Research paper on stroke

Strokes have been around for thousands of years. Hippocrates recognized and described what we now call strokes as the onset of sudden paralysis. In ancient times stroke was called apoplexy and this term was applied to anyone who suddenly became struck down with paralysis. Physicians during that time knew very little about stroke and the only thing that could be done for the condition was to feed and care for the patient. “The first person to investigate apoplexy was a Swiss scientist named Johann Wepfer in 1620. Wepfer was the first to identify postmortem signs of bleeding in the brain in patients that died of apoplexy. Not only did was he the first to identify the blood in the brain of these postmortem apoplexy patients he also was the first to discover that some had blockages in their main arteries. These findings led to the renaming of apoplexy to cerebrovascular disease.” (AHA)

There are basically two types of strokes, ischemic stroke and hemorrhagic stroke. Ischemic stroke occurs when an artery supplying blood to the brain becomes blocked and suddenly stops or decreases the amount of blood to the brain which ultimately causes an infarction. This type of stroke makes up about 80 percent of the strokes in the U.S. Blood clots make up the majority of these blockages.(AHA) Blood clots become more frequent the older a person gets. Blood clots can cause stroke in two ways. Clots can for in a part of the body and travel through blood vessels and then become lodged in a vessel inside the brain. This type of clot is called an embolus. A stroke caused by an embolus is called an embolic stroke. The second type of clot is called a thrombosis. A thrombosis is a formation of a clot in one of the cerebral arteries that stays attached to the artery wall until it grows large enough to restrict blood flow (Yannis 107). Ischemic strokes can also

be caused by stenosis. Stenosis is a narrowing of an artery due to plaque build up. Stenosis can occur in large arteries or small arteries and is referred to as large vessel disease or small vessel disease respectively. The most common blood vessel disease that causes stenosis is atherosclerosis. This is where deposits of plaque build up along the inner artery walls of the large and medium sized arteries causing thickening, hardening and loss of elasticity of the artery walls which decreases blood flow.

The second typo of stroke is called a Hemorrhagic stroke. A hemorrhagic stroke occurs when an artery in the brain burst and spews blood out into the surrounding tissue. These strokes account for about 20 percent of all strokes. (AHA) Hemorrhage can occur in several ways. One common way is an aneurism. An aneurism occurs when a weak or thin spot on a artery wall ruptures. Hemorrhage can also occur when an artery wall breaks open. Plaque on an artery wall causes the wall to loose its elasticity and become brittle and thin. “Hypertension and High blood pressure increase the risk that a brittle artery wall will rupture. A person with arteriovenous malformation (AVM) also has an increased risk of hemorrhagic stroke. AVM’s are a tangle of defective blood vessels and capillaries in the brain that have thin walls. Bleeding from the ruptured vessels can leak into either the substance of the brain or the spaces surrounding the brain” (Piscatella &Franklin 162).

Along with hemorrhagic and ischemic stroke there are also transient ischemic strokes or TIA’s. TIA’s, often called mini strokes, start off like strokes but symptoms resolve themselves in about an hour leaving no noticeable signs. This is usually a sign of a future much more sever type of stroke.

There are many warning signs of a stroke; sudden numbness or weakness in the face, arms or legs usually on one side of the body. Other signs of stroke are sudden trouble seeing, confusion, slurred speech, severe headache, and loss of balance or coordination (Senelick et al 53). Most people who are experiencing a stroke have no idea they are having one. Many people think they are suffering from fatigue or over-exertion, only when it is too late to repair the damage do people usually realize they have had a stroke.

The two most at risk groups for stroke are those people with unhealthy lifestyles and the elderly. Two-thirds of all stroke victims are over the age of 65. Strokes can occur at anytime however. Gender also plays a role in strokes. The stroke risk for men is 1.25 times higher than that of women. Men do have a higher survival rate than women due to the life expectancy of men vs. women. Women are generally older when they encounter a stroke (Harrar 132). Stroke also runs in some families. Some members of a family might have a genetic predisposition for some of the risk factors. Race is also important in determining those at risk. African Americans have almost double the risk compared to Caucasians.

