Physical Labor's Link To Strokes: What You Need To Know

Stroke is a medical emergency that occurs when there is an issue with blood flow to the brain, either due to blocked arteries or bleeding in the brain. It is a leading cause of death and disability worldwide, and recovery can be a long process. Returning to work after a stroke is an important goal for many survivors, as it can improve their quality of life and provide a sense of purpose. However, it is not uncommon for stroke survivors to experience residual impairments, such as fatigue, cognitive problems, and personality changes, that can impact their ability to stay in work. These impairments, particularly the invisible ones, are often not well understood by employers, colleagues, and even the survivors themselves, leading to a lack of support and adjustments in the workplace. This highlights the need for improved awareness and assessments of stroke-related impairments to facilitate a successful return to work and long-term retention of employment.

Risk factors: obesity, diabetes, high blood pressure, atrial fibrillation, smoking, alcoholism, sedentary lifestyle, age, gender

Obesity, diabetes, high blood pressure, atrial fibrillation, smoking, alcoholism, sedentary lifestyle, age, and gender are all risk factors for stroke.

Obesity is a growing problem worldwide, and it often leads to diabetes. Diabetes causes various microvascular and macrovascular changes, which can result in a stroke if cerebral vessels are directly affected. The risk of stroke is higher in younger people with diabetes, and diabetes increases the risk of ischemic stroke in all age groups.

High blood pressure is the number one preventable cause of stroke. It damages arteries throughout the body, creating conditions that can make arteries burst or clog easily. Weakened or blocked arteries in the brain significantly increase the risk of stroke.

Atrial fibrillation (Afib) is a type of irregular heart rhythm that affects the top two chambers of the heart. It can cause the heart to beat very quickly and is the most common type of arrhythmia. Afib increases the risk of ischemic stroke, as it can lead to the formation of blood clots that can travel to the brain.

Smoking and alcoholism are both lifestyle factors that can increase the risk of stroke. While the link between alcoholism and stroke is not well understood, studies have shown a clear association between the two.

A sedentary lifestyle can also increase the risk of stroke, as physical inactivity is a modifiable risk factor. However, it is important to note that intense physical labor or exercise can also increase the risk of stroke in some cases.

Age is a significant risk factor for stroke, as the risk increases with age. However, stroke can occur at any age, and a large proportion of stroke survivors are of working age.

Gender also plays a role in stroke risk, with women having a higher risk of stroke than men. In the United States, stroke kills more women than men, and one in five women will have a stroke in their lifetime.

It is important to note that these risk factors can interact with each other and that having multiple risk factors can further increase the likelihood of stroke. Managing these risk factors through lifestyle changes, medical treatment, and regular health check-ups can help reduce the risk of stroke.

Types: ischemic stroke, hemorrhagic stroke

There are two main types of stroke: ischemic and hemorrhagic. Ischemic strokes are the most common, accounting for about 80% of all strokes. They occur when blood flow to the brain is blocked, causing brain cells to become oxygen-starved and stop functioning properly. Hemorrhagic strokes, on the other hand, are caused by bleeding in or around the brain, often due to ruptured blood vessels or aneurysms.

Ischemic Stroke

Ischemic strokes can be further categorized into several types:

• Thrombosis: Formation of a blood clot in the brain, blocking blood flow.
• Embolism: A fragment of a clot formed elsewhere in the body breaks free and travels to the brain, causing a blockage.
• Lacunar stroke: Small vessel blockage due to long-term untreated conditions like high blood pressure, high cholesterol, or high blood sugar.
• Cryptogenic stroke: Strokes of unknown origin.

Ischemic strokes are typically treated with thrombolytic drugs to dissolve clots and restore blood flow. Mechanical thrombectomy, a catheterization procedure to remove clots, may also be used.

Hemorrhagic Stroke

Hemorrhagic strokes can be divided into two types:

• Intracerebral hemorrhage: Bleeding inside the brain due to a ruptured blood vessel, causing pressure on surrounding brain tissue.
• Subarachnoid hemorrhage: Bleeding into the subarachnoid space, the area between the brain and its outer covering, due to damaged blood vessels.

Treatment for hemorrhagic strokes focuses on reducing blood pressure to limit bleeding and improving clotting to stop the bleeding. Surgery may be necessary to relieve pressure on the brain caused by accumulated blood.

