A good weekend to all who make life in this prestigious community, I hope your day is going very well and that it is being of much benefit.
In my case, when I learn something new, for me it is very useful, the publications I read here always leave me a learning experience, even if it is not in my professional area, but this is a good thing, because the possibility of learning has no limit, unless we put it ourselves.
Yesterday I uploaded the following post: Let's talk about Stroke or cerebrovascular accident, to start this series of 3 posts, where this is the second one, in which I intend to address a topic that unfortunately is very frequent, and more and more even in young population. Let's go to the second part where I will explain details of the most common form of presentation as it is, the ischemic stroke.
As I said before, the brain has a very complex vascular network, which is in charge of supplying blood (the arteries) and collecting metabolic wastes (the veins). In this particular case of stroke what is affected is the arterial system, and it ends up being a big problem.
Let us remember that the arteries are responsible for transporting blood rich in oxygen, glucose, and other molecular elements (proteins, lipids, electrolytes, hormones, neurohormones) necessary for proper functioning, if something like an obstruction occurs in this system, obviously all the flow of necessary nutrients will not reach where they are used, causing damage due to deficiency.
The magnitude of the damage will depend on the areas that irrigated the artery that has been obstructed, and at the same time of the functions that the affected area coordinated; that is to say, if the area that stops receiving blood because of an obstruction is the one in charge of controlling the mobility of the right leg, for example, this leg will be affected and the control that was exercised by means of that specific area of the brain will no longer be possible.
Here I have to make an important distinction, and that is the fact that there are transitory strokes, those where the obstruction of the artery is generated and later the blood flow is released, allowing the area that was momentarily affected, once the irrigation is normalized, to recover practically 100% of its functions. What is called a transitory stroke, usually presents the symptoms of the pathology, they disappear completely when the blood flow is restored, but it should be noted that the chances of a person suffering a transitory stroke end up presenting a permanent picture are high.
But why does a stroke occur?
The main cause of obstruction is the formation of a blood clot (thrombus) which then migrates to another side (becoming an embolus), where it ends up obstructing an artery and limiting the blood supply.
Therefore, we could say that any disease that predisposes to the formation of thrombi and emboli falls within this range of "causes of stroke".
The main cause of this pathology is arterial hypertension, and secondly heart rhythm problems, mainly when they are irregular, which can cause clots to form inside.
But apart from this, there are conditions that are established with the passage of time and by poor eating habits, such as (major predisposing factor), atherosclerosis. This is atheroma or lipid plaques adhered to the internal walls of the arteries, which causes a narrowing of the arterial lumen, predisposing to the formation of clots.
This is even worse when the person suffers from arterial hypertension, since the heart pushes the blood with more force, which means that when it passes through a reduced space the friction is greater and the chances of a clot occurring are higher.
There is a time threshold that defines whether damage is permanent or not, and this has to do with the length of time the obstruction remains. The brain is highly sensitive to the lack of blood, so immediately the obstruction is generated, symptoms begin to appear, but if the clot is destroyed in time with the proper treatment, it may not progress and may even be reversed.
Cerebral hypoxia, a term that refers to the lack of oxygen in the brain, is quite harmful. Brain cells begin to die after 5 minutes without receiving oxygen, or have irreversible damage, that is why rapid attention when a stroke occurs is important.
As you can imagine, the treatment is not oral, it is not a matter of ingesting some pills and that's it, it must be quickly placed intravenously, even a central line is usually used for it, that is, a line that goes directly to the heart so that it is quickly distributed throughout the body, especially to the site that is obstructed.
It is a drug treatment that dissolves the clots, but its effectiveness is largely determined by the moment in which it is administered. Not only because it dissolves the clot or not, but also because if it is too late, blood flow to the area may be restored when it is too late.
It is not an easy disease to treat, neither immediately nor once the crisis has passed, since we could have effects that are permanent in terms of limitations of movement, requiring the person therapy for a long time, perhaps even for life.
I hope this publication has made it much clearer to you what this disease implies, which is not only a momentary affectation but something that can be permanent, totally limiting the life of the person who has suffered it.
