Medical brain notes 7

  PARALYSIS - STROKE Stroke is a very common disease in our country. Stroke is the major cause of death after heart attack, cancer and road accidents. It is really sad and surprising that there is very little awareness among the general public regarding this disease. Like heart attack, knowledge of the risk factors can prevent the occurrence of the disease in majority of cases. If the warning signs are identified in time, immediate safety measures can be taken easily, so that in future any major stroke can be averted. After a stroke it is essential that immediate diagnosis and correct treatment be given to prevent permanent disabilities. This will be beneficial socially, personally, financially, family wise and nationally. This is the main aim behind providing detailed information of paralysis (brain stroke) in this chapter. Paralysis can occur due to obstruction in the blood circulation in the main arteries supplying blood to the brain. The high fat and sweet diet pattern, sedenta...

  Risk factors responsible for occurrence of a stroke are as under :   i.          High blood pressure   ii.                     Diabetes   iii.                 High lipids (fats) in the blood   iv.                 Obesity (excess weight)   v.                 Smoking, tobacco or alcohol abuse   vi.                 Heart disease (IHD), diseases of the valve, irregular pulse (AF)   vii.                 Previous stroke or T.I.A   viii.    ...

  The warning signals of an impending stroke (T.I.A.) : i.                 Feeling of weakness in one side of the body; the limbs of the affected side may stop working or become numb. ii.                 Momentary loss of vision in one or both the eyes. iii.                 Confusion, difficulty in speech or comprehension . far a short period of time.   iv.                 Vertigo, blurring of vision, diplopia, sudden headaches, nausea or vomiting, weakness in both the legs, stumbling, sudden momentary unconsciousness or falling down. These symptoms prevail for certain period of time and if the symptoms are ignored and if no treatment is commenced, paralysis of a whole side ensues, ...

  Prevention of a stroke : i.                 Arteriosclerosis develops gradually and is a slowly progressive disease. The above mentioned risk factors can increase the speed and extent of damage. This can cause a lot of damage. In order to avoid this, obesity should be prevented by taking a proper nutritious diet. Tobacco and smoking should be stopped. ii.                 Blood Pressure: Blood pressure should be regularly checked and if it is high, proper medication should be taken to keep it under control. Even a normal person should intermittently monitor one’s blood pressure, especially if symptoms like headache, dizziness, vertigo, and anxiety occur. Even if a patient has come for any other disease or ailment, according to a notification of the National Stroke Association, it is the duty of the doctor to check the patient’s blood...

  Diagnosis : Paralysis is a disease of the brain and therefore it is necessary to get proper and timely treatment from an experienced Physician or a Neurophysician. In order to locate the lesion and the extent of damage these doctors conduct necessary Physical examinations and use related diagnostic tools like a CT scan or MRI for proper diagnosis and decision of the appropriate line of treatment. It is advisable to get a CT scan done in the initial few hours of a stroke, in order to find out whether the patient is suffering from a hemorrhage or thromboembolism. Hemorrhage can readily be detected in a CT scan very easily. In the cases of thrombosis, CT scan is normal in the first few hours. Therefore, in cases of paralysis if the CT scan does not show a hemorrhage, then usually, immediate treatment for thrombosis is started. Another CT scan done after 24 to 36 hours, with a contrast dye confirms thrombosis along with the extent of damage. With the help of this, one can predict the...

  Details of the treatment of stroke : As soon as the symptoms of stroke or paralysis are seen, immediate treatment should be started in a hospital by an expert physician or a neurologist.  Delay can be dangerous.  If possible, while taking the patient to the intensive care unit, the CT scan should be done on the way, if the facility is available in that city. If the patient is very serious he should be admitted immediately in an ICU (intensive care unit). If the patient is serious and also has edema of the brain along with paralysis, emergency treatment should be initiated in ICU or even at home to prevent him from going into coma. The doctor should ensure that BP, pulse and respiration are maintained at normal levels. If the patient gets a convulsion, it should be immediately brought under control and if he is suffering from blood pressure, diabetes etc then they should also be controlled immediately. In short every minute counts.   Treatment of Paralysis : Six Maj...