A stroke is a condition in which damage to brain tissue occurs as a result of blockage or bleeding of cerebral vessels. When cells in the brain do not receive enough oxygen and nutrients, they are damaged and lose function. It starts suddenly and can often lead to paralysis of a part of the body. Stroke is a health problem that requires urgent intervention.
Stroke is a condition that requires rapid intervention. Early treatment can prevent further brain damage and increase the chances of recovery. Symptoms of stroke include drooping of one side of the face, difficulty speaking, loss of strength in the arms or legs and severe headache.
What are the Causes of Stroke?
Stroke can develop due to various health problems and lifestyle factors. The main causes of this condition, which occurs when the blood flow to the brain is interrupted or the vessels in the brain are damaged, are as follows:
Atherosclerosis (arteriosclerosis): The narrowing and blockage of blood vessels as a result of plaque buildup in the blood vessels is one of the most common causes of stroke. Atherosclerosis is a condition that increases the risk of heart disease and stroke.
High Blood Pressure (Hypertension): High blood pressure can cause brain vessels to weaken and rupture. This increases the risk of stroke.
Diabetes: Diabetes destroys blood vessels, blocking blood flow and can increase the risk of stroke. Atherosclerosis is more common in people with diabetes.
Heart Diseases: In particular, heart rhythm disorders (for example, atrial fibrillation) and valvular heart disease can cause blood clots to form and travel to the brain.
Smoking Smoking narrows the blood vessels, making blood flow more difficult. It also increases the tendency of blood to clot, which significantly increases the risk of stroke.
Alcohol and Drug Addiction: Excessive alcohol consumption and some drugs can raise blood pressure and weaken blood vessels.
Familial Predisposition: People with a family history of stroke have a higher risk of stroke. Genetic factors can affect an individual's vascular health and heart function.
Obesity and Sedentary Lifestyle: Excess weight and a sedentary lifestyle raise blood pressure and cholesterol levels, which increases the risk of stroke.
High Cholesterol: High cholesterol levels can lead to clogged arteries, increasing the risk of stroke. LDL (bad) cholesterol, in particular, forms plaques that cause blood vessel blockage.
Blood Clotting Disorders: Excessive blood clotting can cause clots to block the brain vessels. This can be caused by genetic disorders or side effects of certain medications.
Advanced Age: The risk of stroke increases with age. People aged 55 and over are more likely to have a stroke.
Stress and Anxiety: Prolonged stress can raise blood pressure and impair vascular health, a factor that increases the risk of stroke.
Ischemic Stroke
Ischemic stroke is a condition in which cerebral blood vessels are blocked by a clot or narrowing and oxygen and nutrients cannot reach brain tissue. The death of brain cells due to lack of oxygen leads to loss of function in certain areas of the brain. Ischemic stroke accounts for about 85% of all strokes and usually has a sudden onset.
Ischemic stroke usually starts suddenly and can manifest itself with the following symptoms
- Weakness or paralysis on one side of the body
- Speech disorders (tongue rotation, inability to find words)
- Low percentage (especially on one side)
- Vision loss or double vision
- Loss of balance and coordination problems
- Severe headache (in some cases)
- Loss of consciousness or confusion
Treatment of ischemic stroke is time-critical. It should be intervened as soon as possible to prevent brain damage. Ischemic stroke leads to the death of brain cells that suffer from lack of oxygen due to blockage in the brain vessels. Early diagnosis and treatment are crucial to minimize brain damage and speed up the patient's recovery process.
Hemorrhagic Stroke
A hemorrhagic stroke is a type of stroke that occurs when the vessels of the brain rupture or bleed. The bleeding can put pressure on brain tissue, causing serious damage. While hemorrhagic stroke is less common than ischemic stroke, it is often more serious and can be fatal. Damage to brain tissue damages the nerve cells that control the body, which can lead to paralysis, difficulty speaking or other neurological disorders.
Hemorrhagic stroke usually has a sudden onset and can manifest itself with the following symptoms
- Severe and sudden headache
- Blurred vision or loss of vision
- Speech disorders
- Weakness or paralysis on one side of the body
- Loss of balance and coordination problems
- Loss of consciousness or confusion
- Seizures
Hemorrhagic stroke is treated to stop the bleeding and reduce the pressure on the brain. A hemorrhagic stroke is caused by a rupture or bleeding in the vessels of the brain and usually has more severe consequences. Early intervention is very important because the longer the bleeding continues, the more damage it causes to brain tissue. Hemorrhagic stroke is often associated with factors such as high blood pressure, an aneurysm and head trauma. In such strokes, treatment should be prompt and effective, and the monitoring and rehabilitation process should be carefully managed.
