Strokes are also called brain attack. Are you suffering from complete or partial paralysis?
When brain cells controlling a particular function of body lose their capacity to perform it due to sudden cessation – stoppage of its blood supply resulting in its cells destruction and hence corresponding body parts lose their function and is called paralysis. The brain controls half of body and therefore the paralysis occurs on the side opposite to which this clot has occurred in brain. If the area of brain where cutting off the blood supply occurs controls the movement of the opposite half of the body then it losses capacity to move it and is called hemiplegia or half paralysis. Similarly, part of brain controlling speech (left) if involved produces loss of speech or aphasia whereas language controlling area getting effected by such stroke would produce abnormal words, garbage language or strange language occasionally confused with a psychiatric disease.
Stroke if it involves the vision area of brain it produces loss of vision in the opposite half area of field of vision. However certain areas of brain when they get stroke do not produce loss of power in the limbs or speech but instead result in abrupt onset of abnormal in psychotic delirious behavior, mimicking, acute psychiatric illness. Whereas in a case where despite having good strength in the limbs that person may not be able to stand in a balanced manner and walks in an unsteady fashion happens when cutting off blood supply occurs in the balancing center of brain called the cerebellum. It\’s worth noting that double vision also occurs as manifestation of brain whether the artery supplying brain gets blocked by a clot within its lumen then it is called thrombosis (inside the artery) or the artery leaks from its walls and rupture then it is called haemorrhage and this also results in no supply to specific part of the brain. It is better to understand that in ischemia -infarction of brain occurs when artery has thrombus or clot INSIDE the artery and the blood vessel ( artery)WALL is INTACT whereas in HEMORRHAGE WALL HAS LEAKED OR RUPTURED THE CLOT IS OUTSIDE THE ARTERY IN THE JUNGLE OF NORMAL NERVE FIBERS.
As the main road gets blocked the traffic moves towards its destinations through alternative roots called collaterals Similarly when an artery gets blocked by a clot the damaged area gets blood supply from collaterals arteries. But cutting off the blood supply in brain results in a core central area of unrecoverable destruction of brain cells called infarct which is surrounded by non-functioning of thousands (millions) of unconscious brain cells which can be salvaged. The therapeutic modalities currently in use focus on perfusing these unconscious brain cells by establishing blood supply and helping them to sustain their diminishing energy-producing capacity to recover. Another emerging therapeutic intervention is focused at other components of damaged neurovascular units through attempts to correct the dysfunctional biochemical chain of events to help in recovery.
Prevention of stroke are by attacking the risk factor especially high blood pressure, diabetes and lipid profile management and by reducing the clotting tendency of blood by giving blood thinner. Many people can still have a stroke in the absence of the above risk factors requiring detailed investigation. Many times the walls of arteries of brain get inflamed, swollen called vasculitis / arteritis which reduce the lumen – opening – area through which blood flows and clots and give rise to infarction.
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Surgery to re-establish the blood supply through the artery in an already established full-fledged infarction stroke will not give risk to recovery but if small core area of infarction is surrounded by partially damaged salvageable cells can be helped by clot removing called thrombectomy through interventional Neuroradilogy. Stenting of arteries of brain can prevent future attacks in certain specific situations only.
The scientific neurology world is unanimous in treating brain hemorrhage by surgery ONLYwhen hemorrhage occurs in cerebellum, whereas opinions are divided when it comes to surgery for a brain hemorrhage in other locations and the conclusion is that a very small percentage of brain hemorrhage get benefitted by surgical evacuation of the clot.