A stroke may be called a brain attack. It may happen to any person at any time. A stroke occurs when blood supply to the brain is cut off. The brain cells become oxygen deprived due to the stroke and eventually die. Dead brain cells result in brain dysfunction due to which patients lose control over muscle and memory.

Strokes can be mild to life threatening and requires immediate medical attention. Stroke requires advanced care and should be treated by extensively qualified and experienced medical experts. 

Neurosurgery satisfies all the required clauses for treatment of stroke and accounts for being one of the best ways for management of stroke. Renowned hospitals have a dedicated neurosurgical wing and a team of neurological specialists who know how to deal with stroke the best.

Vascular Neurology
This form of neurology focuses on patients who have undergone a stroke or have experienced symptoms of stroke. A multidisciplinary approach is taken for the prevention of recurrent cerebrovascular conditions.

Types of stroke

Ischemic stroke: This kind of stroke occurs when there is a blockage in a blood vessel, which supplies blood to the brain. This form of stroke is the more common. The underlying cause of this stroke is known as atherosclerosis, which is a condition where fatty deposits occur in the walls of the blood vessels and cause blockage in them.
Hemorrhagic stroke: This type of stroke occurs when a blood vessel gets weak and ruptures into the brain. This is caused by two types of weak blood vessels known as aneurysm and arteriovenous malformation.
Transient ischemic attack: This type of stroke is also known as a mini stroke. These attacks occur because of blood clots. The blockage caused is temporary or transient in nature.
Treatment of Ischemic stroke

Tissue Plasminogen Activator: This is one of the best ways to treat ischemic strokes. This medicine is given to the patient intravenously. It dissolves the blood clot and improves blood flow to the area of the brain which is affected. The medicine should be given within three to four hours after stroke symptoms appear.
Endovascular procedure: This is a process by which the blood clot is removed using a catheter, which gets inserted into the area of the blocked blood vessel. It helps in restoring blood flow to that area. 
Treatment of Hemorrhagic stroke

Endovascular procedure: Several endovascular techniques and methods are used so that the weakening of blood vessels is reduced and less bleeding is caused.
Surgical treatment: Different modes of neurosurgery may be undertaken to stop bleeding and for relieving pressure within the skull.

Role of Neurosurgery in Management of Stroke

Somebody in the world suffers a stroke every two seconds. Stroke affects physical as well as mental health gravely. It can be a life- altering situation leading to new limitations overnight. Such limitations can be physical or mental, affecting mobility and cognition. According to psychologists, cognitive functions of the brain encompass speech, language, functional memory, spatial- motor systems, ability to switch between tasks, executive functions like task organization, attention, and being able to employ tools and symbols.

When the stroke strikes, it irreversibly damages a part of the brain. It happens due to hemorrhage or blocked supply of blood. However, the brain can be trained and taught compensatory strategies. These compensatory strategies consist of attention increasing activities that require neurological utilities. These activities and exercises are formed in a way to improve the memory. Both pictorial and hearing skills are engaged in these activities.

Memory, attention span, and executive activities are dependent on each other and any problem regarding these affects an individual s daily life. That is why to improve the complete mental capacity, exercises are required. These exercises help to improve memory and attention span. In cognitive rehabilitation, goals are set as per the requirements of the patient and treatment is then followed. This requires some plans and strategies to carry out daily activities. These plans may consist of planning and analysis of the task.

The recovery varies from individual to individual depending upon the restoration of the damaged neurological functions supporting specific cognitive area. However, there are very limited types of treatments for cognitive rehabilitation, mostly generic treatments which depends on doctor s experience.

Evidence is found by researchers which supports the cognitive rehabilitation after stroke, in which the areas discussed are smaller than the issues faced by the stroke survivors. The studies fail to talk about the long-term results and common treatments for daily tasks. It is now really important for us to have a serious innovation in the field of cognitive rehabilitation with the amount of stroke patients increasing day by day.

Before one going for rehabilitation, he/ she should ensure that why they need it and what are their needs that are to be fulfilled through rehabilitation. Experts recommend rehabilitation so that patients are able to lead as normal lifestyle as possible post stroke strikes them.

Who are more prone to stroke?