Hemorrhagic Stroke Factors
A hemorrhagic stroke occurs when a blood vessel inside the brain ruptures and starts bleeding. Blood accumulates in the brain tissue, damaging brain cells and causing serious health problems. Although hemorrhagic stroke is less common than ischemic stroke, it can often have more severe consequences. The main risk factors that play a role in the development of hemorrhagic stroke are
High Blood Pressure (Hypertension): High blood pressure can weaken the walls of the brain vessels, causing them to rupture. Long-term hypertension is one of the main causes of brain hemorrhages.
Aneurysm: Bubble-shaped enlargements (aneurysms) that form at weak points in the vessels in the brain can weaken the blood vessels. Burst aneurysms increase the risk of bleeding and stroke. This can be caused by genetic factors or defects in the structure of the blood vessels.
Bleeding Disorders: Diseases that impair the blood's ability to clot (for example, hemophilia or platelet disorders) can cause blood vessels to rupture and not stop bleeding. People with bleeding disorders have a higher risk of hemorrhagic stroke.
Alcohol and substance abuse: Excessive alcohol consumption and some drugs can increase blood pressure and weaken blood vessels. Also, alcohol and certain substances can change the clotting properties of blood, which can lead to increased bleeding.
Brain Tumors: Some tumors in the brain can strain or weaken the blood vessels. Tumors can cause brain vessels to rupture, leading to bleeding.
Vasculitis (Inflammation of the blood vessels): Inflammation of the blood vessels can weaken the vessel walls and cause bleeding. Vasculitis can develop as a result of certain infections, autoimmune diseases or genetic factors.
Family History: Hemorrhagic stroke may be associated with a familial predisposition. Individuals with a family history of hemorrhagic stroke are more likely to experience this condition.
Age and Gender: Hemorrhagic stroke carries an increased risk with age. This type of stroke is more common in men, but women may also be at risk after certain ages.
Excessive Physical Activity or Trauma: Sudden and intense physical activity or blows to the head can lead to ruptured brain vessels. The risk increases especially in people who play heavy sports or in people who have suffered head trauma.
Drug Use (Blood Thinners): Blood thinners help prevent blood vessel blockages, but when overused, they can increase the risk of bleeding and increase the likelihood of developing a hemorrhagic stroke.
Hemorrhagic stroke usually starts suddenly and is characterized by symptoms such as severe headache, loss of consciousness, seizures and speech disorders. Early detection and intervention is vital and can help prevent permanent damage.
Transient Ischemic Attack (TIA)
A Transient Ischemic Attack (TIA) is a condition of short-term neurological symptoms caused by a temporary blockage of blood flow to the brain. A TIA can also be called a "mini-stroke" because the symptoms are temporary and usually resolve completely within 24 hours. However, a TIA can be an indicator of the risk of having a larger stroke and is a condition that requires immediate intervention.
Symptoms vary depending on which area of the brain is affected. But in general, the following may occur:
- Sudden weakness or paralysis: Weakness, numbness or loss of movement on one side of the body (usually the arm or leg).
- Speech disorders: Difficulty understanding, not being able to find words or slurred speech.
- Vision loss: Blurred vision in one or both eyes, loss of vision in one eye.
- Dizziness and loss of balance: Coordination problems, loss of balance or feeling dizzy.
- Facial drooping: A drooping of one side of the face, usually around the mouth or eyes.
- Loss of consciousness or confusion: Difficulty thinking and reacting.
TIA does not cause brain damage, but it increases the risk of permanent stroke, so treatment is important. People who have had a TIA should have regular check-ups to reduce their risk of stroke. Healthy lifestyle changes (balanced diet, regular exercise, avoiding smoking and alcohol) can reduce the risk of TIA recurrence. Regular monitoring of blood pressure and cholesterol levels is also necessary.
A transient ischemic attack (TIA) is usually characterized by transient neurological symptoms and can be an indicator of the risk of serious stroke. Early intervention can help prevent permanent brain damage and reduce the risk of stroke. It is of great importance that people with TIA are urgently evaluated and followed up with appropriate treatment.
Stroke Risk Factors
A stroke is caused by a sudden interruption of blood flow to an area of the brain. Stroke risk is shaped by genetic factors, lifestyle, health status and environmental factors. The main factors that increase the risk of stroke:
High Blood Pressure (Hypertension): High blood pressure is the most important and most common factor of stroke risk. High blood pressure weakens the brain vessels, increases the risk of bleeding and can lead to vascular occlusion. Long-term uncontrolled hypertension increases the risk of hemorrhagic stroke and ischemic stroke.
Diabetes (Diabetes): Diabetes weakens blood vessels and leads to the development of atherosclerosis (arteriosclerosis) in the body. This can lead to blockages in the brain vessels. In addition, high blood sugar levels increase the risk of clotting and raise the risk of stroke.
