A Stroke in a Nutshell

What exactly is a stroke? A stroke is a sudden interruption of blood flow to a specific area of

the brain. As a consequence, nerve cells die of oxygen deprivation .

The tasks controlled by the affected brain region(s), are specifically impaired (e. g. vision or other sensory perceptions die Empfindung , muscle control, speech, memory etc.). Four major types of strokes are differentiated:

Ischemic ischämisch stroke:

When an artery that supplies the brain with oxygenated blood

becomes blocked by a blood clot, we call it an ischemic (reduced

blood flow) stroke.

There are two ways an ischemic stroke can occur :

• Embolic stroke

When a clot (embolus) forms somewhere in the body and travels through the bloodstream to the brain. In the brain it reaches a blood vessel which is too small for the clot and then immediately it gets stuck and stops blood from passing through.

• Thrombotic stroke

“Plaques” can form on the inner wall of the arteries. If so, plaques

(thrombus) may enlarge until they more or less completely block

the artery and stop the blood flow (often the major arteries in the

neck are affected).

Hemorrhagic stroke:

We talk about a hemorrhagic stroke when a vessel ruptures in the brain. When this happens, blood leaks into the brain and the delivery of oxygen is interruped. Although at only 15 % of all strokes it is less common than the ischemic stroke, it is still far more dangerous.

We differentiate between two types of haemorrhages, according to their location in the brain:

• Intracerebral haemorrhage:

An artery deep inside the brain bleeds directly into the brain tissue.

In most cases hypertension or aged-arteries cause this type of stroke.

• Subarachnoid haemorrhage (SAH):

This is a bleeding on the brain surface and into the brain liquorfilled subarachnoid space. The bleeding often occurs at an ( innate ) cerebral aneurysm das Aneurysma .

Transient ischemic (TIA) stroke attack:

Also known as a mini-stroke, it is a temporary blockage of blood supply and occurs when a clot or debris blocks the blood flow to part of your nervous system. The brain cells start dying, and the patient experiences signs that something is wrong. After clearing, the brain region gets oxygen again and the symptoms disappear. During a TIA, the brain is not permanently damaged , but after experiencing a TIA, the risk of a stroke is higher.

Childhood stroke:

Each year about 0.002 % of all children may experience a stroke. In very rare cases a stroke occurs in unborn babies. The causes of this kind of stroke are not fully understood. It is also a result of blood supply disruption . A stroke in infants is very difficult to diagnose. We do know that a number of medical conditions can increase the chance of having a childhood stroke. But almost a quarter das Viertel of all children do not have any of these risk factors. It is unknown, why these children may then have a stroke.

Common risk factors for strokes in children are:

• heart disease (congenital heart defects) or heart surgery

• head injury, brain tumors, some types of cancer

• dehydration

• disease of the arteries (abnormal blood vessels in the brain)

• abnormal blood clotting

• low blood count

• prolonged low blood pressure

• some viral infections

• major infections around the ear sinuses or nose

• sickle cell disease and thalassaemia

• immune disorders

• central venous catheters

• head or neck trauma

• pregnancy related high blood pressure in the mother

• maternal history of infertility

• maternal infection in the fluid surrounding an unborn baby

• pregnancy related high blood pressure in the mother

Cryptogenic strokes:

There are some strokes where the unknown cause(s) are unknown: these are called cryptogenic strokes.

Which general symptoms does a stroke patient experience? Watch out for the following signs if you think that you or someone else is suffering from a stroke. Keep an eye on the duration, it can affect your treatment options.

• Difficulty forming words and trouble with understanding

• Paralysis or numbness of the face, arm or leg

• Difficulty swallowing

• Trouble with seeing in one or both eyes

• Headache

• Trouble with walking

• Weakness

• Nausea, vomiting

The F.A.S.T. test The Australian Stroke Foundation recommends the F.A.S.T. test as an easy way to remember the most common signs of stroke.

Using the F.A.S.T. test involves asking four simple questions:

Face Check their face. Has their mouth drooped ?

Arms Can they lift both armes?

Speech Is their speech slurred ? Do they understand you?

Time Is critical. If you see any of these signs call 112 straight away.

http://www.strokefoundation.com.au/

What risk factors are already known? There are some risk factors you can control:

• High blood pressure

• Smoking

• Diabetes

• Unhealthy Diets

• Physical Inactivity

• Obesity

• High Blood Cholesterol

• Carotid Artery Disease

• Peripheral Artery Disease

• Atrial Fibrillation

• Other Heart Disease

• Sickle Cell Anemia

There are some risk factors you can’t control:

• Age

• Family History

• Race

• Gender

• Prior Stroke , TIA or Heart Attack

. . . and there are some additional factors:

• Geographic Location

• Socioeconomic Factors

• Alcohol Abuse

• Drug Abuse

• Sleep Habits

What tests are performed in hospital after a stroke? Common tests include:

• Physical examination

• Brain scans (CT and MRI of the brain)

• Heart tests (ECG and echocardiogram)

• Blood tests

• Other tests (Transcranial Doppler, Cerebral angiogram, Carotid duplex, urine tests or chest x-rays)

Immediate treatments:

After the diagnostic tests, the doctors will start with emergency treatments specific to the type of stroke you suffer from:

• In case of an ischemic stroke, doctors will try to quickly restore blood flow to your affected brain area. The blood clot must be removed to allow blood to flow again.

• The treatment of hemorrhagic stroke comprises stopping the blood loss and reducing the pressure in your brain. Often, surgery is performed.

• Following the immediate treatment; patients need to undergo a substantial recovery period and often a course of rehabilitation. The goals are to recover as many functions of the damaged brain parts as possible and to return the patient to independent living.

EXERCISE: 1. What is the most important modifiable risk factor for stroke?

a. Blood pressure b. Diabetes c. Smoking

2. The two major types of stroke are ischemic and hemorrhagic.

a. True b. False

3. What does stroke mean?

a. Bleeding in the brain from a blood vessel b. Loss of oxygen to part of the brain c. Blocked blood vessel in the brain d. All of the above

You’ll find the answer on: http://tinyurl.com/weiterbildung-englisch

BIBLIOGRAPHY 1. http://dict.leo.org. 2. www.dict.cc. 3. www.webster-dictionary.org. 4. http://www.strokefoundation.com.au/. 5. http://www.stroke.org.uk/. 6. Torbey MT, Selim MH: The Stroke Book, 2nd edition, Cambridge University Press 2013. 7. Taylor JB.: Mit einem Schlag, Knaur 2006.

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTA. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten. Kontakt: mail@lobitz-seminare.de www.lobitz-seminare.de

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Lösung für Exercise: Answer: 1. a Answer: 2. a Answer: 3. d

A Stroke in a Nutshell

What exactly is a stroke?

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A Stroke in a Nutshell

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