High blood pressure is one of the leading causes of stroke. As many as 50 million Americans have high blood pressure and only 31 % know they have it. High blood pressure puts unnecessary strain on blood vessel walls causing them to thicken and deteriorate. Smoking almost doubles your risk of ischemic stroke and increases your risk of hemorrhagic stroke by 3.5 percent (AHA). High alcohol content can lead to stroke.

While studies show that a small amount of alcohol can lead to a reduced risk for stroke meanwhile large amounts of alcohol can lead to blood viscosity and high platelet levels. Using illegal drugs can also lead to stroke. For example cocaine can act on other risk factors such as hypertension, heart disease, or vascular disease and trigger a stroke (Senelick et al 33). After hypertension heart disease is the second most powerful risk factor for stroke. Diabetes is another disease that increases a persons risk for stroke. People with diabetes are three times more likely to experience a stroke.

Stroke not only takes a toll on the victims and families it also affects the rest of us. Financially stroke cost the U.S. and estimated 43 billion dollars a year. Cost for medical care is approximately 28 billion per year. Indirect cost such as lost productive is estimated at 15 million dollars per year. The average cost to care for a patient suffering from stroke is about 15 thousand dollars for 90 days. For about 10 percent of patients the cost exceeds 35,000 dollars for the first 90 days due to increase complications (Geriatric Times 37). The death rate among stroke victims has decreased significantly since the 1950’s, perhaps reflecting dietary changes as well as increased awareness of the dangers of hypertension and smoking. According to the American Heart Association (2003) 600,000 Americans each year suffer from stroke. The number killed from stroke is approximately 160,000 per year (AHA 2003).

“Generally there are three treatment stages: prevention, therapy immediately after a stroke and post stroke rehab. Therapies to prevent stroke are based on an individuals modifiable risk factors such as smoking or drug use. Acute therapies try and prevent the damage of stroke while it is happening. For instance taking an aspirin to thin your blood during a stroke will allow the blood to flow more easily”, (FDA 36). Post stroke treatment is done to over-come the disabilities associated with having a stroke. Medication, surgery, physical therapy and occupational therapy are some examples of post stroke treatment. Clinical trials are currently being done to advance the care of stroke victims. “There are currently 421 clinical trials being conducted that could in some way benefit the victims of stroke”, (AHA).

Currently I care for my 92 year old grandmother. She has been in good health until recently. A few weeks ago she experienced a mini-stroke and for the following 3 days her speech was slurred, her memory was sketchy, and she seemed continuously fatigued. After phoning her doctor I realized that she had fallen victim to a stroke. The symptoms came on very quickly and after 3 days they went away just as fast. This is undoubtedly a warning sign of a possibility of a bigger and more debilitating stroke. During the research of this paper I learned that strokes effect all ages. Before I began this research I was under the impression that strokes only affected older individuals. I read stories from people that have experienced strokes in their early 20’s and even some stories from mothers whose baby’s had strokes in the womb. This incapacitating disease cannot be prevented altogether but the number of strokes can be decreased greatly through educating people on the benefits of living a healthy lifestyle and ways of preventing stroke.

References

American Heart Association. (2003) Stroke . www.americanheart.org

Funk and Wagnall’s . New Encyclopedia. (1999) P.132

www.americanheart.org/funkwagnells

Geriatric Times. (Oct.2003) Recognizing and Preventing Stroke. 8-9

Harrar S. (April 2003) It Could Happen to You. Prevention. 132-39

J. C. Piscatella and B. A. Franklin. Take a Load Off Your Heart

(New York: Workman,2003) 162

R. C. Senelick, P. Russi, K. Dougherry and , Living With Stroke: A Guide for Families New York: McGraw-Hill. Contemporary, 1999 P. 33, 45, 53

T. Yannis MD. The Heart Disease Breakthrough . New York: John Wiley and Sons,

1995. 107