Old age people, alcoholics, people with high cholesterol levels, active smokers, Diabetic patients, people who consume drugs, people suffering from Hypertension, patients going through transient ischemic attack (TIA) are all very much prone to a stroke.

It is also very important to consult a doctor after stroke. He will advise you the best possible way to treat the problem. 

Take away

Stroke these days can happen to anyone which although largely depends upon the age factor, but one's lifestyle can also make him/her the target of stroke. There is cognitive rehabilitation which can help a person to recover post stroke through activities and exercises and change in lifestyle. It is important for an individual to consult a doctor if he/she finds any difficulty in carrying out daily activities with one side of the body.

Cognitive Rehabilitation Post Brain Stroke!

Stroke is one of the major reasons for disability in adults. In the US alone, 7 million people suffer from a stroke in a year. After a stroke, the affected individual suffers from lots of health issues. They feel week and fatigued. An ache in one side of the body, inability to walk, and social disability are experienced. Emotional and cognitive functioning is disturbed. Continuum care is recommended for the affected individuals and they need interdisciplinary care to ensure they can do things independently. This is where occupational therapy plays a vital role.

What does the therapist do? 

Using a range of evidence-based methods, the occupational therapists can address the physical, emotional, and mental challenges caused by the stroke. Occupational therapy does not concentrate only on the ailment. It takes into account the emotional needs, desires, limitations, and activities of the stroke survivors. It helps them to recoup the skill to get the daily chores done independently. An occupational therapist surveys the home of the stroke survivor and evaluates the risk of hazards. The practitioner also helps the affected individuals in coping with the loss of vision and memory. The physical strength and fortitude are augmented. The major focus will be on making the affected reach the heights of performance in the valued occupations.

How does it help? 

Studies prove that occupational therapy does not only help one to recover faster, but also prevents worsening of the condition further. The stroke survivor, who receives the occupational therapy, is independent when it comes to daily living chores. Wouldn t it be a great improvement on the emotional health when the affected feels he or she can get things done with little or occasional help? Also, this reduces the caregiver burden. The family is relieved that the survivor can eat, bath, and take a few things without someone having to sit closer and help. This mentally boosts the caregivers and the family to motivate the survivor. The stroke survivor also looks forward to the rehabilitation treatment as the occupational therapy makes them feel great.

Transitional and community integration services can make sure that the patients are engaged in their specific environments, once they get back home after occupational therapy in the specialized care center. After a certain period, when the stroke survivors show considerable improvement, the practitioner again evaluates to find if activities like driving can be resumed by the clients. Community mobility of different choices is recommended if the client is not fit for driving. There are driver rehab programs and the driving skills can be regained.

An occupational therapist spends more time with the client than any other healthcare professional. This is because the practitioner is responsible for alleviating the challenges faced by the affected individual emotionally and physically. The practitioner not only helps the client to achieve the goals but also ensures that the client is psychologically motivated whenever he or she is discouraged. Rehabilitation can reverse the damage done to the brain. But it takes lots of efforts to learn the things to do them in a different way. An occupational therapist makes this goal easier for his or her clients.

Occupational Therapy For People Recovering From A Stroke! 

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements. 

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supply of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burst or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.  Remembering the F.A.S.T. acronym can help with recognizing the onset of stroke (Face, Arms, Speed, Time - explained below). 

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke

Treatment depends on the type of stroke.
Ischemic strokes can be treated with 'clot-busting' drugs.
Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
The most effective way to prevent strokes is through maintaining a healthy lifestyle.
What is TPA?
TPA is a thrombolytic or a  Clot Buster  drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 4.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.
Rush to the nearest Stroke Centre whenever you experience such symptoms.
U can save the brain cells dying if you reach within 4.5 hrs by the CLOT BUSTER. 
Endovascular procedures 
Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which trained doctors try  removing a large blood clot by sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention
The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including 

High blood pressure,
Cigarette smoking,
Diabetes
Atrial fibrillation and
Physical inactivity.
More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 
Rehabilitation
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke.

Brain Stroke - Things You Must Know!

