Celebrovascular accident, commonly called stroke, refers to a condition that occurs when blood flow to apart of the brain is stopped (Brass, 2). It is taken to be a disease of the old although it also affects the young. The probability of suffering stroke increases with age. The disruption of blood supply to the brain could be be as a result of a burst blood vessel or when a blood vessel is blocked by a clot. Stroke normally brings about a disturbance in brain functions. On most occasions, the effect on the brain is permanent. Stroke has many symptoms, but one of the most common is that one stroke feels sudden weakness in the face, and arms (Shah, 2). It mostly affects a single side of the body. However, the symptoms depend on the part of the brain that is affected.

Nerve cells in the brain need a continuous supply of blood, oxygen and glucose for them to function normally. When the supply of these resources to the brain is impaired, a part of the brain stops functioning temporarily (Brass, 3). If the part of the brain stop functioning for too long, the brain cells die. Death of brain cells is followed by permanent damage. This is because the several parts of the body controlled by affected part of the brain no longer receive instructions from the brain. Body function affected by stroke may include, speech, limb movements and even memory. Hence the symptoms of stroke will depend on both the blood vessel affected as well as the part of the brain that is affected.

The two major mechanisms of stroke are ischemia and hemorrhage (Shah 3). Ischemia, the most common form of stroke, results from decreased circulation of blood which deprives nerve cells of necessary substrates. Brain does not store glucose, the major substrate, and is also incapable of anaerobic respiration. Intra-cerebral hemorrhage, on the other hand, occurs as a result of a deep seated blood vessel disrupting connecting pathways in the brain leading to destruction of brain tissue (Brass, 7). Unlike most of other body cells, brain cells cannot divide to form new cells, hence the cells that die as a result of stroke are not replaced. This limits the brain’s ability to heal after injury. Hence recovery from stroke is only partial in most cases. The amount of disability that one develops after stroke also depends on the amount of brain tissue lost. Minor stroke leads to minor effects, for instance body weakness in limbs. Major stroke may lead total paralysis or even death. Other factors that determine how severe the stroke will be include how healthy the circulation system is, temperature and collateral circulation.

Treatment of stroke majorly seeks to halt it progression, as opposed to reversing its effects. By halting its progression, doctors are able to prevent its recurrence. Studies have shown that brain cells can recover even after being deprived of oxygen for several hours (Shah, 5). It has been found that lack of lack of blood flow to brain tissues is not the only reason that causes death of brain cells during stroke. Other factors like build up of toxin build up, and inflammation make a significant contribution. Hence in treatment of stroke doctors seek to stem ischemic cascade. By so doing, they are able to prevent further damage on the brain.

Treatment of acute stroke mainly involves maintaining fluids and chemical substances in blood. These are substances and potassium. In treating such a case, the medical professionals focus on avoiding low blood pressure as well as other secondary complications that come with stroke. These are complications like pneumonia, bedsores, and urinary tract infections. Most of the monitoring that follows a severe stroke include laboratory test to ascertain whether other body organs are affected.

Medications given to stroke patients include anti-coagulants, for instance, Heparin. Although heparin does not dissolve clots in blood, it plays an important role in inhibiting the formation of new clots (Brass, 7). This helps prevent subsequent strokes. Administering anti-coagulants to stroke patients is very important as subsequent stroke is a common occurrence among patients with ischemic stroke. Other medicines used in the treatment of stroke are the heparinoids. These are just as effective as the anti-coagulants and present a lower risk of bleeding compared to heparin. Surgery is rarely used to treat stroke. On rare occasions, it is used for treatment of subarachnoid and brain hemorrhage.

A common anti-coagulant used in the treatment of stroke is warfarin. Anti-coagulants work by interfering with enzymes that cause blood clotting. Warfarin is a strong anti-coagulant and in only used when other drugs such as aspirin have failed to deliver the desired results (Brass, 8). A very high dose of Warfarin increases the risk of stroke while a dosage that is too high increases the risk of bleeding complications. Stroke patients under warfarin medication need to be closely monitored and subjected to prothrombin time tests to measure how fast blood clotting is occurring. Studies have shown that some foods rich in vitamin C such as spinach have the same effect as warfarin. However, no food restrictions are normally given to stroke patients.

Long term treatment of stroke places emphasis on both recovery and rehabilitation of the patient (Shah, 9). Treatment at this stage also focuses on preventing any vascular events from developing. Therapy is also administered on the patient to deal with risk factors. These are factors like diabetes, high blood pressure, and cessation of smoking. A stroke patient risks developing other complications as a result of the stroke and all these factors must be taken care of in the, in the treatment.

