I. Definition.
Stroke, commonly known as a “stroke,” is an acute illness caused by disease of the blood vessels that carry blood to the brain (cerebrovascular). Stroke causes irreversible damage to brain tissue and usually occurs when a blood vessel in the brain breaks or becomes blocked. If nerve cells lack sufficient oxygen supply, they die within minutes. The body functions controlled by these nerve cells are then lost. Because dead brain cells cannot regenerate, the consequences of a stroke are usually permanent.
II. Etiology.
The main risk factors for the development of stroke are hypertension, coronary heart disease, diabetes, hyperlipidemia, smoking, alcohol consumption, and obesity. Other factors include: atherosclerosis, collagen disease or arteritis causing intimal hyperplasia and hypertrophy, carotid artery trauma, tumor compression of the carotid artery, carotid artery thrombosis associated with pediatric cervical lymphadenitis and tonsillitis, and cervical spondylosis or cranial base compression of the vertebral artery can cause stroke.
III. Classification.
Strokes are usually divided into two categories: ischemic strokes and hemorrhagic strokes.
1. Ischemic strokes mainly include.
(1) transient ischemic attack (TIA), which is a transient, ischemic, focal damage to brain tissue resulting in functional impairment.
(2) Cerebral infarction, including cerebral thrombosis and cerebral embolism. (1) Cerebral thrombosis, which mostly develops from blockage of blood clots formed by local lesions of cerebral vessels caused by atherosclerosis, various arteritis, trauma and other physical factors, and blood disorders. ② Cerebral embolism, which can be induced by the emboli produced by various diseases entering the bloodstream and blocking the blood vessels in the brain. Clinically, heart disease is the most common cause; followed by fracture, or fat into the blood after trauma; worm eggs or bacterial infection; air into the blood such as pneumothorax, emboli formed by phlebitis, and other factors, embolism caused by cerebral vessels.
2. Hemorrhagic stroke mainly includes.
(1) cerebral hemorrhage, which refers to the ruptured blood vessels of the brain parenchyma bleeding, excluding traumatic cerebral hemorrhage. Mostly caused by hypertension, cerebral atherosclerosis, tumors, etc.
(2) Subarachnoid hemorrhage, caused by rupture and bleeding of blood vessels on the brain surface and at the base of the brain, with blood flowing directly into the subarachnoid space. Common causes include ruptured aneurysm, vascular malformation, hypertension, arteriosclerosis, blood disorders, etc.
IV. Prevention.
1. When to start stroke prevention
Stroke prevention should start at an early age. This is because pathological changes in atherosclerosis often begin already in childhood and get progressively worse with age, mainly related to high fat content in food and high sugar diet leading to obesity at an early age. Hyperlipidemia and obesity are the main causes of atherosclerosis. From early childhood, proper control of high cholesterol and high sugar food intake, more fruits and vegetables; develop the habit of not eating in a partial and excessive manner; actively participate in various sports and develop good living habits, which are extremely beneficial to people’s life.
2.How to prevent
(1)Primary prevention
The purpose of primary prevention is to reduce the risk of stroke for those who have stroke risk factors but have not yet had a stroke. Since hypertension is the most important risk factor, the presence or absence of hypertension should be determined first, and the blood pressure should be controlled within a reasonable range by appropriate treatment. Diabetes should also be controlled by diet and medication, if needed. Close monitoring of blood lipids including cholesterol levels, dietary changes and medication as necessary can normalize blood lipids. Smoking cessation and avoidance of excessive alcohol consumption are also essential.
If the patient has had a previous episode of TIA, a thorough examination is needed to determine the cause of the TIA and to prevent a possible future stroke by treating the cause.
Patients with arrhythmias (e.g., atrial fibrillation) and other heart conditions (e.g., prosthetic valves and cardiomyopathy) should also be treated with long-term medications to prevent stroke.
(2) Secondary prevention
If a patient has a history of TIA or stroke, the risk of having another stroke is very high. Secondary prevention means to avoid the risk of recurrent stroke in those patients who have had a stroke by various methods. In these patients, a thorough examination and evaluation should be performed to determine the cause of the disease. Although each patient should be evaluated individually, the general principles of developing a treatment strategy are the same. Some patients are not suitable for particular treatments because of potential side effects or other medical problems. Therefore, a thorough physical examination and diagnostic tests should be performed prior to treatment to determine if the patient is able to receive treatment. It is also important to educate patients about the signs and symptoms of stroke and TIA and to ask them to name which signs and symptoms they have had.