Stroke 2 by

Our Problem: Stroke

osnedeke — 2023-08-31 20:05:41 UTC

We chose to study strokes because it is the number 5 cause of death in America. Many people have family members, close friends, or relatives who have suffered from a stroke, so it is important to learn more about them. This allows us to be more prepared, proactive, and aware of strokes and about who is most at risk.

Who is most likely affected by a stroke?

osnedeke — 2023-08-31 20:09:28 UTC

People 55 or older are most at risk than younger people.

Most Common Causes of Stroke

ahkim9 — 2023-08-31 20:10:00 UTC

1. blocked artery (ischemic stroke)
- It happens when the brain's blood vessels become narrowed or blocked, causing severely reduced blood flow. This is caused by fatty deposits that build up in blood vessels or by blood clots or other debris that travel through the bloodstream, most often from the heart, and lodge in the blood vessels in the brain.
2. leaking or bursting of a blood vessel (hemorrhagic stroke)
- Hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect the blood vessels.
Some common reasons:

Uncontrolled high blood pressure
Over-treatment with blood thinners (anticoagulants)
Bulges at weak spots in your blood vessel walls (aneurysms)
Trauma (such as a car accident)
Protein deposits in blood vessel walls that lead to weakness in the vessel wall (cerebral amyloid angiopathy)
Ischemic stroke leading to hemorrhage

Genetics

mecox7 — 2023-08-31 20:12:20 UTC

Genetic factors also play a role in strokes. Genetic disorders like sickle cell disease can increase the chances of having a stroke. People with a family history of strokes are also more at risk because they may share common environments and other potentially similar factors that may increase their risk. When genetics combines with unhealthy lifestyle choices, like smoking and having a poor diet, chances for stroke also increase.

Medical Risk Factors

hmmclain — 2023-08-31 20:12:35 UTC

Strokes can have an increased likelihood due to smoking, high blood pressure, diabetes, and cardio vascular disease. To avoid strokes, doctors encourage a healthy diet and consistent exercise.

African Americans and Hispanics

rliu141 — 2023-08-31 20:13:55 UTC

African Americans and Hispanics have the highest rate of stroke than any other race or ethnicity. Per 100,000 population, 223 African Americans, 196 Hispanic Americans, and 93 white Americans had strokes when adjusted for age. African American adults are also 45% more likely to die, the highest rate of death, followed by Hispanic Americans.

Middle Cerebral Artery

hmmclain — 2023-09-07 19:54:04 UTC

Commonly in a stroke, the middle cerebral artery becomes blocked. Clots form in the brain slowly over time-caused by fatty plaques in a process called atherosclerosis- eventually clogging arteries or causing blood vessels to break, leading to damage in the brain.

Atherosclerosis

ahkim9 — 2023-09-07 20:00:39 UTC

Commonly referred to as “hardening of the arteries,” is a pathological process in which calcified lipid or fatty deposits from the flowing blood accumulate circumferentially. The plaques form, the walls become thick, fibrotic, and calcified, and the lumen narrows, reducing the flow of blood to the tissues the artery supplies.

Blood Vessel Hemorrhagic Stroke

osnedeke — 2023-09-07 20:03:36 UTC

In some cases the brain doesn't receive enough oxygen causing brain leaks and ruptures of the vessels.

Hemorrhage and Vasospasm

rliu141 — 2023-09-07 20:04:25 UTC

Hemorrhages occur after the blood vessels weaken and eventually rupture. Blood seeps into the surrounding brain tissue which clots, accumulates, and compresses from the displaced volume. This causes enlargement. Vasospasms come when the contraction of these blood vessels causes a narrowing of the arteries.

Thrombus and Reduced Systemic Pressure

mecox7 — 2023-09-07 20:06:40 UTC

A sudden increase in blood pressure increases the risk of an ischemic stroke. This is because high blood pressure can damage blood vessels, making them less flexible and more vulnerable to blood clot formation. These blood clots (thrombus) cause blocked arteries. Because of this, the brain tissue is prevented from getting oxygen and nutrients. Within minutes the brain cells begin to die, and the neurons are unable to send messages down the axons to one another.

symptoms of a stroke

ahkim9 — 2023-09-14 19:57:03 UTC

The beginning of a stroke may entail a sudden difficulty of walking, dizziness, loss of balance, or lack of coordination

symptoms of a stoke

ahkim9 — 2023-09-14 19:58:07 UTC

One symptom of a stroke can be having trouble seeing in one or both eyes

Symptoms: Numbness/Weakness

mecox7 — 2023-09-14 19:58:17 UTC

A common symptom of stroke is sudden numbness/weakness in the face, arm, or leg. This is usually limited to one side of the body

Treatment One: Thrombolysis.

hmmclain — 2023-09-14 19:58:50 UTC

Thrombolysis is a medicine that clears blood clots and vesicles, especially in the region around the brain and heart. It is administered to stroke patients with the intent of returning blood flow to the brain, hopefully healing the impacted area before cell death and degradation.

