STROKES
We all fear losing our mental and physical independence. A stroke is probably the most frightening nervous system disease. Strokes are more common in older people, and their effects can be devastating. However, a great deal can be done to decrease the risk of strokes and improve the outcome. Stroke means the sudden, spontaneous loss of use, feeling, or control of one or more limbs or the impairment of speech and mental function. It may also be complicated by problems with balance and vision. In order for such an episode to be called a stroke, it must occur suddenly. Similar nervous system impairment can happen more slowly and be the result of other diseases, such as a brain tumor or abscess.
The most common cause of strokes is damage to the blood vessels supplying the brain. Many individuals develop atherosclerosis, and they are more likely to experience brain damage should one of these blood vessels leak or become blocked by a blood clot that forms on the uneven surface of the diseased artery.
A stroke can occur when small particles of a blood clot become dislodged from a diseased heart and travel to the brain. This results in a cerebral embolus, and it is more common in older people because heart disease is more prevalent. Many people suffer from high blood pressure, which left untreated can weaken the blood vessels in the brain. A stroke occurs when one of these vessels bursts.
A stroke can vary in its appearance, severity, and duration. Some people suffer from a weakness of a limb or speech impairment for a few minutes or hours and then the symptoms improve. Others may feel numbness and tingling of their face or hands, which also passes in time. These attacks are often called transient strokes because the symptoms improve spontaneously.
A stroke that occurs, returns, and wanes may be the signal of a severe episode that will become permanent. This signal should be reported to your physician immediately.
Sometimes the first episode of nervous system disease may be a stroke that does not improve within minutes or hours. This is referred to as a completed stroke. The damage is not reversible because the brain, when injured severely by an interruption of blood supply, cannot retrieve its function. The symptoms may be a loss of speech and consciousness, as well as weakness of one side of the body.
During the first few hours and days after a completed stroke has occurred, the individual may not be able to respond to normal environmental stimulation. The level of consciousness may be impaired. It is during this crucial period that complications such as pneumonia and problems with heart ailments set in. However, with careful observation and treatment most people can be brought through this period and undertake a program of rehabilitation.
One condition that occurs in elderly individuals can mimic a stroke, but if found and treated early can have a more positive outcome. This condition is a subdural hematoma and is the result of bleeding within the skull, between the lining of the brain and the bones that surround it. It can occur following a fall, especially if the person is taking anticoagulants (blood thinners). Sometimes it occurs without injury, and the symptoms may develop gradually, with an eventual weakness of limbs, loss of balance, and changes in personality, speech, and memory. If the blood clot (hematoma) is removed through surgery, the results can be dramatic. This type of surgery is so simple that it should never be refused because of age.
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