A stroke is a medical emergency caused by a disruption in blood supply to a part of the brain. When brain cells do not receive oxygen and nutrients, they begin to die within minutes. Stroke leads to sudden neurological symptoms such as weakness, speech problems, and loss of coordination. Early detection and treatment are essential to prevent long-term disability or death.
1. Types of Stroke
A. Ischemic Stroke (Most common)
Occurs when a blood vessel supplying the brain becomes blocked.
- Thrombotic stroke: Clot forms inside a brain artery.
- Embolic stroke: Clot travels from another part of the body (often the heart).
B. Hemorrhagic Stroke
Occurs when a blood vessel ruptures and bleeds into the brain tissue.
- Intracerebral hemorrhage
- Subarachnoid hemorrhage
C. Transient Ischemic Attack (TIA)
A “mini-stroke” where symptoms last less than 24 hours. It is a warning sign of a future major stroke.
2. Causes and Risk Factors
Major Causes
- Atherosclerosis
- Hypertension
- Atrial fibrillation
- Blood clots
- Aneurysm rupture (in hemorrhagic stroke)
Risk Factors
- High blood pressure (strongest risk factor)
- Diabetes
- High cholesterol
- Smoking
- Obesity
- Physical inactivity
- Excessive alcohol intake
- Older age
- Family history of stroke
3. Symptoms of Stroke
FAST Warning Signs
- F – Face drooping
- A – Arm weakness
- S – Speech difficulty
- T – Time to call emergency services
Other Symptoms
- Sudden severe headache
- Loss of balance
- Blurred or double vision
- Difficulty understanding speech
- Numbness on one side of the body
- Loss of consciousness
4. Diagnosis
Rapid diagnosis is essential for timely treatment.
- CT Scan: Differentiates ischemic vs. hemorrhagic stroke
- MRI: Detects early brain damage
- Blood tests: Glucose, clotting profile
- ECG: Detects atrial fibrillation
- Carotid Doppler: Checks for carotid artery blockage
5. Treatment of Stroke
A. Treatment of Ischemic Stroke
1. Thrombolytics
Used to dissolve clots. Must be given within 4.5 hours of symptom onset.
- Alteplase (tPA): Gold standard therapy
2. Antiplatelet Agents
- Aspirin
- Clopidogrel
3. Anticoagulants
Used when stroke is due to atrial fibrillation.
- Warfarin
- Apixaban
- Rivaroxaban
4. Mechanical Thrombectomy
Removal of clot using a specialized device (within 6–24 hours).
B. Treatment of Hemorrhagic Stroke
- Control blood pressure
- Stop anticoagulants if the patient is using them
- Reverse anticoagulation when required (e.g., vitamin K)
- Surgical removal of hematoma in some cases
- Treat aneurysm with coiling or clipping
6. Post-Stroke Rehabilitation
Rehabilitation helps patients regain lost functions and independence.
- Physiotherapy to restore movement
- Occupational therapy for daily activities
- Speech therapy for communication problems
- Cognitive rehabilitation
- Psychological counseling
7. Complications
- Paralysis
- Speech difficulties
- Memory problems
- Depression
- Recurrent stroke
- Difficulty swallowing
8. Prevention of Stroke
- Control blood pressure
- Manage diabetes
- Lower cholesterol
- Stop smoking
- Exercise regularly
- Maintain a healthy diet
- Avoid excessive alcohol
9. Role of the Pharmacist
- Educate patients on stroke warning signs
- Monitor blood pressure and blood sugar levels
- Ensure correct medication use (antiplatelets, anticoagulants)
- Check for drug interactions
- Counsel on lifestyle modifications
- Support medication adherence
Detailed Notes:
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