CHAPTER I

INTRODUCING
1.1

Background

1.2

Advantage

1.3

Purpose

1.4

Formulation of The Problem

1. What is the definition of stroke?
2. What causes stroke?
3. What is the risk factor of stroke?
4. What is the symptoms of stroke?
5. What is the diagnosis of stroke?
6. How is the prevention of stroke?
7. What is the effects of stroke?
8. How is the prevention of stroke?

CHAPTER II
DISCUSSION
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2.1

Definition
A cerebrovascular accident is the medical term for a stroke. A stroke is when
blood flow to a part of brain is stopped either by a blockage or a ruptured artery. If
blood flow is cut off for longer than a few seconds, the brain cannot get blood and
oxygen. Brain cells can die, causing lasting damage. There are important signs of a
stroke that you should be aware of and watch out for. If you think that you or someone
around you might be having a stroke, it is important to seek medical attention
immediately. The more quickly you get treatment, the better the prognosis. When a
stroke goes untreated for too long, there can be permanent brain damage.

2.2

Causes
There are two main types of cerebrovascular accident or stroke
1. Ischemic stroke
Ischemic stroke occurs when a blood vessel that supplies bloodto the
brain is blocked by a blood clot. This may happen in two ways:

A clot may form in an artery that is already very narrow. This is called
a thrombotic stroke .

A clot may break off from another place in the blood vessels of the
brain, or from some other part of the body, and move up to the brain.
This is called cerebral embolism, or an embolic stroke .
Ischemic strokes may be caused by clogged arteries. Fat, cholesterol,

and other substances collect on the artery walls, forming a sticky substance
called plaque.
2. Hemorrhagic stroke
A hemorrhagic stroke occurs when a blood vessel in part of the brain
becomes weak and bursts open, causing blood to leak into the brain. In both
cases, part of the brain is deprived of blood and oxygen, causing the brains
cells to die. Some people have defects in the blood vessels of the brain that
make this more likely. These defects may include:
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Aneurysm, is a weak area in the wall of a blood vessel that causes the
blood vessel to bulge or balloon out. When an aneurysm occurs in a
blood vessel of the brain, it is called a cerebral aneurysm

Arteriovenous malformation (AVM), is an abnormal connection

between the arteries and veins in the brain that usually forms before
birth.

2.3

Stroke Risk Factor

High blood pressure is the number one risk factor for strokes. The other major
risk factors are:

Atrial fibrillation or flutter is a common type of abnormal heartbeat. The heart

rhythm is fast and irregular in this condition

Diabetes

Family history of stroke

High cholesterol

Increasing age, especially after age 55

Race (black people are more likely to die of a stroke)

Stroke risk is also higher in:

People who have heart disease or poor blood flow in their legs caused by
narrowed arteries

People who have unhealthy lifestyle habits such as

o
o
o
o
o

Being overweight or obese

Drinking heavily
Eating too much fat or salt
Smoking
Taking cocaine and other illegal drugs
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Birth control pills can increase the chances of having blood clots. The risk is
highest in woman who smoke and are older than 35

2.4

Symptoms
The symptoms of stroke depend on what part of the brain is damaged. In some
cases, a person may not know that a stroke has occurred. Most of the time, symptoms
develop suddenly and without warning. However, symptoms may occur on and off for
the first day or two. Symptoms are usually most severe when the stroke first happens,
but they may slowly get worse. A headache may occur if the stroke is caused by
bleeding in the brain. The headache:

Starts suddenly and may be severe

Occurs when you are lying flat

Wakes you up from sleep

Gets worse when you change positions or when you bend, strain, or cough
Other symptoms depend on how severe the stroke is and what part of the brain

is affected. Symptoms may include:

Change in alertness (including sleepiness, unconsciousness, and coma)

Changes in hearing

Changes in taste

Changes that affect touch and the ability to feel pain, pressure, or different
temperatures

Clumsiness

Confusion or loss of memory

Difficulty swallowing
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Difficulty writing or reading

Dizziness or abnormal feeling of movement (vertigo)

Lack of control over the bladder or bowels

Loss of balance

Loss of coordination

Muscle weakness in the face, arm, or leg (usually just on one side)

Numbness or tingling on one side of the body

Personality, mood, or emotional changes

Problems with eyesight, including decreased vision, double vision, or total

loss of vision

2.5

Trouble speaking or understanding others who are speaking

Trouble walking

Diagnosis
Your doctor may also perform diagnostic tests to confirm a stroke and to
pinpoint its location:

Blood tests: Your doctor may want to test your blood for clotting time, blood
sugar levels, or infection. These can all affect the likelihood and progression
of a stroke.

Angiogram: By adding a dye to your blood and then taking an X-ray of your
head, your doctor can find the blocked or hemorrhaged blood vessel.

Carotid ultrasound: Using sound waves to image the blood vessels in your
neck helps to determine if there is abnormal blood flow towards your brain.
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Computed tomography (CT) scan: A CT scan is often performed soon after

symptoms of a stroke develop to find the problem area or other problems that
might rule out a stroke.

Magnetic resonance imaging (MRI): MRIs can also be used to check for
damaged blood vessels.

Echocardiogram: This imaging technique uses sound waves to create a picture

of your heart. It can help to find the source of blood clots.

