Strokes

What are Strokes?

Strokes are a medical emergency occurring when the blood supply to the brain is disrupted, depriving brain tissue of oxygen and nutrients. This can lead to the rapid death of brain cells, causing physical, cognitive, and emotional impairments. Strokes are among the leading causes of death and long-term disability worldwide, including Singapore.

Types of Strokes

Strokes are classified into three main types based on their underlying cause:

• Ischaemic Stroke: The most common type, caused by a blood clot or other obstruction in a blood vessel supplying the brain. Subtypes include:

  • Thrombotic Stroke: A clot forms in one of the brain's arteries.

  • Embolic Stroke: A clot or other debris forms elsewhere in the body and travels to the brain.

• Haemorrhagic Stroke: Occurs when a blood vessel in the brain bursts, leading to bleeding (haemorrhage). Subtypes include:

  • Intracerebral Haemorrhage: Bleeding occurs directly into the brain tissue.

  • Subarachnoid Haemorrhage: Bleeding occurs in the space between the brain and the thin tissues covering it.

• Transient Ischaemic Attack (TIA): Often referred to as a "mini-stroke," this occurs when blood flow to the brain is temporarily blocked, causing stroke-like symptoms that resolve within 24 hours. TIAs serve as a warning sign for a future stroke.

Symptoms of Strokes

Recognising stroke symptoms promptly can save lives. Common signs include:

• Sudden numbness or weakness, especially on one side of the body

• Difficulty speaking or understanding speech

• Vision problems in one or both eyes

• Sudden dizziness, loss of balance, or coordination

• Severe headache with no known cause

The acronym FAST can help remember the warning signs:

• Face drooping

• Arm weakness

• Speech difficulties

• Time to call emergency services immediately

Diagnosis and Treatment Options

Diagnosis: Accurate and timely diagnosis is crucial for effective stroke management:

• Imaging Studies:

  • CT Scan: Quickly identifies bleeding in the brain.

  • MRI: Offers detailed images to detect areas of brain damage.

• Blood Tests: Check for clotting issues or infections.

• Carotid Ultrasound: Examines blood flow in the neck arteries.

• Cerebral Angiography: Provides detailed images of the brain’s blood vessels.

Treatment: Treatment depends on the type and severity of the stroke:

• Ischaemic Stroke:

  • Thrombolytic Therapy: Medications like tissue plasminogen activator (tPA) dissolve clots if administered within the treatment window.

  • Mechanical Thrombectomy: A procedure to physically remove the clot using specialised tools.

  • Antiplatelet or Anticoagulant Therapy: Prevents future clots.

• Haemorrhagic Stroke:

  • Surgical Intervention: Repairs damaged blood vessels or removes accumulated blood.

  • Medications: Lower blood pressure or reduce brain swelling.

• Rehabilitation:

  • Physical, occupational, and speech therapies to regain lost skills and improve quality of life.

Conclusion

Strokes are life-threatening emergencies requiring immediate attention. Recognising symptoms early and seeking prompt medical care can significantly reduce the risk of permanent damage. At Singapore Brain Spine Nerves Center, we offer comprehensive stroke care, from acute management to rehabilitation, ensuring a multidisciplinary approach tailored to each patient’s needs. If you or a loved one are experiencing stroke symptoms, don’t delay—act FAST and seek medical attention immediately.