Nitrous Oxide: Stroke Risk And Danger

Nitrous oxide, or NOS, is often referred to as 'laughing gas' and is used as a recreational drug. It is a colourless, non-flammable gas with a slightly sweet odour and taste. NOS can be fatal if inhaled in large doses as it can cause oxygen deprivation, ultimately leading to suffocation.

A stroke, on the other hand, is a life-threatening medical condition that occurs when there is an issue with blood flow to the brain. This can be due to a blocked artery or bleeding in the brain. The effects of a stroke can be permanent and include loss of movement, speech, or vision.

Therefore, NOS and strokes are distinct and unrelated conditions. While NOS can be dangerous if misused, it does not cause strokes.

The two types of stroke: ischemic and hemorrhagic

Strokes are a life-threatening condition that occurs when the brain doesn't receive enough blood flow. This usually happens due to a blocked artery or bleeding in the brain. There are two main types of strokes: ischemic and hemorrhagic.

Ischemic stroke

Ischemic strokes are the most common type, accounting for about 80-87% of all strokes. They occur when a blood vessel supplying the brain becomes blocked, usually by a blood clot, impairing blood flow to that part of the brain. This can also rarely occur due to a blockage in a vein. As a result, brain cells and tissues begin to die within minutes due to a lack of oxygen and nutrients. Ischemic strokes are further divided into two groups:

• Thrombotic strokes: Caused by a blood clot that develops in the blood vessels inside the brain.
• Embolic strokes: Caused by a blood clot or plaque debris that forms elsewhere in the body and travels to a blood vessel in the brain through the bloodstream.

Hemorrhagic stroke

Hemorrhagic strokes, on the other hand, are caused by bleeding. They occur when a blood vessel supplying the brain ruptures and bleeds. This bleeding can be due to the rupture of an aneurysm or an arteriovenous malformation. About 10-13% of strokes are hemorrhagic.

Hemorrhagic strokes can be divided into two main categories:

• Intracerebral hemorrhage: Bleeding occurs from blood vessels within the brain.
• Subarachnoid hemorrhage: Bleeding occurs in the subarachnoid space, which is the space between the brain and the membranes that cover it.

Both types of strokes require immediate medical attention to prevent permanent damage or death. Treatment options vary depending on the type of stroke and can include medication and surgery.

Risk factors for stroke

A stroke is a life-threatening medical emergency that occurs when there is an issue with blood flow to the brain. While anyone can have a stroke at any age, certain factors can increase the chances of having one. Understanding these risk factors and taking steps to control them is crucial for stroke prevention. Here are some of the key risk factors for stroke:

