Stroke Essay
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Stroke, an injury to the brain from failure in blood flow or bleeding leaves millions of human beings disabled. This is one of the most devastating and costly health problems that society faces.
It affects more than 500,000 Americans each year, although Americans managed to cut the stroke death rate nearly in half during the 1970's and 1980's the 1990's is the Decade of the Brain. The nonfatal strokes, which have been decreasing along with the stroke death rate, now appear to be increasing for unknown causes. Of the more than three million Americans who have survived a stroke, more than two million end up with crippling disabilities, including paralysis, loss of speech, and lapses of memory.
Stroke (cerebrovascular accident, CVA) is a broad term, since it refers to almost any occurrence that prevents adequate amounts of blood from reaching a portion of the brain, which in turn causes brain cells to die. This may happen either over a period of time or quite suddenly, depending on the cause. The number of cells involved effects the persons' outcome.
A stroke or "brain attack" is usually the result of progressive disease that develops over many years. A stroke occurs when brain cells die because of inadequate blood flow. When blood flow fails, brain cells are robbed of vital supplies of oxygen and nutrients. Some strokes have little recognizable effect. Other can quickly cause death. While not usually fatal, a blockage of a blood vessel in the brain or neck is the most frequent cause of a stroke. It can leave a portion of dead tissue in the brain, called a cerebral infarction, which can result in a disability. These blockages come from three different conditions thrombosis, the formation of a clot within a blood vessel of the brain or neck. Embolism, the movement of a clot from another part of the body to the neck or brain. Stenosis, is a severe narrowing of an artery to the brain. About 80 percent of all strokes are caused by blockage and the other 20 percent from bleeding.
A haemorrhagic stroke can result from bleeding into the brain called intracerebral hemorrhage or into the space surrounding the brain called subarachnoid hemorrhage. While, less common than either cerebral infarction or intracerebral hemorrhage , subarachniod hemorrhage can frequently lead to death. Many strokes could be prevented by paying attention to the waring signs and risk factors.
Having a risk factor for stroke doesn't necessarily foretell a stroke. Conversely, not having a risk factor doesn't mean a stroke can't occur. But the risk of a stroke goes up as both the number and the severity of risk factors increase. A physician can identify and help treat and monitor the progress of many of these warning signs and risk factors.
WARNING SIGNS
* SUDDEN WEAKNESS, NUMBNESS OF THE FACE ARM AND/OR LEG
* TEMPORARY DIFFICULTY OR LOSS OF SPEECH, OR TROUBLE UNDERSTANDING SPEECH
* UNEXPLAINED HEADACHES OR CHANGE IN THE PATTER OF HEADACHES
* DOUBLE VISION WHICH LASTS FOR A SHORT TIME
* TEMPORARY UNSTEADINESS OR DIZZINESS
RISK FACTORS
* HIGH BLOOD PRESSURE
* CIGARETTE SMOKING
* HEART DISEASE
* DIABETES
* TRANSIENT ISCHEMIC ATTACKS
A person who has had a stroke appears, literally, to be stricken down. He or she may be partially paralysed, speechless, and sometimes, unconscious. If cells that control the movements of the arm are involved, the person will be unable to move his or her arm. However, if the cells that are destroyed only carry instruction from the controlling centre to the muscles, new pathways many are made that utilize other nerves which bypass the damaged area or areas.
In such a case although the patient may be unable to move his arm at first, he will gradually regain control of the muscles used in the arm movements. The disturbance in circulation maybe due to any one of the following factors:
1) A small percentage of strokes are caused by a cerebral embolism which is a small clot of blood circulating in the bloodstream, lodges in one of the tiny blood vessels in the brain. Since blood cannot pass this plug, the nerve cell that the small vessel normally supplies with blood will die. The number of cells that die will depend on the size of the plugged vessel.
2) A more common cause of a stroke is a cerebral thrombosis, which is a stationary blood clot that forms in the blood vessel and closes it. The result is the same as in case of a cerebral embolism.
3) A stroke is also caused by hemorrhage from a broken blood vessel. The cells beyond the break are deprived of oxygen, and there is pressure on cells in the area surrounding the break. Some of these cells may be able to function again after the blood is absorbed and the pressure relieved. When blood escapes from a vessel, it quickly forms a clot using thrombin and myosin, which closes the break and stops the hemorrhage. Later the clot is absorbed, thus removing the pressure.
4) Any accident that causes physical damage to the brain may produce the same results as a stroke. In general, the symptoms will be similar, and the person may be treated in the same way as on whose disability is cause by a stroke.
Known treatable risk factors may explain the higher rates of death and disability from strokes among African-Americans and Hispanics. The proportion of people with theses risk factors is predominantly higher in African-Americans and other minorities. For example, about 33 percent of white adult American men have high blood pressure compared to 38 percent of African-American adult men and 25 percent of white adult American women have high blood pressure compared to 39 percent of adult African-American women. Smoking among white men at 28 percent and among white women at 28 percent; among African-American the figures are 33 percent for man and 22 percent for women
Nearly 50 million American adults are too fat, but 20 percent of them are over their desired weight. Primarily as a result of more risk factors, African-Americans experience more strokes, have more severe strokes, and are twice as likely to die of a stroke as white Americans. Risk factors conditions are frequently worse among some minorities and may lead to stroke recurrence, which is an important contributor to increased disabilities.
To show some hope for these risk factor minorities, Dr. Ralph Sacco at Columbia University in New York City is...
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