Stroke or Cerebrovascular Disease - Case Study Example

CEREBROVASCULAR DISEASE OR STROKE Introduction Stroke or cerebrovascular disease is caused by a disturbance in the blood vessels supplying blood to the brain and subsequently a rapid loss of brain’s functionality can be noticed. There are two causes behind it. In the first place ischemia or lack of blood supply caused by thrombosis or embolism can serve as the trigger. Secondly, a hemorrhagic condition in a blood vessel could trigger it off. The etymology of the word “stroke” can be traced back to the Latin word icere which means “to strike”(Medical Encyclopedia). A number of risk factors have been identified by researchers in the latest medical literature and they include old age, high blood pressure or hypertension, diabetes, cigarette smoking mild stroke or transient ischemic attack (TIA), diabetes, high levels of Low Density Lipoproteins or bad cholesterol, cigarette smoking, atrial fibrillation, the contraceptive pill, migraine with aura, and thrombophilia. Hypertension is said to be the most noticeable causal factor in stroke contributing for almost 50% of the attacks(NINDS). The symptoms include numbness or weakness of face, arm, or leg, especially on one side of the body, dizziness or loss of balance while walking, confusion or difficulty in speech or understanding speech, difficulty in seeing or blurred eye-sight in one eye or both the eyes and sudden severe headache with no known cause. The epidemiology of the disease has been particularly varied and complex, though treatment regimes necessarily focus on the primary causal factors such as hypertension, diabetes and LDLs. Above all resistance to aspirin, the least-costly treatment pill, has been a cause for worry among the medical fraternity. Analysis Stroke has become the number three killer in many European and North American countries, including the USA. Heart disease and stroke go hand in glove and claim many lives in these countries. Current research efforts by scientists are focused on the study of the mechanisms of stroke risk factors and the process of brain damage that results from stroke. According to them initial brain damage is caused by the lack of blood flow to the brain tissue. But it is the secondary phase of brain damage that is very important in understanding both the pathology and epidemiology of the disease. According to researchers the secondary phase is caused by a toxic reaction to the primary damage and mainly involves the excitatory neurochemical,“glutamate”(National Stroke Association). Epidemiology of stroke deals with the incidence, distribution and control of the disease in a population. Naturally an excess amount of glutamate in the brain could cause the release of more toxic chemicals, thus causing damage to brain cells. It is here that the researchers are trying to establish a link between the most vulnerable population and the incidence of stroke. Many years ago, scientists noticed with alarm that people in the southeastern states had the highest stroke mortality rate in the USA. They in fact came to the conclusion that the rise in the incidence of stroke in the region was due to the high level of concentration of African-Americans there (NINDS). The link between poverty and poor healthcare was suspected. They named this region the stroke belt. However, subsequent developments in research indicated that there were other risk factors that contributed to the higher incidence of stroke than poor healthcare. Higher mortality rates due to stroke can be attributed to a multiplicity of risk factors including genetics and modifiable lifestyles. These two groups of risk factors are said to be the most worrying right now because they are very difficult to track (Taylor, 2008, p.39). Cigarette smoking is the most potential modifiable risk factor for stroke. Smoking almost doubles a persons risk for ischemic stroke, irrespective of other risk factors, and according to scientists smoking increases “a persons risk for subarachnoid hemorrhage by up to 3.5 percent”. Smoking is said to have a direct greater toll on the number of deaths due to stroke among young adults than in older adults. On the other hand risk factors like hypertension, heart disease and diabetes account for a greater number of strokes in older adults(American Stroke Association) Heavy alcohol consumption as against moderate drinking is another modifiable risk factor for stroke. It is a well known fact that heavy presence of alcohol in blood leads to high blood pressure. Though scientists hold the view that heavy drinking is a risk factor for both hemorrhagic and ischemic stroke, there is considerable amount of empirical evidence to prove that daily consumption of moderate amounts of alcohol could have some benefits to the drinker’s health, probably because alcoholic beverages reduce the clotting ability of platelets in the blood. Moderate alcohol consumption may have the same impact that aspirin has in decreasing blood clotting and preventing ischemic stroke(Pubmed.com). Heavy alcohol consumption, on the other hand, might seriously diminish platelets in blood and jeopardize blood clotting and blood viscosity (thickness) in a manner that would lead to a hemorrhagic condition(Doidge, 2007, p.132). Psychological factors and heavy drinking have been correlated to produce a common causality in hemorrhagic condition, though scientists do not agree on a common risk factor for a particular population stock. Ethnicity and other demographic variables have attracted the attention of high profile researchers in the USA recently, specially at the PUBMED. Conclusion Stroke is someties treated with thrombolysis (clot-busting technology), but there has been an ever increasing emphasis on physiotherapy and occupational therapy so that physical causal factors such as variations in blood cells counts and so on could be used to diagnose the latent development of the disease. This kind of supportive care puts the patient effectively on surveillance. When the patient is diagnosed with a progressive stage of the disease secondary prevention methods such as anti-blood clotting or antiplatelet drugs may be prescribed. Aspirin and very often dipyridamole are prescribed for patients who have been put on regular surveillance (Medscapetoday). Further drugs might be prescribed to control blood pressure with the attendant benefits of reduced blood pressure and reduced risk. Another treatment technique is the anticoagulation drugs given to selected patients who might suffer from a higher incidence of blood clotting.(Pubmed.com). However it must be noted that stroke patients are increasingly developing resistance to aspirin. Recent studies have suggested that some patients may not obtain the full benefits of aspirins antiplatelet effects. An international roundtable of experts was held November 6, 2004, in New Orleans, Louisiana, to address the concept of aspirin resistance and its clinical implications. Finally it must be noted that effective treatment depends on the historical case study of the patient(BBC, health conditions). REFERENCES 1. Taylor, Jill Bolte, (2008), My Stroke of Insight: A Brain Scientist’s Personal Journey, New York, Penguin Group. 2. Doidge, Norman (2007), The Brain That Changes Itself: Stories of Personal Triumph, From the Frontiers of Brain Science, New York, Penguin Group. 3. Peterson Powers, (2008), Aspirin Resistance, Fact and Fiction, Retrieved on June 24, 2008 from www.medscape.com 4. National Institute of Neurological Disorders and Stroke, Stroke: Hope Through Research, Retrieved on June 24, 2008 from www.ninds.nih.gov/disorders/ 5. BBC- Health – Conditions, Retrieved on June 24, 2008, from www.bbc.com 6. Pubmed, Guidelines for Prevention of Stroke, Retrieved on June 24, 2008 from www.ncbi.nlm.nih.gov 7. Pubmed, Anticoagulant Patients Information, Retrieved on June 24, 2008, from www.ncbi.nlm.gov 8. National stroke Association, ACCORD Results Show Increased Mortality With Aggressive Diabetes Treatment, Retrieved on June 24, 2008 from www.stroke.org 9. American Stroke Association, Stroke Risk Factors May Signal Faster Cognitive Decline in Elderly, retrieved on June 24, 2008, from www.strokeassociation.org 10. Medlineplus, Medical Encyclopedia, Retrieved on June 24, 2008 from www.nlm.nih.gov/medlineplus 11. Stroke – Heart and Stroke Foundation of Canada, retrieved on June 24, 2008 from www. heartandstroke.com 12. National Institute of Neurological Disorders (see above) Read More