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Cerebrovascular accidents (CVA): Stroke: definition

Stroke: definition

Stroke or stroke are 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 are 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 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, rainfed, 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.

Stroke Prevention Stroke

With what should we be confused?
Migraine is a diagnosis not to be confused. Will include the crisis can simulate a stroke only a history of migraine and a medical examination make a difference.

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 make a difference.
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.

Cerebrovascular accidents (CVA) Preparing consultation

When to consult?

Stroke is a medical emergency call the SAMU Centre 15 is essential to organize relief, the diagnosis and provide treatment in a medical unit neurovascular example.

The symptoms are sometimes transient (weakness of a member who declines, loss of vision and normal vision ...) these signs should be taken seriously as they may evolve into a more serious accident and definitive.

What is the doctor?
The doctor will confirm the diagnosis by clinical examination and additional tests such as CT scan. The scanner can most often highlight hematoma, infarct zone or any other cause. At a very early stage of ischemic stroke, the scanner can be normal while MRI allows more accurate diagnosis and early.

Other tests are available to determine the cause of the accident, such as Doppler of the neck vessels, electrocardiogram or Holter (continuous recording over 24 hours).

Treatments vary depending on the type of stroke, the period of care and scope.

Ischemic stroke may benefit from treatments to unblock the artery (thrombolysis), hemorrhagic stroke treatment stopping the bleeding or draining the hematoma.

How to prepare my next visit?
After stroke begins a phase of active rehabilitation to continue sometimes years. Compliance with prescribed medication regimens and examinations to be performed is essential to prevent recurrence. Tell your doctor about any difficulty in the proper observance, as well as any change in lifestyle.

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