• Age: The risk of having a stroke increases with age, especially after 55. The chance of a stroke more than doubles every 10 years from that age.
• Previous Stroke or Transient Ischemic Attack (TIA): A history of stroke or TIA, also known as a "mini-stroke," significantly increases the likelihood of another stroke.
• High Blood Pressure: High blood pressure is a leading cause of stroke. It can damage blood vessels (arteries) supplying blood to the brain and is a common risk factor for both ischemic and hemorrhagic strokes.
• Cholesterol and Lipids: High cholesterol and lipid levels can contribute to atherosclerosis, which is the thickening or hardening of arteries due to plaque buildup. This can narrow the arteries and reduce blood flow to the brain.
• Heart Disorders: Common heart disorders, such as coronary artery disease, heart valve defects, irregular heartbeat (including atrial fibrillation), and enlarged heart chambers, can increase the risk of stroke by causing blood clots or blocking blood flow to the brain.
• Diabetes: Diabetes disrupts blood sugar levels and can prevent oxygen and nutrients from reaching the brain. It is also associated with high blood pressure, further increasing the risk of stroke.
• Obesity: Obesity is linked to higher "bad" cholesterol and triglyceride levels and lower "good" cholesterol levels. It can also lead to high blood pressure and diabetes, both of which are risk factors for stroke.
• Sickle Cell Disease: This blood disorder is linked to ischemic stroke, particularly in Black children. Sickle cell disease causes red blood cells to form an abnormal sickle shape, which can block blood flow to the brain if they get stuck in blood vessels.
• Lifestyle Choices: Unhealthy lifestyle choices can increase the risk of stroke. These include:
• Diet: A diet high in saturated fats, trans fat, and cholesterol is linked to stroke and related conditions like heart disease. Excessive salt (sodium) intake can also raise blood pressure levels.
• Physical Inactivity: Lack of physical activity can contribute to other risk factors for stroke, such as obesity, high blood pressure, high cholesterol, and diabetes.
• Alcohol Consumption: Drinking too much alcohol can raise blood pressure and triglyceride levels, increasing the risk of stroke.
• Tobacco Use: Smoking can damage the heart and blood vessels, and nicotine raises blood pressure, increasing the risk of stroke.
• Illegal Drug Use: Intravenous drug abuse, particularly of drugs like cocaine, carries a high risk of stroke due to blood clots and other cardiovascular problems.
• Genetics and Family History: A family history of stroke, particularly at a younger age, increases the risk. Certain genetic factors, such as blood type (especially type AB), also play a role in stroke risk.
• Race and Ethnicity: In the United States, stroke occurs more frequently in Black, Alaska Native, American Indian, and Hispanic adults compared to White adults.
• Sex: While men are more likely to have a stroke at younger ages, women tend to live longer, resulting in a higher lifetime risk of stroke. Additionally, women who take birth control pills or use hormone replacement therapy, as well as women during pregnancy and postpartum, are at higher risk.
• Other Medical Conditions:
• Sleep Apnea: Sleep apnea and other sleep disorders can increase the risk of stroke.
• Kidney Disease: Kidney disease is associated with an increased risk of stroke.
• Migraine Headaches: Migraines, especially with auras, have been linked to a higher risk of stroke.
• Environmental Factors: Living or working in areas with air pollution can contribute to stroke risk.
• Psychological Factors: Anxiety, depression, high stress levels, long working hours, and lack of social contact may also raise the risk of stroke.

Symptoms of a stroke

A stroke is a life-threatening medical emergency that requires immediate attention. It occurs when there is an issue with blood flow to the brain, either due to blocked blood vessels or bleeding in the brain. The quicker a stroke is treated, the more likely it is that the person will recover without any disabilities.

• Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
• Face Drooping – One side of the face may droop or feel numb. Ask the person to smile and check if their smile is uneven.
• Arm Weakness – One arm may feel weak or numb. Ask the person to raise both arms and check if one arm drifts downward.
• Speech Difficulty – Speech may be slurred, or the person may have trouble speaking or understanding speech.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
• Severe Headache with no known cause.
• Emotional instability and personality changes.
• Memory loss.
• Passing out or fainting.

If you or someone you know is experiencing any of these symptoms, it is crucial to act F.A.S.T. (Face, Arm, Speech, Time) and call 911 immediately. Do not drive to the hospital; instead, call for an ambulance so that medical personnel can provide life-saving treatment on the way to the hospital. Time is critical in treating a stroke, and early treatment can significantly improve the chances of recovery and reduce the risk of permanent damage or death.

Treatment for stroke

Strokes are a life-threatening medical emergency and require immediate medical attention to prevent permanent damage or death. If you or someone you know is experiencing symptoms of a stroke, call emergency services immediately. The quicker a person having a stroke receives treatment, the more likely they are to recover without disability.

• Call 911 or your local emergency number right away if you notice any signs of a stroke. Do not drive yourself or the person experiencing stroke symptoms to the hospital.
• Emergency medical services (EMS) will begin treatment on the way to the hospital, which is crucial for the patient's recovery.
• Once at the hospital, the patient may receive emergency care, treatment to prevent another stroke, and/or rehabilitation to treat the side effects of the stroke.
• Brain scans will be performed to determine the type of stroke the patient had. They may also be seen by specialists such as a neurologist or neurosurgeon.
• Treatment will depend on the type of stroke: ischemic or hemorrhagic.

Ischemic stroke treatment:

• The top priority is to restore circulation to the affected areas of the brain by using thrombolytic drugs (clot-busting drugs) to break up blood clots.
• Tissue plasminogen activator (tPA) is a commonly used thrombolytic drug that improves the chances of recovering from an ischemic stroke.
• Other treatments include blood thinners and surgery to remove the clot.