2.6

Treatment
Treatment for a stroke depends on the type. In the case of an ischemic stroke,
the goal is to remove the blockage. In the case of a hemorrhagic stroke, treatments are
aimed at controlling the bleeding.
1. To treat an ischemic stroke, may be given a clot-dissolving drug or a blood
thinner. You may also be given aspirin to prevent a second stroke. In some
cases, emergency treatment may include injecting medicine into the brain or
removing a blockage with surgery. The following steps are critical before
injecting a clot-buster drug:

Before the thrombolytic is given, a CT scan must first confirm that the
stroke is not hemorrhagic. If the stroke is ischemic, a CT scan can also
suggest if injuries are very extensive, which might affect the use of
thrombolytics.

Thrombolytics must be administered within 3 hours of a stroke to have any

effect. Best results are achieved if patients are treated with 90 minutes of a
stroke. Thrombolytics carry a risk for hemorrhage, so they may not be
appropriate for patients with existing risk factors for bleeding.

2. To treat a hemorrhagic stroke, may be given a drug that lowers the pressure in
your brain caused by the bleeding. may also need surgery, if the bleeding is
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severe, to remove excess blood. You may also need surgery to repair the
ruptured blood vessel.
After any type of stroke, there is a recovery period that varies depending on
how severe the stroke was may need to participate in rehabilitation because of the
effects of the stroke. This can include speech therapy, occupational therapy, or work
with a psychiatrist, neurologist, or other professionals. The goal of treatment after a
stroke is to help the patients recover as much function as possible and prevent future
strokes. Recovery will begin while they are still in the hospital or at a rehabilitation
center. It will continue when they go home from the hospital or center. During stroke
recovery, the patients will learn how to manage:

2.7

Bladder and bowel problems

Living at home instead of a nursing facility

Loss of movement or feeling in one or more parts of the body

Muscle and nerve problems

Muscle spasms

Pressure sores

Speech problems

Stroke rehabilitation

Swallowing and eating problems

Thinking and memory problems

Effects of Stroke

A stroke can cause various disabilities. The type of disability depends on

which part of the brain was damaged. According to the U.S. National Institutes of
Health, the five main types of stroke disabilities are:

Paralysis or Problems Controlling Movement (Motor Control). Paralysis tends

to occur on opposite side of the body from the side of the brain damage. If
someone has brain damage on the left side of the brain, the right side of the
body will be affected, and the reverse is also true. One-sided paralysis is called
hemiplegia, and one-sided weakness is called hemiparesis. Hemiplegia or
hemiparesis can affect a persons ability to walk or grasp objects. Loss of
muscle control can also cause problems swallowing (dysphagia) or speaking
(dysarthria). Patients may also have difficulty with coordination and balance
(ataxia).

Sensory Disturbances Including Pain. Stroke can affect the ability to feel
touch, pain, temperature, or position. Pain, numbness, and tingling or pricking
sensations can occur in the paralyzed or weakened limb (paresthesia).
Sometimes patients have problems recognizing their affected arm or leg. Some
stroke survivors experience chronic pain, which often results from a joint
becoming immobilized or frozen. Muscle stiffness or spasms are common.
Sensory disturbances can also affect the ability to urinate or control bowels.

Problems Using or Understanding Language (Aphasia). At least 25% of

stroke survivors have language impairments, which affect the ability to speak,
write, and understand spoken or written language. This condition is called
aphasia. Sometimes patients will know the right words but have problems
saying them (dysarthria).

Problems with Thinking and Memory. Stroke can affect attention span and
short-term memory. This can impair the ability to make plans, learn new tasks,
follow instructions, or comprehend meaning. Some stroke survivors are unable
to recognize or understand their physical impairments or are unaware of
sensations affecting the stroke-impaired side of the body.

Emotional Disturbances. Some emotional and personality changes that follow

a stroke are caused by the effects of brain damage. Clinical depression is very
common, and is not only a psychological response to stroke but a symptom of
physical changes in the brain. Patients may have difficulty controlling
emotions or may exhibit inappropriate emotional responses (crying, laughing,
or smiling for no apparent reason).

2.8

Prevention
There are many risk factors for having a stroke. Correspondingly, there are
many measures that can be taken to help prevent them. These preventive measures are
similar to the actions that would take to help prevent heart disease, and include the
following:

Maintain normal blood pressure

Limit saturated fat and cholesterol intake

Refrain from smoking and drink alcohol in moderation

Control diabetes

Maintain a healthy weight

Get regular exercise

Eat good nutrition :

o Choose a diet rich in fruits, vegetables, and whole grains.
o Choose lean proteins, such as chicken, fish, beans and legumes.
o Choose low-fat dairy products, such as 1% milk and other low-fat items.
o Avoid sodium (salt) and fats found in fried foods, processed foods, and
baked goods.

o Eat fewer animal products and foods that contain cheese, cream, or eggs.
If the doctor knows that someone at risk for a stroke, they may be prescribed
medications to prevent one. These include drugs that thin the blood and prevent clot
formation.

CHAPTER III
CLOSING
3.1

Conclusion
Stroke or CVA is damage to the brain caused by a disruption of the
blood supply to a part of the brain. This disruption of blood supply can be
caused by a blood clot known as Ischemic Stroke, or by a ruptured artery
known as Hemorrhagic Stroke. Stroke as a dangerous disease has own
symptoms and effects that we have to be aware of them. Besides, there are
many measures that can be taken to help prevent them and many treatments to
anticipate them.

3.2

Suggestion
To anticipate the risks of the stroke, it will be better for us to
understand the symptoms and the effects by looking for other responsible
literature and avoid everything causes stroke by implement healthy life
pattern.

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REFERENCES

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