of stroke is a Tissue Plasminogen Activator (t-PA) and others are an Endovascular Procedure or a Mechanical Thrombectomy.

According to etiology of stroke, the patient received different therapeutic options. Immediately aspirin and Tissue Plasminogen Activator (t-PA), an Endovascular Procedure or a Mechanical Thrombectomy may help to remove a blood clot which is occluded the brain vessels. To control blood pressure, aspirin and lipid control are always needed to prevent recurrent stroke.