Treatment Two: Carotid Endarterectomy

osnedeke — 2023-09-14 19:59:10 UTC

Carotid endarterectomy is surgery to treat carotid artery disease. The carotid arteries are the main blood vessels that carry oxygen and blood to the brain. In carotid artery disease, these arteries become narrowed. This reduces blood flow to the brain and could cause a stroke.

Symptoms: Sudden Confusion

mecox7 — 2023-09-14 20:00:33 UTC

Another warning sign or symptom of a stroke is sudden confusion. This can be detected by trouble speaking, understanding, disorientation, etc.

MRI Diagnosis

rliu141 — 2023-09-14 20:03:52 UTC

An MRI is typically done to diagnose a stroke because it can detect damage done by an ischemic stroke and brain hemorrhages. Also, the doctor can specify a dye into the blood vessel which can let the doctor see the blood flow through the arteries to see where the blood clot is.

CT Scan Diagnosis

rliu141 — 2023-09-14 20:05:04 UTC

Computed tomography (CT) uses X-rays to take clear, detailed pictures of your brain. It is often done right after a suspected stroke. A brain CT scan can show whether there is bleeding in the brain or damage to the brain cells from a stroke.

Changes to Memory

hmmclain — 2023-09-21 19:48:29 UTC

After experiencing a stroke, many people report a loss of memory from around the time of the event and onward. This occurs because of damage to the hippocampus, the portion of your brain responsible for creating and encoding long term memories.

Insomnia

rliu141 — 2023-09-21 19:48:42 UTC

Insomnia is common in stroke patients and affects 20–56% of them. About 18% of the people reported new-onset insomnia after their stroke. Insomnia typically occurs in the setting of the acute phase of the stroke.

Paralysis

ahkim9 — 2023-09-21 19:51:55 UTC

Paralysis is the loss of voluntary muscle movement. It usually occurs on the side of the body opposite to the side of the brain that the stroke has damaged.

A severe example is the locked-in syndrome which occurs when there is severe damage to the brain stem which can occur after a stroke.

People with locked-in syndrome are usually aware of what is happening around them but cannot speak, move, or show facial expressions. They can only communicate through eye movements or blinking.

Trouble Speaking and Understanding

mecox7 — 2023-09-21 19:56:34 UTC

A common long-term effect of strokes is aphasia. There are many different types of aphasia like Broca's aphasia and Wernicke’s aphasia. Broca's aphasia is characterized by the inability to produce speech, but comprehension remains intact. Wernicke's aphasia is when individuals are able to say words, but the meaning is unclear even though their hearing remains intact. Both are common long-term consequences of stroke.

Speech Therapy

rliu141 — 2023-09-28 19:56:41 UTC

The first diagnostic evaluation for speech therapy usually costs between $150-400. Half an hour sessions cost $65-175, but this varies based on geographical location and instructor expertise. Many stroke patients have damage to their brain's speech center. This means that many stroke patients cannot speak yet, so speech therapy becomes medically necessary. Speech therapy is not covered on many insurance plans, so many suggest going to a low-cost clinic instead. However, because stroke is considered a critical condition, insurance companies may deem speech therapy medically necessary.

Prozac (fluoxetine)

hmmclain — 2023-09-28 20:02:22 UTC

Prozac is a medicine often prescribed to aid patients with aggression or behavioral disorders that are present after extreme cases of stroke. If the doctor deems it necessary to treatment, insurances will often cover it, but if the patients does not qualify for any reason, the medicines can range up to 500 dollars. If a patient does not receive Prozac when its prescribed, then can suffer from continual behavioral disorders- sometimes permanently.

Occupational Therapy

mecox7 — 2023-09-28 20:02:33 UTC

For patients not covered by health insurance, occupational therapy typically costs about $150-$200 for an initial evaluation, then $50-$400 per hour, depending on the type of service and the provider. Occupational therapy typically is covered by health insurance in certain cases. For example, Aetna considers short-term occupational therapy medically necessary to help regain daily living functions lost as a result of an injury or illness, but typically does not cover it when the primary diagnosis is mental retardation or developmental delay. Some policies limit the total number of sessions. For patients covered by health insurance, typical out-of-pocket costs consist of coinsurance of 10%-50% and copays for any required medical devices. The American Occupational Therapy Association states that stroke patients who receive occupational therapy are “significantly less likely to deteriorate and more likely to be independent in their ability to perform activities of daily living and the end of treatment.”

Psychotherapy

rliu141 — 2023-10-05 20:02:11 UTC

Psychotherapy is the quintessential form of therapy that involves talking with a licensed therapist. This helps via talking about emotional issues. Psychotherapy can be useful to help stroke patients with post-stroke depression and other depressive symptoms or anxiety. The professionals that are licensed for psychotherapy include psychologists, psychiatrists, social workers, licensed professional clinical counselors, licensed marriage and family therapists, pastoral counselors, and psychiatric nurse practitioners.

