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Cerebrovascular accidents (CVA)

Stroke: definition

Stroke or stroke is commonly called "brain attacks." They correspond to a sudden stop of blood flow in the brain, either by blockage of an artery (known as ischemic stroke) or by rupture of a cerebral artery (called a hemorrhagic stroke).

Depending on the location and extent of the area of the brain affected, the consequences are very different from simple weakness in a limb to death through paralysis and coma.

Sometimes at the beginning of the stroke, signs and very discreet reversible as a difficulty using his hands and / or vision loss should alert fleeting: it is indeed a transient ischemic attack (TIA ) to be quickly diagnosed and treated.

Risks and consequences of stroke

Stroke is the third-leading cause of death and the leading cause of non-traumatic disability in adults in industrialized countries. Nearly 130,000 cases each year is to be deplored, causing 40 000 deaths. Ischemic stroke (or cerebral infarction) is the most common.

Stroke fit into the context of cardiovascular disease, for which prevention is a key (fight against risk factors such as hypertension, smoking, diabetes, high cholesterol or inactivity).

Causes and mechanisms of stroke

There are two mechanisms of stroke:

- In 80% of cases, it is the blockage of an artery in the brain that causes a lack of blood in a brain area more or less extensive. This obstruction is related to a blood clot (coagulated blood) promoted by cardiac arrhythmias such as atrial fibrillation or neck artery lesions. Aging arteries and age-related risk factors play a role. The affected area, rain fed, lack of oxygen and sugar, and dies (cerebral infarction);

- In other rarer cases, a rupture of an artery to the brain causing a stroke the consequences may be the same but the disease tends to occur in young adults, often regardless of risk factors for cardiovascular disease.

Signs and symptoms of stroke

Stroke occurs most often suddenly, in full activity or at rest.

Symptoms depend on the affected area and extent but are usually marked with:

- Paralysis (or weakness) may affect half of the body (hemiplegia), face or one member;

- Difficulty speaking (slurred, loss of words, unable to speak ...)

- Visual impairment (blindness in one eye, double vision, amputation of part of the visual field ...)

- Headache, impaired consciousness, coma;

- Epilepsy, loss of balance ...

Symptoms may be isolated or associated; in all cases, they require urgent care.

With what should we be confused?

Migraine is a diagnosis not to be confused. It will include the crisis can simulate a stroke only a history of migraine and a medical examination cause a change.

Similarly, some paralysis or sensory disturbances are due to diseases unrelated to stroke (a frigore facial paralysis, neuralgia ...): Again, it is best not to ignore them and consult the doctor to cause a change.

Is there a prevention possible?

Prevention is based on changes in lifestyle: smoking cessation, regular physical activity (30 minutes, three times per week) and dietary measures are priorities.

Other risk factors for cardiovascular disease such as hypertension, high cholesterol or diabetes must be controlled, if necessary with the help of medication.

Excessive alcohol consumption (more than three glasses of wine / day for men and two drinks / day for women) is also deleterious and should be reduced, as well as the intake of saturated fatty acids (butter, meat fat, cheese, charcuterie), in favor of mono-unsaturated (olive oil, rapeseed) or polyunsaturated fatty acids contained in fish, for example.

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