A Message from the Heart to the Heart
Prepared by:
Dr. Abdulwahab Arrazaghi
(Specialist of Internal Medicine and Cardiovascular Diseases)
University of Toronto, Canada

Stroke (Cerebrovascular Accident)

1. What is a stroke ?
A stroke is a life-threatening event, in which the brain's vital supply of blood is disrupted. A stroke can affect any center in the brain including speech, behavior, thought pattern and memory etc. It may also result in paralysis and eventually death.

2. What causes stroke ?
A stroke occurs when an artery to the brain ruptures or become blocked by a blood clot. This will lead to cutting off the supply of oxygen to that particular area affected by the blockage. Brain tissue that is deprived of oxygen dies within minutes as a result the part of the body controlled by these brain cells cannot function properly.
It is well known that the hypertension, high cholesterol, diabetes, smoking, and loss of exercise can accelerate atherosclerosis.

3. What are the presenting symptoms of stroke ?
These vary including sudden weakness or numbness of the face, arm, and leg usually involving one side of the body (unilateral). It may also present by loss of speech or trouble speaking or understanding a speech. Presentation can also include loss of vision more so involving one eye, unexplained dizziness, or unsteadiness of gait, or simply unexplainable fall. On other occasions, the presentation can be with a sudden severe headache.

4. How stroke is diagnosed and treated ?
A careful physical and neurological exam usually confirms the diagnosis. Urgent CAT scan of the head (computerized tomography of the brain) or an MRI (magnetic resonance imaging scan) can pinpoint the focal area involved in the stroke and also can give prognostic information to indicate the outcome based on the size of the area involved and the extent of brain damaged.
Treatment of stroke would involve urgent hospitalization. If a hemorrhage was ruled out; if he, or she fits specific criteria, will receive a clot buster administered through an intravenous injection. The purpose of that is to dissolve the clot blocking the vessel at that time; and this has been shown to improve not only the patient's survival, but diminish the residual weakness if any after an event of stroke.