What is a Stroke?

Stroke, medically known as Cerebrovascular accident (CVA), is a condition where the blood flow in the brain is impeded due to a ruptured blood vessel or a plaque blockage. The blood constantly supplies the brain with oxygen. When the brain cells are deprived of their needed supply and nutrients, they will die within minutes. This can result in permanent brain damage, bleeding, or worse, death. 

A stroke is considered a medical emergency. Every second is vital to a victim’s survival, and it requires emergency treatment. Being equipped with enough knowledge on stroke and its warning signs could help you save a person’s life. 

What Are the Different Types of Stroke?

The two known types of stroke are ischemic stroke and hemorrhagic stroke:

Ischemic Stroke

This is the type that is more common among the two. According to the CDC, it accounts for 87% of all strokes suffered. It happens when a blood clot plugs the blood flow to the brain. 

The blood clot may be formed somewhere in the body and gets lodged in the brain, or it can be formed in the brain’s blood vessels.

Atherosclerosis causes the narrowing of blood flow due to fatty plaques that line the wall of the blood vessels. When these plaques pile up and grow in size, it can reduce the flow of blood in certain parts of the body. 

When the debris or clot is developed in other areas of the body and gets stuck up in the brain, it is referred to as an embolic stroke or embolism. But, when the blood clot is formed in the artery wall of the neck and the brain, it is called thrombotic stroke or thromboembolism. 

Transient ischemic attacks (TIA) have stroke-like symptoms that occur months before a stroke could happen. It serves as a warning sign that there is already a clot that temporarily blocks a blood vessel, and a future stroke could happen. It comes on quickly and resolves 15-20 minutes after. Since it is temporary, it doesn’t usually cause permanent brain damage.

Hemorrhagic Stroke

A hemorrhagic stroke happens when a blood vessel in the brain ruptures and leaks blood. Most of the treatment focuses on bleeding control to prevent the leakage from damaging the brain cells. 

The blood leakage in the brain can cause excessive swelling and put pressure on the surrounding brain tissues if not controlled immediately. 

Conditions that cause this kind of stroke to happen are: 

• Aneurysm rupture in the brain
• Aging blood vessel
• Ballooning of the artery wall
• Arteriovenous malformation
• Uncontrolled hypertension

Signs and Symptoms of Stroke

A stroke can happen suddenly and requires an emergent response—every second counts to save a life. Knowing the signs and symptoms is essential to help you identify if the patient is having an attack. 

Listed below are some of the common signs of stroke in both men and women. It is easier to remember if you use the acronym “FASTER.”

• F– Facial drooping: Weakness of one side of the face. The patient usually has an uneven smile.
• A– Arms: Weakness and numbness of the arms. When asked to raise both arms, one arm will start to drop or fall down faster compared to the other. 
• S – Stability: This refers to the steadiness of the feet. The patient feels dizzy with an unstable gait and balance. An evident loss of coordination could also be possible.
• T – Talking in slurred speech is one of the most common indicators of stroke. Sometimes the patient is unable to talk or difficult to understand. 
• E – Eyes: Stroke patients could also be experiencing double or blurry vision and difficulty seeing with both eyes.
• R – React: Trying to remember when the first symptoms began. Immediate response is to call the emergency line and bring the patient to the hospital even if the symptoms go away. 

Nursing Interventions for Stroke

Providing a holistic, interactive, and comprehensive approach when caring for stroke patients is important in achieving optimum health outcomes. Giving the right kind of intervention for stroke patients has a significant impact on their recovery. 

• Proper monitoring of vital signs and GCS– hourly monitoring of the patient’s vital signs and neuro status easily recognizes stroke and reduces time delay. Glasgow Coma Scale is a tool used to calculate the patient’s consciousness level. The maximum score is 15, which means the patient is normal, and the minimum score is three which suggests comatose.
• Proper Positioning- how the patient is being positioned is important in relieving contractures and preventing pressures on the surrounding tissues of the brain. Elevating the head part of the bed lowers blood pressure. It maintains proper skeletal alignment and the swelling of extremities.
• Assessment with NIH stroke scale-This is a diagnostic tool used to assess the severity of stroke that the patient experienced. It also predicts the damage to the patient’s overall health condition. If the score ranges from 21-42, it means that the patient is experiencing severe stroke symptoms.
• Prevention of edema-If the limb lacks movement due to weakness or numbness, it is usually at risk for edema. Elevation of the affected extremities can prevent edematous or fluid build-up in the muscles.
• Proper Diet- Assist the patient to sit upright when eating or drinking. Stroke patients have a higher risk of aspiration due to dysphagia. Serve a thickened liquid or mechanical soft food for easier swallowing and digestion. 

Diagnosis and Treatment for Stroke

Imaging tests and blood tests help identify what kind of stroke the patient is having.

• CT scan– the patient will undergo a series of X-rays to know if the patient is having an ischemic type of stroke. CT scan provides images to know if there is bleeding in the brain. 
• Echocardiogram – creates detailed images of the heart using sound waves. We can easily locate the blood clot that could travel to the brain and cause stroke, through this device. 
• Cerebral Angiogram- is a procedure done by injecting a dye into the blood vessels of the brain. This will show a more visible image of the blood vessel when placed under an x-ray.
• Surgical treatment- hemorrhagic stroke can be treated with surgery. If the bleeding was caused by a damaged blood vessel, surgeons would place a metal clip through a more invasive procedure.
• Stroke rehab– for the patient to completely recover from stroke, rehabilitation can be very helpful.