The History of Stroke

What is a stroke?

A stroke is a very serious medical condition. A stroke happens when the flow of blood to your brain is blocked or impaired. The impairment of blood flow is usually caused by a broken blood vessel or a blood clot. And just like a heart attack, a poor supply of oxygen-rich blood can cause the death of the tissues.

A reduced blood flow to your brain causes the brain cells to die. When these cells begin to die, the patient will start to experience symptoms in those parts of the body that are controlled by these dead cells. Common symptoms experienced may include paralysis, sudden weakness, numbness of your limbs or face. As such, stroke patients usually find it hard to think clearly, breathe, or even move.

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The early conception of stroke

Clinicians now understand what causes a stroke. The implications of this dreaded disease are also well understood. However, the occurrences in the brain leading to stroke haven’t always been well understood. Stroke was identified over 2,400 years ago by Hippocrates. It was first named apoplexy. Apoplexy is a Greek term for “struck down by violence.” Apoplexy described the condition but did not give any insight into its connection with your brain.

In the 1600s, Jacob Wepfer, a doctor, discovered that the blood supply in the brains of stroke patients was always disrupted. In some cases, massive hemorrhage occurred in the brain, while in other cases, the arteries supplying the brain were blocked.

More discoveries were made regarding the causes of apoplexy, as well as its symptoms and treatment. Based on these discoveries, apoplexy was categorized based on the causes. It was after the categorization that the condition became known as cerebrovascular accident and stroke.

Current perception of stroke

Currently, there are two types of stroke: ischaemic stroke and hemorrhagic stroke. Ischaemic stroke is more common than hemorrhagic stroke. In an ischaemic stroke, a blood clot is lodged in the brain, thus preventing the free flow of blood to the various parts of your brain.

In hemorrhagic stroke, there is a rupture of a blood vessel in your brain. This results in the pooling of blood in your brain. The severity of a stroke depends on the number of brain cells that are affected, as well as the location of the hemorrhage.

A report by the National Stroke Association states that stroke is the 5^th major cause of death in the United States. But then, over 7 million Americans have survived a stroke. Advancements in medical science have made it possible for stroke patients to survive the condition with fewer complications.

Treatments for stroke: Looking back in history

Treatment of stroke began as far back as the 1800s. Back then, doctors performed surgeries on the carotid arteries. These arteries supply the brain with blood. A stroke is caused by the development of clots in these carotid arteries. Operation on the carotid arteries was done to reduce the accumulation of cholesterol and also flush out those blockages that could cause a stroke. The first carotid artery surgery was performed in 1807 by Dr. Amos Twitchell in New Hampshire. This procedure is now referred to as carotid endarterectomy.

It is important to note that carotid artery surgeries helped to prevent a stroke, but actual treatments for an existing stroke were few. Most treatments focused on assisting patients to manage complications such as eating problems, speech impairments, or weakness. Effective stroke treatment was implemented in 1996. The FDA consented to the use of a tissue plasminogen activator (TPA) for the treatment of this condition. TPA dissolves the clots that cause an ischaemic stroke.

TPA is effective. However, the medication must be administered at least 4.5 hours after the onset of symptoms. This means that getting prompt medical attention is vital to reversing or reducing the symptoms of this condition. If your loved one has a stroke or is experiencing its symptoms, then call 911 or the emergency number in your location, or take them to a healthcare facility without delay.

Advancements in stroke treatments

Ischaemic strokes

Tissue plasminogen activator is the most accepted treatment for ischaemic stroke. But there has been a recent advancement known as mechanical thrombectomy. With mechanical thrombectomy, the clinician can physically extract the clot from a stroke patient. This procedure was launched in 2004, and since then, over 10,000 people have been treated.

There’s however a slight drawback in this procedure. Many surgeons are yet to be trained in this procedure, and the equipment needed to perform this is very expensive. It is a fact that TPA is the most widely used treatment for ischaemic strokes. However, mechanical thrombectomy is increasing in popularity, and more surgeons now understand how to perform it.

Haemorrhagic strokes

A lot of advancements have been made in hemorrhagic stroke as well. If a large portion of the brain is affected by a hemorrhagic stroke, doctors may perform surgery to minimize long-term damage. The surgery will also ease the pressure on the brain. The following surgical treatments may be used for hemorrhagic stroke:

• Surgical clipping: A clip is placed on the base of the area responsible for the hemorrhage. The clip will stop the flow of blood and prevent further bleeding.
• Coiling: A wire is guided through the groin up to the brain region. While guiding the wire, small coils are inserted to fill weak areas and bleeding regions. This can stop the bleeding.
• Surgical removal: If other methods fail, the surgeon can take out a small part of the damaged region. Surgical removal usually serves as a last resort because of the risk involved.

Have there been any advancements in stroke prevention?

There’s no doubt that stroke is a primary cause of disability. However, it is worth knowing that over 80% of stroke cases can be prevented. Recent research has yielded several prevention strategies for high-risk individuals. Major risk factors for stroke include:

• Being over 75 years of age
• Congestive heart failure
• Atrial fibrillation
• High blood pressure
• Diabetes
• History of transient ischaemic attack or stroke

If you have any of these risk factors, then you should consult your doctor about the necessary preventive measures. The following measures are usually recommended by doctors:

• Stop smoking (if you’re a smoker)
• Exercise 3-4 days weekly for at least 40 minutes daily
• Eat a diet rich in vegetables and fruits, and low in sodium
• Administration of medications to control diabetes or high blood pressure
• Anticoagulant medications to help prevent blood clotting