Stroke is a condition known to all for its deadly impact. Even if the affected person survives, the after-effects can be immensely debilitating right from affecting movement to speech. Being informed, you can protect yourself and your loved ones from both ischemic and hemorrhagic stroke. Here are the common signs of stroke that you should be aware of:

Numbing of arms and legs: Many people wake up and find that their arms and legs are numb and they tend to assume that it is due to compression of the nerve. But the actual reality is that the flow of blood through the arteries running up to the spine is reduced, and it has led to weakness or numbness on either side of the body.
Double vision and blurriness: Vision problems can also be a strong indicator of stroke even though most people think it is due to long hours of work or aging. When you see two images of the same object, it doesn t have to mean that you are reading too much. It could mean that the blood vessel in charge of supplying oxygen to the eyes has been disrupted or blocked.
Slurred speech: Some medicines, particular painkillers can cause speech issues. But this is not the case always; if it is not a side effect that you typically experience after taking painkillers, you should consult a healthcare expert without any delay. 
Confusion and trouble over thinking and articulating: When you find yourself in a state where you cannot recall the right word to explain the right thing, you may rest assured that it is an issue stemming from the stroke. If you find yourself to struggle thinking or finding a word very commonly, then you are heading for big trouble.
Balance problems: Some people have balance issues, and they think it is due to the dose of alcohol, but experts say it is crucial to identify whether this assumption is correct. You will never have delayed balance problems, and therefore, you cannot blame a drink that you had last day. So, if you have balance issues without any identifiable reason, it is advisable to call a doctor.
A headache that becomes intolerable at times: Headaches can be a sign of a migraine but in case you are not prone to this ailment, then the debilitating headache could indicate a stroke. Migraine headaches can also mean stroke since both of them have similar signs and symptoms.
Fatigue that won t let you stay upright: If you are not doing any physically strenuous job but still feel tired most of the time, it could be a warning sign of stroke. If it continues for over a week, it is recommended that you consult an expert immediately.
Equipped with this knowledge, stay aware and pay attention to the indications your body gives to take care of yourself.


7 Signs You Are Having A Stroke!

Stroke is a medical condition in which the flow of blood towards the brain is poor and causes the death of certain cells. There are two common types of stroke: 

1. Ischemic- due to lack of blood flow
2. Hemorrhagic- due to bleeding

Signs and symptoms of stroke 

Problems with movement
Inability to feel  on one side of the body
Problems understanding or in speech
Vertigo
Loss of vision
Difficulty in carrying out everyday activities
Role of Physiotherapy for Patients with Stroke

The main focus of physiotherapy is to help you use your arms and legs to regain as much strength and movement as possible. 
If you have one-sided paralysis, correct positioning is important to prevent spasm or injury.
It helps you to sit up as this will help you avoid blood clots in your legs, improve your breathing and help you recover quickly.
If you are unable to move, you may be given chest physiotherapy to keep your lungs free of infection.
What does a Physiotherapist do?

A physiotherapist advises you on how you should be positioned when lying or sitting, and how often you need to be moved.
Motivates you to be actively involved in your physiotherapy sessions to help you relearn normal patterns of movement
Decides when you should begin to start walking and what equipment is needed to move or support you
Provides therapy to strengthen your limbs and teach you how to move again as independently as possible
Takes care of the fact that no complications should arise and you have a smooth recovery.
Treatment Techniques:

Strength Training: It is evident that strength training can improve upper-limb strength and function without increasing tone or pain in individuals with stroke.
Gaming: Goal orientated computer gaming has proven to significantly reduce upper limb impairment in stroke survivors.
Virtual Reality: Virtual reality training has been shown to be effective in restoring upper limb motor impairments and motor-related functional abilities.
Mirror Therapy: Mirror therapy has been shown to have a beneficial effect on motor control and function compared to conventional therapy.
Robot-Assisted Therapy: It has been shown to have a beneficial effect on motor recovery and function.
In the upper extremity with severe impairment and/or poor prognosis for recovery, Chedoke McMaster Stroke Assessment (CMSA) of Arm and Hand < Stage 4) treatment should focus on maintaining a comfortable, pain-free, mobile arm and hand. Engage in repetitive and intense use of novel tasks that challenge the stroke survivor to acquire necessary motor skills to use the involved upper limb during functional tasks and activities. Engage in motor-learning training including the use of imagery.

Stroke - How Physiotherapy Can Help With It?

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