Medication that prevents normal functioning of platelets, for instance aspirin is also used in the treatment of stroke. They are used to lower the chances of blood clotting. Aspirin is especially useful to those individuals who are at a high risk of developing stroke (Brass, 11). However, treatment using aspirin is complicated in cases where the actual dosage for the individual is unknown. A dosage that is too low has little or no effect while one that is too high may cause more blood clots. Hence aspirin should not be administered to those stroke patients whose blood pressure is not normal. In treating stroke patients aspirin is mainly used as part of a larger vascular disease prevention program (Brass, 12). Ticlopidine, another ant-platelet medication, has been found to be over ten times effective than aspirin. Hence it is more effective in reducing stroke in people who have experienced minor stroke compared to aspirin. However, Ticlopidine has serious side effects that include diarrhea, rashes and lowering the white blood cell count.

Surgery is not encouraged as a way of treating stroke. It is mostly used when there is an early discovery of a blockage in the carotid artery. The main goal for carrying out surgery in treating a stroke case is to provide a way for blood to reach the brain. The most common surgery procedure is the carotid endarterectomy (Brass, 13). In this procedure, a narrowing of the carotid artery is removed. This procedure has high chances of reducing stroke and is seen as one procedure that is likely to get into frequent use in treating stroke in the near future. Just like other surgical procedures, removing carotid stenosis has its own risks too. There is a risk that such a procedure can mutate into a more serious complication.

Another procedure used to provide blood to the brain during stroke is a procedure referred to as extracranial-intracranial by-pass. In this procedure, an artery from the scalp is connected to an artery on the surface of the brain by creating an opening in the skull of the patient. The procedure is a complicated one and can only be undertaken by experts.

Taking care of a patient recovering from stroke must take into account factors like weakness in the arms and the legs. The patient may also not be able to speak as clearly as before (Bouziana & Tziomalos, 61). To prevent recurrence of stroke, the patient should be assisted to cope with emotions, as well as those of the family. In case the patient has a problem feeding, the caregiver should organize for him to be fed intravenously. This should be done until one is able to swallow by himself. The patient’s position in bed has to be changed frequently. To improve blood circulation, physical therapist should help the patient move his limbs once in a while. The patient may also need speech therapy and occupational therapy to help him adjust.

Patients with acute stroke constantly show signs of malnutrition. Dysphagia too contributes to this condition. Poor nutrition during the recovery stage only serves to accelerate brain damage (Hajishafiee et al., 291). A stroke patient who suffers from diabetes is at a higher risk of developing malnutrition. A patient should take fruits and vegetables rich in vitamins B, D, A, E, and Zinc. Patients recovering from stroke are advised to take food rich in protein as protein malnutrition is one of the most common problems among stroke patients. For the first 21 days, a stroke patient should consume 19.4-22.3 Kcals/kg/day. This takes care of their 81-90% protein requirements. Clinically stable patients are recommended to take above 1g/kg daily protein intake, above 25Kcal/kg of carbohydrates. A carbohydrate/ protein ratio of less than 2.5 should be maintained (Bouziana & Tziomalos, 63). High intake of carbohydrate increases the risk of stroke. This is especially if it’s from refined sources. Hence should carbohydrate rich foods should be avoided.

Studies show that stroke can be prevented by taking proper diet. One should take a diet that is low in calories, that is saturated and is low in cholesterol (Bouziana & Tziomalos, 63). Such a diet reduces the risk of stroke. To minimize the risk of stroke one should reduce intake of salt as salt contributes to high blood pressure. Large intake of fruits and vegetables also helps reduce the risk of stroke. Citrus fruits, broccoli and cauliflower have a high concentration of folic acid fiber and potassium which help reduce the risk of stroke (Hajishafiee et al., 291). Eating food that is cooked in low fat, which does not contain saturated also reduces the risk of stroke and heart attacks. One is advised to take lean meats, for example, chicken and fish, low fat dairy products like skimmed milk, eggs and whole grain products. One is also advised to take foods that contain vitamin B12 and B6 such as bananas and watermelons.

Works cited

Maryam Hajishafiee, Reza Ghiasvand, Leila Darvishi, Zahra Maghsoudi, Shekoofe Ghasemi,

Mitra Hariri, et al., 2013. Dietary Intake of Different Carbohydrates Among Incident Stroke Patients During Previous Year. International Journal of preventive medicine 4(2) 291-293

Lawrence M. Brass. Stroke. 2010. Retrieved from http://doc.med.yale.edu/heartbk/18.pdf

Sid Shah. Stroke Pathophysiology. 2000. Retrieved from

http://www.uic.edu/com/ferne/pdf/pathophys0501.pdf

Stella D. Bouziana & Konstantinos Tziomalos . Malnutrition in Patients with Acute Stroke. 2011. Journal of Nutrition and Metabolism 11(1) 61-68.

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