Brain Damage: Understanding Ischemic Strokes And Their Impact

Ischemic strokes are caused by a blockage in a blood vessel that supplies blood to the brain, usually due to a blood clot or fatty deposits. As a result, brain cells are damaged or die, which can lead to brain damage or death. The extent of brain damage caused by an ischemic stroke depends on the extent and duration of the blockage. Immediate medical attention is crucial to prevent permanent damage and increase the chances of survival.

Brain cells begin to die within minutes of interrupted blood flow

Interrupted blood flow to the brain, known as cerebral ischemia, can result in brain damage or death. Brain cells are highly sensitive to disruptions in blood flow and begin to die within minutes of oxygen-rich blood supply being cut off. This is because the brain, despite only weighing around 2.5% of a typical individual's body weight, accounts for about 25% of a person's metabolic demand.

The extent of neuronal injury resulting from compromised cerebral perfusion depends on both the extent and duration of the hypoperfusion. Brain ischemia can be global or focal. Global cerebral ischemia is usually caused by systemic hypotension, while focal brain ischemia is most often caused by thrombosis or embolism.

The blockage that causes an ischemic stroke is often a blood clot or fatty deposits inside the blood vessel. This blockage can appear at the neck level or in the skull. Blood clots usually start in the heart and travel through the circulatory system. When a clot blocks a brain artery, a region of the brain doesn't get enough oxygen-rich blood, and cells start to die.

The symptoms of an ischemic stroke depend on which area of the brain is affected. Common symptoms include facial drooping, limb weakness on one side, and slurred speech. Other symptoms include dizziness, loss of coordination, and vision problems.

Ischemic strokes are a medical emergency, and immediate treatment is crucial to prevent permanent damage. The first goal of treatment is to restore blood flow to the affected area of the brain, usually through medication or surgery.

The human brain is highly sensitive to disruptions in blood flow, and cerebral ischemia can result in severe and permanent consequences, including brain damage and death.

Brain damage can cause changes in how you think, feel and communicate

Ischemic strokes occur when a blockage cuts off the blood supply to the brain, killing brain cells. This damage to brain cells can affect how the body works, and can also change how you think, feel, and communicate.

Thinking

Cognitive changes resulting from brain damage can include attention and concentration difficulties, literal interpretation, reduced reasoning and problem-solving skills, and slowed speed of information processing. For example, a person may struggle to concentrate on a TV programme or conversation, or they may have trouble accessing information they know, such as word recall or remembering people's names. They may also take things literally, struggle to grasp humour or sarcasm, and have difficulty understanding common expressions.

Feeling

Brain damage can affect how a person feels, causing emotional effects such as executive dysfunction, fatigue, and pathological laughter.

Communicating

Communication problems are common after brain damage. These can be caused by impairments to the physical ability to speak, or to the ability to understand and express language. Social communication difficulties may also arise, such as failing to recognise everyday social cues, both verbal and non-verbal. For example, a person may not realise that someone is uncomfortable with the topic of conversation or that they are in a hurry to leave. They may also struggle with turn-taking in conversation, either being overly talkative or failing to realise when it is their turn to speak.

Ischemic strokes are caused by blood clots or fatty plaque

Ischemic strokes are the most common type of stroke, accounting for around 85%- 87% of all cases. They occur when blood flow to the brain is blocked, cutting off the blood supply and causing brain cells to die. This blockage is usually caused by blood clots or fatty plaque, which can travel to the brain from the heart or a distant artery, or even originate in a brain artery.

Blood clots can form due to several factors, such as an irregular heartbeat, problems with the heart valve, infection of the heart muscle, hardening of the arteries, blood clotting disorders, inflammation of the blood vessels, or a heart attack. Fatty plaque, on the other hand, can build up in the arteries supplying blood to the brain, narrowing them and reducing blood flow. This is known as atherosclerosis.

The symptoms of an ischemic stroke depend on which region of the brain is affected. Common signs include drooping of the face or mouth on one side, weakness or paralysis in one or more limbs, difficulty speaking, dizziness, and vision problems.

It is crucial to seek immediate medical attention if you suspect an ischemic stroke, as prompt treatment improves the chances of recovery and prevents permanent damage. Treatment options include medication to dissolve clots, such as tissue plasminogen (tPA), and surgical procedures like thrombectomy to remove clots.

The risk of ischemic strokes can be reduced by addressing certain lifestyle factors and underlying conditions. Maintaining a healthy weight, consuming less alcohol, following a healthy diet, and engaging in regular physical activity are recommended. Additionally, managing conditions like high blood pressure, high cholesterol, diabetes, and atrial fibrillation can help lower the chances of experiencing an ischemic stroke.

Treatment must be administered within 3-4 hours to prevent permanent damage

Ischemic strokes are medical emergencies that require immediate attention to prevent permanent brain damage or death. They occur when a blockage cuts off the blood supply to the brain, causing brain cells to die within minutes. As such, treatment must be administered within 3 to 4 hours of the first symptoms to improve outcomes and prevent permanent damage.

The first goal of treatment for ischemic strokes is to restore blood flow to the affected area of the brain. This is done through thrombolytic therapy, which involves the use of intravenous (IV) tissue plasminogen activator (tPA) medication to break up blood clots. tPA is most effective when given within 3 to 4 hours of the first symptoms and cannot be administered more than 5 hours after the start of the stroke. Research has shown that the earlier a patient receives tPA, the more likely they are to have better outcomes.

If tPA is not an option or is unsuccessful, mechanical thrombectomy can be performed to remove blood clots. This procedure involves inserting a catheter (a small, thin tube) into a blood vessel and steering it up to the clot in the brain, where it can be removed. Thrombectomy is also time-sensitive, with the best window for the procedure being within 24 hours of symptom onset.

In addition to thrombolytic therapy and thrombectomy, other treatments may be administered to manage blood pressure, improve clotting, and reduce pressure inside the skull. These treatments include:

• Blood pressure management: Lowering blood pressure can reduce bleeding and make it easier for clots to seal the damaged blood vessel.
• Blood thinning medications: These medications can prevent further clots from forming.
• Oxygen therapy: Providing extra oxygen can help restore oxygen to the brain and make it easier for the patient to breathe.
• Blood sugar management: Monitoring blood glucose levels can aid in brain recovery.
• Mild intentional hypothermia: Lowering the body temperature can slow down brain damage during and after a stroke, although this is rarely done.

After receiving initial treatment for an ischemic stroke, patients may require long-term treatments and rehabilitation. Long-term treatments may include the use of medications such as aspirin or anticoagulants to prevent further clots. Rehabilitation may involve speech therapy, physical therapy, occupational therapy, and cognitive therapy to help patients regain language, speaking abilities, motor skills, coordination, and cognitive functions.

The most common symptoms of an ischemic stroke include facial drooping and limb weakness

Ischemic strokes are caused by a blockage in a blood vessel that supplies blood to the brain. This blockage may be caused by a blood clot or fatty deposits in the blood vessel. When blood flow to the brain is blocked, brain cells can die within minutes, which is why ischemic strokes can cause brain damage.

The most common symptoms of an ischemic stroke include:

• Facial drooping or numbness on one side of the face
• Weakness or paralysis in one or more limbs, often on one side of the body
• Slurred speech or difficulty speaking and understanding speech
• Loss of coordination
• Vision problems, such as blurred vision or double vision
• Dizziness and vertigo

These symptoms typically occur suddenly and without warning, and immediate medical care is essential to prevent permanent damage and improve the chances of recovery.

Frequently asked questions