Cognitive behavior therapy (CBT)

mecox7 — 2023-10-05 20:04:03 UTC

CBT focuses on identifying and modifying negative thoughts, beliefs, and behaviors. It helps individuals develop healthier coping strategies and adapt to the emotional and behavioral changes after a stroke. This helps with the short-term effects as the patients learn how to control the new behaviors they have, as well as the long-term effects because the effects of stroke can be life-long. This can be delivered by psychiatrists, psychologists, mental health nurses, and general practitioners.

Speech Therapy

rliu141 — 2023-10-12 19:57:31 UTC

Speech therapy is used to help aphasia. This can help with pronunciation, grammar, voice quality, fluency, and articulation. The professional who gives this type of therapy is a speech and language pathologist.

Mirror Therapy

mecox7 — 2023-10-19 19:59:46 UTC

Mirror therapy is when a mirror is used to create a reflective illusion of an affected limb in order to trick the brain into thinking movement has occurred without pain, or to create positive visual feedback of a limb movement. It involves placing the affected limb behind a mirror. The mirror is positioned so the reflection of the opposing limb appears in place of the hidden limb. The short-term and long-term effects of a stroke mirror therapy treat are limb coordination and more long-term nerve damage. The type of professional that does mirror therapy is a physical therapist.

Stop Smoking

rliu141 — 2023-10-26 19:26:10 UTC

One lifestyle change after a stroke that a patient would have to adapt to is to stop smoking. Smoking damages and tightens blood vessels increasing the risk of a stroke, so quitting would be necessary for some stroke patients. On a scale of 1-10, it would be a difficulty of 9 because it is addictive. The professional that would help with this would be a smoking cessation advisor.

Disabilities

hmmclain — 2023-10-26 19:27:13 UTC

Stroke attacks can leave a victim with multiple disabilities, including losing the ability to walk, and the ability to speak. To recover and adapt to these lifestyle changes, stroke victims will meet with a range of staff to help them with rehabilitations into society, ranging from physical therapists, personal therapists, speech therapists, psychologists, and pharmacists. These changes range in difficulty, but many would be high, around 8-10/10.

Obesity

mecox7 — 2023-11-02 20:05:30 UTC

Obesity can lead to multiple complications after experiencing a stroke, ranging from more difficult surgeries and certain medicines/physical therapies that cannot be administered due to their higher BMI and blood pressure, or lack of physical ability.

Elderly

rliu141 — 2023-11-02 20:06:19 UTC

The elderly are more affected by a stroke primarily because they have high blood pressure and diabetes. In addition to this, the elderly have to manage multiple conditions, making healthcare more difficult to receive.

Eating Healthy

mecox7 — 2023-11-09 19:55:10 UTC

One preventative measure that could reduce the risk of a person having a stroke is eating a healthy, balanced diet. A healthy diet includes plenty of fresh fruits and vegetables. Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol. Limiting salt (sodium) in your diet can also lower your blood pressure. Some challenges people would face are healthy food is often more expensive than unhealthy food. Some people might not have access to healthy foods.

Regular Physical Activity

rliu141 — 2023-11-09 19:57:01 UTC

Regular physical activity can reduce the risk of a stroke by strengthening neurological pathways and increasing bone density and muscle mass thus lowering injury risk. This can include leisurely low intensity state state cardio like walking which is recommended for stroke patients to prevent a future stroke and can gradually build up to resistance training. However, regular physical activity differs from training exercises in that it is consistent and unplanned and a part of daily life. This decreases the susceptibility to quitting due to lifestyle or other changes. The consistency of regular physical activity also helps blood flow which is important to preventing a stroke caused by blood clotting.

Exercise

hmmclain — 2023-11-09 19:57:21 UTC

To avoid Strokes, especially in the elderly, exercise is crucial to keep blood pressures low and to clear the build up of cholesterol in the blood stream. Even light jogging for half an hour a day can go a long way in improving cardio health and blood pressure health. Beginning exercise can be difficult for many who have not done it before, or are out of shape. Clearing the initial effort may require meetings with dietitians and PT's.

Wearable Monitor Devices

osnedeke — 2023-11-16 19:49:17 UTC

For patients that are stroke prone, or have a history of strokes, there are wearable devices that can monitor the heart rate and muscle flexion of the patient. If the device determines the patient may be undergoing a stroke, it will prompt an interactive pop up. If this is not reacted to, the device can contact healthcare workers or 911 for the patient. These devices can malfunction, which can result in improper readings or inappropriate contact of authorities.

Functional Electrical Stimulation

mecox7 — 2023-11-16 19:50:27 UTC

Functional electrical stimulation is used to help treat the effects of strokes.
In functional electrical stimulation, electricity is applied to weakened muscles, causing them to contract. The electrical stimulation may help reeducate your muscles which is a treatment and form of rehabilitation for stroke patients. The risks include irritation or infection at the site of electrode placement (internal and external systems), scar tissue that forms around the electrode (called encapsulation), broken wires, and electrodes that move after placement.