Brain and Spine Surgery



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Overview

 

Cerebrovascular disease is any disorder that affects the disease in the blood vessels that feed oxygen-rich blood to the face and brain. Most often, this term is used to describe “hardening” (atherosclerosis) of the carotid arteries, which supply the brain with blood.

This form of cerebrovascular disease is similar to coronary artery disease, which occurs in the blood vessels that supply the heart with oxygen-rich blood. It is also referred to as ischemic disease, or a disease that causes a lack of blood flow.


Types of stroke


Most strokes happen when a blood clot blocks one of the arteries (blood vessels) that carries blood to the brain. This type of stroke is called an ischaemic stroke.

  • Transient ischaemic attack (TIA) or 'mini-stroke' is a short-term stroke that lasts for less than 24 hours. The oxygen supply to the brain is quickly restored and symptoms disappear. A transient stroke needs prompt medical attention because it indicates a serious risk of a major stroke.
  • Cerebral thrombosis is when a blood clot (thrombus) forms in an artery that supplies blood to the brain. Blood vessels that are furred up with fatty deposits (atheroma) make a blockage more likely. The clot prevents blood flowing to the brain and cells are starved of oxygen.
  • Cerebral embolism is a blood clot that forms elsewhere in the body before travelling through the blood vessels and lodging in the brain. In the brain, it starve cells of oxygen. An irregular heartbeat or recent heart attack may make you prone to forming blood clots.
  • Cerebral haemorrhage is when a blood vessel bursts inside the brain and bleeds (haemorrhages). With a haemorrhage, blood seeps into the brain tissue and causes extra damage.
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Risk Factors

  • Age and sex
  • Hypertension
  • Cardiac disease
  • Smoking and metabolic disorders
  • Oral contraceptives and vascular disorders


What Are The Symptoms Of A Stroke?

The most common signs of a stroke are :-
  • weakness down one side of the body, ranging from numbness to paralysis that can affect the arm and leg
  • weakness down one side of the face, causing the mouth to droop
  • speech may be difficult or become difficult to understand
  • swallowing may be affected
  • loss of muscle coordination or balance
  • brief loss of vision
  • severe headache
  • confusion.

Causes

  • Arterial wall disorders
  • Embolism from the heart
  • Hematologic disorders and miscellaneous

How Is A Stroke Treated?

Immediate treatment

In hospital, brain scans are needed to find out what type of stroke you've had.
  • If a blood clot is the cause, 'clot busting' medication may be used to dissolve the clot, but this must be given within three hours of the stroke. Anti-clotting medication such as aspirin may also be given to stop the stroke from getting worse.
  • Anti-clotting medication is not given in strokes caused by haemorrhaging because it will make the bleeding worse.


Other treatment includes: -
  • tests on key functions like swallowing and movement
  • checks on oxygen, glucose and blood pressure levels.


If swallowing is affected, you may be fed by a tube or given fluids into a vein (intravenously) to avoid food going into the lungs.


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