Hemorrhagic stroke treatment:

• Treatment depends on the location and severity of the bleeding.
• Reducing blood pressure is crucial to lowering the amount of bleeding and preventing it from worsening.
• Surgery may be necessary to stop the bleeding and relieve pressure on the brain from accumulated blood.
• Endovascular procedures and surgical treatments may be used to repair a weak spot or break in a blood vessel.

Stroke rehabilitation:

• Rehabilitation is a crucial part of stroke recovery and can take many forms, including speech therapy, physical therapy, and occupational therapy.
• Speech therapy helps individuals regain language and speaking abilities and improve their ability to control muscles related to breathing, eating, drinking, and swallowing.
• Physical therapy assists individuals in improving or regaining movement and coordination skills affected by the stroke.
• Occupational therapy focuses on retraining the brain to perform daily activities such as eating, drinking, dressing, bathing, reading, and writing.
• Cognitive therapy can help with memory problems, difficulty concentrating, and other cognitive challenges.

It is important to work closely with your healthcare provider to determine the best treatment plan for your specific case, including any necessary lifestyle changes to lower the risk of another stroke.

Complications of having a stroke

A stroke is a life-threatening medical emergency that occurs when there is an issue with blood flow to the brain. It can be caused by blocked arteries or bleeding in the brain, resulting in brain cells dying due to lack of oxygen. Anybody can have a stroke, but certain factors increase the risk, including high blood pressure, high cholesterol, Type 2 diabetes, and a history of heart attack or irregular heart rhythms.

• Brain Edema: This is the swelling of the brain caused by a build-up of fluid and pressure inside the skull, affecting oxygen and blood flow to the brain. Brain edema is life-threatening and requires immediate treatment, including medication, IV fluids, oxygen therapy, surgery, or ventriculostomy.
• Pneumonia: A common infection affecting the lungs, pneumonia may occur as a complication during stroke recovery. It can be treated with antibiotics, and the risk can be reduced with swallowing, respiratory therapy, and deep breathing exercises.
• Dysphagia (Swallowing Problems): Dysphagia is common after a stroke and can cause food, drinks, or saliva to be breathed into the lungs. Treatment includes taking small bites and sips, sitting up straight, and turning the head to one side while eating and drinking.
• Urinary Tract Infections (UTIs): UTIs are common after a stroke due to bladder control problems. They are usually treated with antibiotics and bladder training programs.
• Seizures: Abnormal electrical activity in the brain cells can cause convulsions, twitching, and changes in awareness. Treatment options include medication, dietary changes, surgery, or electrical stimulation.
• Clinical Depression: Depression is a common mental health issue following a stroke, and it can cause emotional and physical reactions to changes and losses. Treatment may include antidepressant medication, psychotherapy, or both, and referral to a stroke support group.
• Bedsores: Bedsores, or pressure ulcers, develop due to decreased mobility and increased pressure on certain body areas. Treatment includes frequent turning, good nutrition, wound cleaning, and, in severe cases, removal of damaged tissue or skin grafts.
• Limb Contractures: Reduced range of motion or lack of exercise can lead to shortened muscles, causing pain and loss of movement. Treatment may include physical therapy, range-of-motion exercises, supportive devices, medication, heat therapy, or surgery.
• Hemiplegic Shoulder Pain: Weakness or paralysis can cause the affected arm to hang, pulling on the shoulder and resulting in pain. Treatment typically involves range-of-motion exercises, physical therapy, and supportive devices like slings.
• Deep Venous Thrombosis (DVT): DVT is a serious condition where blood clots form in the legs due to immobility after a stroke. It requires immediate attention to prevent clots from traveling to the lungs. Treatment includes medication (e.g., blood thinners) and compression socks, along with range-of-motion exercises and physical therapy.
• Aphasia: Brain damage after a stroke can lead to aphasia, or difficulty in understanding and expressing speech. Speech therapy is the primary treatment.
• Headaches: Painkillers and increased fluid intake are typically used to treat headaches.
• Involuntary Muscle Tightening: Stiffness and reduced range of motion can occur due to muscles not being able to move freely. Treatment includes physical therapy, range-of-motion exercises, supportive devices, and medication.

Frequently asked questions