Ischemic Stroke

Ischemic stroke is a stroke caused by a blood clot that blocks a blood vessel in the brain. This condition causes the supply of oxygen and nutrients to the brain to be disrupted. Ischemic stroke is an emergency condition, because it can cause the death of brain cells within minutes.

In general, stroke is divided into two types, namely ischemic stroke and hemorrhagic stroke. Hemorrhagic stroke is caused by the rupture of a blood vessel in the brain. Meanwhile, ischemic stroke occurs when blood vessels in the brain are blocked.

Ischemic stroke is also known as infarction stroke. This stroke is the most common type.

Causes of Ischemic Stroke

The main cause of ischemic stroke is atherosclerosis. Atherosclerosis can cause two types of blood clots, namely:

Thrombosis, namely the formation of a blood clot in one of the arteries that supply blood to the brain. This blood clot does not come from another blood vessel.
Embolism, which is the formation of blood clots in other organs, such as the heart or the large arteries in the neck and chest. This blood clot then breaks free and flows into the blood vessels of the brain.

Ischemic stroke risk factors

The risk of ischemic stroke in a person can increase due to the following conditions or factors:

Age over 55 years
Hypertension
Heart disease
Heart rhythm disturbances ( arrhythmias )
Diabetes
Smoking habit
Hormone therapy
History of TIA or heart attack
High cholesterol
Rarely exercise or physical activity
Obesity
Alcohol addiction
Drug use

Ischemic Stroke Symptoms

Symptoms of ischemic stroke depend on the part of the brain that is affected and usually appear suddenly. Some of the common symptoms of an ischemic stroke are:

It is difficult to lift the arm or leg because it is limp or numb
One side of the face droops due to weakened facial muscles
Impaired speech or difficulty understanding what other people are saying
Confused, dizzy, and severe headache
Impaired vision in one or both eyes
Impaired balance and movement of the body

When to see a doctor

Immediately consult a doctor if you or someone close to you experiences the ischemic stroke symptoms mentioned above.

A quick way to recognize stroke symptoms is FAST ( face , arms , speech , time ). Here is the explanation:

Face : one side of the face down
Arms : one side of the arm is difficult to lift
S peech : slurred speech suddenly or unable to speak
Time : if any of these symptoms are present, immediately take them to the emergency room at the nearest hospital

Ischemic Stroke Diagnosis

To diagnose ischemic stroke, the doctor will conduct a debriefing with the patient's family members regarding the initial symptoms appearing, as well as the patient's and family's medical history.

After that, the doctor will carry out a thorough physical and neurological examination. During a physical examination, the doctor will also check blood pressure.

Furthermore, to confirm the diagnosis, the doctor will carry out supporting examinations in the form of:

Blood test, to determine blood sugar levels, signs of infection, and blood clotting speed
CT scan of the head , to check for brain damage, brain bleeding, tumors, or other health problems
MRI , to detect signs of bleeding and cells damaged by ischemic stroke
carotid ultrasound, to detect atherosclerosis in the large arteries of the neck (carotid arteries)
Electrocardiography, to check heart rhythm and detect heart disease or arrhythmias
Echocardiography , to detect the source of blood clots in the heart that can cause embolism

Ischemic Stroke Treatment

Ischemic stroke patients need to be hospitalized in the hospital to receive treatment from a doctor. The actions taken by the doctor aim to restore blood flow to the brain.

There are several treatment methods that can be given by doctors, namely:

1. rtPA injection

rtPA ( recombinant tissue plasminogen activator ) injections are given by infusion within 3–4.5 hours after the first symptoms appear. Giving this drug aims to restore the condition of blood flow to the brain.

2. Anticoagulant drugs

Anticoagulant drugs, such as warfarin , are usually given to ischemic stroke patients with heart rhythm disturbances. This drug works to prevent blood clots from happening again.

3. Other drugs

Antihypertensive drugs, such as beta blockers , and cholesterol-lowering drugs, such as rosuvastatin , will also be prescribed by the doctor. These drugs function to maintain normal blood pressure and prevent the development of atherosclerosis.

4. Operation thrombectomy

If the above treatments are ineffective, the doctor will perform a blood clot-breaking operation by inserting a small tube through the thigh vein. This action can be done up to 24 hours after the appearance of the first symptoms.

5. Carotid endarterectomy surgery

In patients with ischemic stroke, blood clots that block blood vessels of the brain can originate from the carotid artery. Carotid endarterectomy surgery aims to remove fatty plaques in these blood vessels.

Ischemic Stroke Recovery

The doctor will suggest long-term treatment to help the patient fully recover. This post- stroke therapy is given based on the severity of the patient and the part of the brain that is affected.

Some of the therapies that can be done by patients are:

Physiotherapy

In general, physiotherapy has short and long term goals. In the short term, the patient will be trained to do simple things, such as picking up objects. While on the long term target, the patient will be trained to stand and walk.

Occupational therapy

Patients who find it difficult to perform simple movements, such as buttoning a shirt, may undergo occupational therapy . This therapy can also train patients to use equipment that facilitates daily work.

talk therapy

Impaired speech in ischemic stroke sufferers is caused by damage to the part of the brain that regulates speech, or is called aphasia . To restore the ability to communicate, the doctor will recommend the patient to undergo speech therapy.

Ischemic Stroke Complications

Ischemic stroke can cause serious complications in the form of:

Difficulty speaking
Decreased ability to think and remember
Changes in behavior
Paralysis
Dead

Ischemic Stroke Prevention

Ischemic stroke can be prevented by adopting a healthy lifestyle and routine check-ups if you have a history of certain diseases. In addition, the way to prevent ischemic stroke is the same as efforts to prevent heart disease, such as: