Stroke is one of the most dreaded life threatening and altering health conditions affecting the world’s population. Fear of stroke is majorly due to its lasting effects on surviving victims like paralysis. It is also feared due to the fact that it can cause death if not treated immediately and properly. Actually almost quarter of stroke victims always die. According to a 2004 research conducted by American Heart Association, about 700,000 new or recurrent cases of stroke occur yearly in the United States of America. According to the same study, about 4.9 million stroke survivors live today. The same research also estimates the direct and indirect costs of stroke to be about 53.6 billion American dollars. The 30 year projection by the study shows that these numbers will increase and as such outpace the overall population growth.
Available statistics is a pointer to the devastating effects that stroke has on the victims as well as o family and friends. Imagine your spouse, parent, child, brother/sister or your closest friend permanently paralyzed after a stroke. Now you have to spoon feed them, wash them and move them around on wheelchairs. Majority of survivors of stroke lose their jobs because of paralysis that renders them unable to perform at work.
The effects of stroke could be social, economic, physical and emotional.
Emotional effects of stroke
When a stroke victim is hospitalized, it affects their emotions due to the strange environment in the hospital. The change in routine and lack of ability to take in what is happening to them is a serious blow to their emotions.
Physical effects of stoke
Onset of stroke causes loss of power in the muscles of the face, trunk, arm and leg on one side of the body. The power however gradually returns in most cases. However, the limbs need to be put through a range of movements and placed in the right position lest they stiffen and become useless even with the return of power. Survivors may in such cases need to move around on wheel chairs and be assisted with their daily physical activities
Financial effects of stroke
Hospitalization bills, loss of employment and the cost of assistance that a stroke survivor would need are some of the financial implications of stroke.
Social effects of a stroke
After an attack by stroke, the life of the survivor greatly changes not only for them but for people close to them too.
It would not make sense to discuss stroke without giving its scientific definition and explaining how it occurs.
Stroke, also referred to as cerebro-vascular accident (CVA) is a medical condition resulting from cut-off of blood supply to part of the brain. Brain tissues in the affected area are damaged and eventually die off. This is because the interrupted blood supply deprives the tissues of oxygen and nutrients which they require to function always supplied in blood.
Depending on what causes the cut-off of blood supply to the tissues, there are two kinds of stroke:
- Ischemic stroke occurs when a blood clot interrupts the supply of blood to the brain tissues in the affected area. This kind accounts for about 85% of all stroke cases.
- Hemorrhagic stroke results when blood vessels in the brain rapture and bleed thus interrupting supply of blood to the tissues of the affected area.
In the affected area, there are two major zones of injury:
- The core ischemic zone is the zone of severe ischemia with blood flow as low as 10 to 25%. This leads to loss of oxygen and nutrients thus energy stores are rapidly depleted. The result of this is death of neurons and supporting cellular elements
- Ischemic penumbra zone is a thin layer of tissues that are found between the core ischemic zone and the normally perfused area. Cells in this zone may remain viable for several hours since arteries anastomosing with branches of the blocked vascular tree supply blood to them. This supply is however not sufficient enough to sustain the neural nutrient and oxygen demand indefinitely. The cells of the penumbra will thus eventually die unless there is reestablishment of reperfusion during the early stages of stroke.
Pharmacological interventions are most effective in the penumbra zone. All acute stroke therapies aim at saving the penumbra.
The only approved treatment for acute ischemic stroke to date is intravenous tissue plasminogen activator (IV t-PA). The aim of this treatment is to restore the patency of the artery and increase blood flow. This has the effect of reducing the amount of cerebral damage and in effect reduces functional deficits. Its use is limited to 3-4.5 hours after the onset of stroke. This is because chances of it causing a cerebral hemorrhage drastically increase after several hours.
Another treatment called Neurothrombectomy is approved in US for use in removing blood clots in a time span of 8 hours from the onset of stroke. It requires the services of an experienced invasive neurologist.
There exists an unmet need to develop more treatments of acute ischemic stroke.
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