Smoking: Smoking narrows blood vessels, blocking blood flow and increasing the tendency to clot. Smoking also accelerates atherosclerosis, causing damage to the brain vessels. Smokers have a higher risk of stroke than non-smokers.
High Cholesterol: High cholesterol causes plaque to build up in the blood vessels, causing narrowing and blockage of the blood vessels. This can block blood flow in the brain vessels and increase the risk of ischemic stroke. Low-density lipoprotein (LDL) cholesterol is a factor that increases the risk of stroke.
Obesity: Being overweight can lead to a confluence of stroke risk factors such as high blood pressure, diabetes and high cholesterol. Obesity is also associated with heart disease, which directly affects the risk of stroke.
Lack of Physical Activity: A sedentary lifestyle sets the stage for the development of cardiovascular diseases, hypertension, diabetes and obesity. Not exercising regularly is an important factor that increases the risk of stroke.
Family History of Stroke: People with a family history of stroke have a higher risk of stroke due to genetic predisposition. Genetic factors in the family may affect blood clotting disorders or vascular diseases.
Age: The risk of stroke increases with age. People aged 55 and over are more likely to have a stroke. With age, blood vessels weaken and the risk of clotting increases. Also, the frequency of conditions that increase the risk of stroke, such as heart disease, increases in older people.
Gender: While men can have a stroke at a younger age than women, the risk of stroke increases in postmenopausal women due to changes in hormone levels. Women on hormone therapy may be at higher risk of stroke in some cases.
Alcohol Consumption: Excessive alcohol consumption raises blood pressure, disrupts heart rhythm and weakens blood vessels. Alcohol can also increase the risk of stroke by affecting blood clotting.
Stress and Psychological Factors: High levels of stress can trigger heart disease, hypertension and other stroke risk factors. In addition, psychological conditions such as depression can also increase the risk of stroke.
Aneurysms: The formation of aneurysms (blood vessel bubbles) in the vessels of the brain can cause them to weaken and burst. When an aneurysm bursts, a hemorrhagic stroke occurs, which can be life-threatening.
Sleep Apnea: Sleep apnea adversely affects blood vessels by causing breathing to stop and oxygen levels to drop. Prolonged sleep apnea can increase the risk of stroke.
The risk of stroke can be significantly reduced with lifestyle changes, regular medical check-ups and a healthy lifestyle. Managing factors such as high blood pressure, diabetes, smoking, alcohol consumption and a sedentary lifestyle can minimize the risk of stroke. Early diagnosis and treatment are critical to reduce the likelihood of stroke and minimize its effects.
Medical Risk Factors
Stroke can be triggered by various medical conditions, along with genetic and environmental factors. The main medical factors that increase the risk of stroke are:
High Blood Pressure (Hypertension): It is the most important determinant of stroke risk. Prolonged high blood pressure can weaken blood vessels and increase clot formation.
Diabetes (Diabetes): High blood sugar levels destroy blood vessels and accelerate atherosclerosis, increasing the risk of stroke.
High Cholesterol: High levels of LDL (bad cholesterol) can lead to blocked arteries.
Heart Diseases: Heart rhythm disorders, especially atrial fibrillation, increase the risk of stroke by causing blood clots to travel to the brain vessels.
Blood Clotting Disorders: Excessive blood clotting can cause clots to block the brain vessels.
Obesity and Sedentary Lifestyle: Obesity is associated with factors such as hypertension and diabetes, which increase the risk of stroke.
These medical risk factors can be controlled with lifestyle changes and treatment, so regular health check-ups are important.
Other Health Problems That Can Occur During a Stroke
Stroke not only affects brain function, but can also lead to various health problems in other systems of the body. The main health problems during or after a stroke can be the following:
Brain Swelling (Edema): Damage to brain tissue during a stroke can lead to brain swelling. Brain edema can cause headaches, loss of consciousness, seizures and in severe cases can be life-threatening.
Respiratory Problems: Stroke can affect the respiratory muscles, which can cause breathing difficulties. Respiratory obstructions or lung infections (e.g. pneumonia) can develop.
Heart Problems: Stroke can also affect heart function. In particular, the risk of heart rhythm disorders (atrial fibrillation) or heart attack may increase. People who have had a stroke should also have their heart health closely monitored.
Paralysis of one side of the body (hemiparesis): When a stroke affects one hemisphere of the brain, paralysis (hemiparesis) can develop on the opposite side of the body. This can severely limit a person's mobility and activities of daily living.
Urinary and Stool Control Problems: Stroke can affect control of the urinary tract or bowel. People who have had a stroke may develop problems such as loss of bladder control, incontinence or fecal incontinence.
