Stroke is defined as any acute onset focal or generalized brain dysfunction lasting more than 24 hours due solely to vascular causes [Langhorn et al., 2011]. 20% of stroke is hemorrhagic, and about 80% is ischemic. Stroke is the 2nd most common cause of death in people over 60 years of age, but also the 5th most common cause of death in people aged 15-59 years.
24–50% of people who suffer from stroke will have some functional disability within 6–12 months after the episode [Bakas 2012]
Stroke can lead to a wide variety of symptoms and signs. Still, the most common lesion is upper and lower limb disability, which usually affects movement control [Brewer et al., 2013].
A stroke starts with a sudden onset of one or more symptoms:
1. Paralysis of the arms or legs, usually on one side of the body eg, left arm, and leg
2. Numbness in the hands or feet or sometimes on the face
3. Difficulty speaking
4. Difficulty walking (gait instability)
5. Dizziness and balance affected
6. Decreased vision or diplopia
7. Headache and vomiting
8. Drop of the corner of the mouth (crooked mouth)
9. Finally, in serious strokes, the patient loses consciousness and falls into a coma.
Factors that increase a person's chances of having a stroke are:
- The existence of a similar episode in the past, either for the patient himself or for one of his parents
- The existence of a transient ischemic attack or the presence of myocardial infarction (means that the entire vascular system is affected)
- Age. Being over 55 increases the chances of a stroke, although we can see a stroke in children
- Carotid stenosis from atherosclerosis
- High blood cholesterol
- Other heart diseases, e.g., heart failure, arrhythmias such as atrial fibrillation, etc.
- Estrogen therapy / contraceptives
- Diseases related to blood clotting e.g., thrombophilia
- The use of euphoric substances e.g., cocaine, amphetamines
The impact of a stroke depends on two things:
1. The area of brain damage
2. The extent of the brain damage
If the brain damage affects one of the three protruding pathways of the central nervous system - the sphincter, spine, symptoms may include:
- Hemiplegia and facial muscle weakness
- Reduction of sense
- Initial instability (decreased muscle tone), resistance to spasticity (increased muscle tone), excessive reflexes, and involuntary synergies
In most cases, the symptoms affect only one side of the body (hemiplegia). Depending on the part of the brain that is affected, the damage is usually on the opposite side of the body. However, since these pathways travel to the spinal cord and any damage there can also cause these symptoms, the presence of any of these symptoms does not necessarily mean a stroke.