Symptoms: loss of balance, loss of vision, face drooping, inability to lift arms, slurred speech, dizziness, vomiting, seizures, coma

Symptoms of a Stroke

Loss of Balance

If you experience a stroke, you may have problems with your balance and coordination. This can lead to a loss of balance and falls.

Loss of Vision

Vision problems are common after a stroke, with about two-thirds of people experiencing some changes to their vision. These issues can range from blurred vision to complete loss of vision in one or both eyes.

Face Drooping

Facial drooping or paralysis on one side of the face is a common symptom of a stroke. It occurs when the facial muscles are not working properly due to damage to the brain or nerves in the face.

Inability to Lift Arms

You may experience weakness or numbness in your arms and legs, making it difficult or impossible to lift your arms. This is often accompanied by a loss of sensation and muscle control.

Slurred Speech

Slurred speech, also known as dysarthria, is a common symptom of a stroke. It occurs due to damage to the part of the brain that controls speech and language.

Dizziness

Dizziness and a loss of balance are common symptoms of a stroke and can lead to falls and injuries.

Vomiting

Nausea and vomiting are symptoms of a hemorrhagic stroke, which is caused by bleeding in the brain. This type of stroke can be life-threatening and requires immediate medical attention.

Seizures

Seizures can occur after a stroke, especially if the stroke was severe or affected the cerebral cortex. Some people may develop epilepsy as a result of the stroke.

Coma

In severe cases, a stroke can lead to a coma or even death. It is crucial to seek immediate medical attention if you or someone you know is exhibiting any of the above symptoms.

Diagnosis: neurological examination, CT scan, lab blood tests, electrocardiogram, MRI scan, electroencephalogram

If a doctor suspects that someone has had a stroke, they will run a series of tests to diagnose the type of stroke and the extent of the brain damage. Here is a list of the diagnostic tests that may be performed:

Neurological Examination

The FAST (Face, Arm, Speech Test) is a simple and quick test that can be used to identify a potential stroke. It involves checking for facial weakness, arm weakness, and speech disturbance. This test can be performed by medical and non-medical professionals and is often one of the first assessments conducted.

CT Scan

A computed tomography (CT) scan is often one of the first tests performed during a stroke evaluation. It uses X-rays to capture images of the skull and brain from multiple angles, which are then used to create cross-sectional images. CT scans can detect abnormalities in the brain, such as blood clots, tumours, and blood vessel defects. They are particularly useful in distinguishing between ischemic and haemorrhagic strokes.

Lab Blood Tests

Blood tests can help identify a stroke by checking various factors, such as how quickly the blood clots. They also provide valuable information about the patient's overall health and can help rule out other potential causes of symptoms.

Electrocardiogram (ECG)

An ECG is used to assess the heart's electrical activity and can help identify any cardiac issues that may have contributed to the stroke. It is a non-invasive test that records the heart's electrical signals via small electrodes placed on the skin.

MRI Scan

Magnetic resonance imaging (MRI) uses strong magnetic fields and radio waves to create detailed images of the brain. It can detect abnormalities in the brain and is particularly useful in identifying ischemic and haemorrhagic strokes. MRI scans provide more detailed images than CT scans and can be used as a follow-up to further investigate potential causes.

Electroencephalogram (EEG)

While not mentioned in the sources provided, an EEG is often used to assess brain activity and can help detect abnormalities in brain function. It involves placing electrodes on the scalp to record electrical activity in the brain.

Treatment: thrombolytic drugs, blood pressure management, thrombectomy, surgery

Treatment for a stroke depends on the type of stroke and how soon treatment is administered after the stroke. Here are some of the treatments for stroke:

Thrombolytic Drugs

Thrombolytic drugs are used to dissolve existing blood clots and are an option within the first three to four and a half hours after the onset of stroke symptoms. After this time frame, the risk of dangerous bleeding complications increases.

Blood Pressure Management

Lowering blood pressure is a critical aspect of treating hemorrhagic strokes, as high blood pressure is usually the cause. Lowering blood pressure limits bleeding and facilitates clotting to seal the damaged blood vessel.

Thrombectomy

Thrombectomy is a catheterization procedure used to remove blood clots. It is often performed when thrombolytic drugs are not an option or are ineffective. Thrombectomy procedures are most effective within 24 hours of the onset of stroke symptoms.

Surgery

In some cases, surgery may be necessary to relieve pressure on the brain caused by accumulated blood. This is particularly common with subarachnoid hemorrhages, which occur on the outer surface of the brain.

Frequently asked questions