Swallowing Difficulties (Dysphagia): Stroke can cause swallowing difficulties by disrupting swallowing reflexes. This can cause feeding difficulties and the risk of choking. In addition, infections such as pneumonia may develop as a result of food entering the lungs.
Speech and Language Problems (Aphasia): Stroke can affect the language processing part of the brain, which can lead to aphasia (speech impairment). The person may struggle to find the right words, have difficulty understanding or may not be able to speak at all.
Vision Problems: A stroke can cause loss of vision or double vision (diplopia). The interruption of blood flow to the visual center of the brain can lead to temporary or permanent loss of vision.
Psychological Problems (Depression and Anxiety): Depression, anxiety and other psychological disorders can be common after a stroke. The person may have difficulty coping with the emotional burden of losing physical and cognitive functions.
Seizures (Epilepsy): Damage to the brain can lead to seizures. Seizures that develop after a stroke can be long-lasting and may need to be treated.
Muscle stiffness on both sides of the body (spasticity): Stroke can cause stiffness (spasticity) in the muscles. This can cause overstretching of the muscles and involuntary contractions, which can limit a person's mobility.
Brain hemorrhage (hemorrhagic stroke): If the stroke occurred through bleeding, bleeding inside the brain can further damage surrounding tissues and lead to more serious complications. This can cause further brain damage and can be life-threatening.
Stroke not only affects brain function, it can affect a person's overall health and quality of life for a long time. Therefore, it is important that people who have had a stroke are monitored and treated by a multidisciplinary team.
What are the Symptoms of Stroke?
Stroke symptoms often appear suddenly and are serious health conditions that need to be assessed quickly. As a stroke occurs when the blood supply to the brain is interrupted, the symptoms vary depending on the area of the brain affected. Common symptoms include:
- Loss of Consciousness: The person may suddenly lose consciousness or experience confusion and inability to wake up.
- Facial Asymmetry: A drooping or asymmetrical appearance of one side of the face (for example, one side becomes numb or droops down when smiling).
- Arm and Leg Weakness or Paralysis: Weakness or paralysis of the arm, leg or both on one side of the body may develop.
- Speech Difficulties: Slurred speech, inability to pronounce words correctly or incomprehensible speech.
- Visual Impairments: Sudden loss of vision or double vision in one or both eyes.
- Headaches: Severe and sudden onset of headaches, especially in the case of cerebral hemorrhage (hemorrhagic stroke).
- Balance Problems: Difficulty walking, balancing or feeling dizzy.
- Swallowing Difficulty: Difficulty swallowing or a feeling of choking.
What are the Diagnostic Methods for Stroke?
Stroke is diagnosed by clinical examination and various imaging tests. Diagnostic methods include the following:
Physical Examination: The doctor performs a nervous system examination and evaluates factors such as muscle strength, reflexes, balance and coordination.
Computed Tomography (CT): It is used for the fastest diagnosis of stroke. It shows bleeding or vascular occlusion in the brain.
Magnetic Resonance Imaging (MRI): More detailed images of the brain can be taken to determine the type of stroke (ischemic or hemorrhagic).
Doppler Ultrasonography: Used to detect blockages in the vessels that carry blood to the brain.
Blood Tests: This is done to assess factors such as blood clotting disorders, sugar and cholesterol levels.
Electrocardiogram (ECG): It is used to assess whether heart rhythm disturbances are present.
Stroke Treatment Methods
Stroke treatment varies according to the type of stroke and the area of the brain it affects. Treatment methods may include:
Ischemic Stroke Treatment:
- Thrombectomy: A procedure to remove a blood clot.
- Thrombolytic Therapy: If the person who has had a stroke has a clot in their veins, medication to dissolve the clot (usually to be administered within 4.5 hours).
- Hemorrhagic Stroke Treatment:
- Brain Bleeding Control: Attempts are made to stop the bleeding. Medications and surgical interventions can be applied to stop bleeding.
- Blood Pressure Management: If bleeding continues, blood pressure is controlled to prevent the spread of bleeding.
- Rehabilitation: Physical therapy, speech therapy, psychological support and other rehabilitation methods can help restore function after a stroke.
Stroke Surgery
Surgical intervention may be necessary in some cases in stroke treatment. Surgeries can be performed for the following purposes:
Surgical Intervention in Case of Bleeding: In patients with hemorrhagic stroke, bleeding can be stopped by intervening in the bleeding area in the brain.
Aneurysm Repair: When vascular bubbles (aneurysms) in the brain rupture, surgical intervention can be performed in these areas.
Carotid Artery Surgery: Neck arteries blocked by atherosclerosis can be opened, which reduces the risk of stroke.