A stroke, also known as cerebrovascular accident (CVA), cerebrovascular insult(CVI), or brain attack, can occur when a part of the brain is deprived of blood flow. When brain cells are deprived of oxygen they begin to die, due to which the functions controlled by that part of the brain also stops, which results in different types of disabilities among stroke survivors.
There are two types of strokes

• Hemorrhagic
• Ischemic stroke

The first is caused when a brain aneurysm or a weak blood vessel bursts. Most of the time, this type of stroke leads to death. The second one happens when a clot blocks the flow of blood to the brain. Patients suffering from stroke suffer from various side-effects, the most common ones being paralysis or loss of feeling in a certain part of the body, problem in understanding or talking and loss of vision on one side. The side-effects start showing up immediately after a person has had a stroke.

In certain conditions, blood flow to a certain part of the brain stops for only some time and hence the body suffers stroke-like symptoms which only last a couple of hours before disappearing. This is known as a transient ischemic attack (TIA). Unfortunately, the effects of a stroke can be debilitating and also permanent. Hence, it's important to know the symptoms of a stroke and rush the patient to a doctor as soon as possible. Sometimes early treatment can save a lot of damage.

What are the warning signs or symptoms?
There may be no warning signs of a stroke until it actually occurs. You might be having symptoms that may warn you that you might be about to have a stroke.

General symptoms of a stroke, according to Dr.
- Face: Does the face droop on one side when the person tries to smile?
- Arms: Is one arm lower when the person tries to raise both arms?
- Speech: Can the person repeat a simple sentence? Is speech slurred or hard to understand?
- Time: During a stroke every minute counts. If you observe any of these signs, call your local emergency number immediately.
Other symptoms of a stroke include:
All strokes involve symptoms that relate to impairment of nerve function. A patient might complain of a few of the following or all of the following symptoms:
- Confusion
- changes in the level of consciousness
- trouble speaking
- trouble understanding speech
- vertigo
- balance problems
- headache
- nausea
- vomiting
Nausea, sometimes accompanies a stroke, particularly when the stroke involves bleeding inside the brain. The symptoms typically arise suddenly and most commonly occur on one side of the body as the brain controls the ipsilateral part of the body, i.e. brain lobes control opposite parts of the body. Example, a right brain stroke would make the left side of the body weak.

Depending on the part of the brain where the stroke has occurred, be it ischemic or hemorrhagic the effect would be seen in the body. The brain controls different functions of the body like speaking, hearing, listening other than the motor functions.

For example, most people's speech center is located in the left half of the brain so a stroke affecting the left side of the brain would affect speech and comprehension. It also would be associated with weakness of the right side of the body.

Who is at a higher risk of stroke?
Many factors can increase your risk of a stroke. Some factors can also increase your chances of having a heart attack. Potentially treatable stroke risk factors include:
Lifestyle risk factors
- Being overweight or obese
- Physical inactivity
- Heavy or binge drinking
- Use of illicit drugs such as cocaine and methamphetamines
Medical risk factors
- High blood pressure
- Cigarette smoking or exposure to secondhand smoke
- High cholesterol
- Diabetes
- Obstructive sleep
- Cardiovascular disease
Other factors associated with a higher risk of stroke include:
- Personal or family history of stroke, heart attack or transient ischemic attack.
- Being age 55 or older.
- Men have a higher risk of stroke than women

What to do if you feel FAST with a patient?
Time is the key to recovery in a stroke patient. If you feel someone around you has symptoms of stroke, the patient should be rushed to a hospital in emergency services. If during the initial phase of the attack the treatment is given, maximum number of brain cells could be prevented from dying as death of brain cell is an irreversible process. The damage which has been caused by the death of brain cells cannot be recovered.
The following things can be done other than taking him to the hospital
- Make the patient lie on one side with their head slightly raised and supported in case they vomit.
- Check to see if they're breathing. If they're not breathing at all, perform Cardio Pulmonary Resuscitation. If they're having difficulty breathing, loosen any constrictive clothing.
- Do not give them anything to eat or drink.
- If the person is showing any weakness in a limb, avoid moving them.
- You yourself need to be calm and patient to tell and brief the doctor about the event.

Diagnosis
On physical examination a doctor in the emergency would be able to confirm if it is a Stoke. To confirm it clinically a CT Scan or MRI of the brain would be done which would confirm on the type of stroke i.e. ischemic or hemorrhagic, and the lobe of the brain where it has occurred.
PS: There is an urgency to make the diagnosis and determine whether treatment clot-busting drugs to "reverse" the stroke is a possibility. The time frame to intervene is narrow and may be as short as 3 to 4 ½ hours after onset of symptoms.

The specialist, a Neuro physician or Neuro surgeon would further decide on the treatment and keep the patient in the Intensive Care Unit for further care.

Treatment
Depending on the type of stroke the treatment is planned. For an ischemic stroke, the treatment is generally through medications by a Neuro physician. If the stroke is hemorrhagic then the intervention of a Neuro surgeon may be required to remove the blood clot depending on the site of clot. If the clot is deep inside the brain it is generally not operated upon. If the clot is in the outer coverings or near the coverings of the brain the Neuro surgeon might take a call.

Recover from a Stroke
After first aid and treatment, the stroke recovery process varies. It depends on many factors, such as how fast treatment was received or if the person has other medical conditions. The first stage of recovery is known as acute care. It takes place in a hospital where your condition is assessed, stabilized, and treated. Rehabilitation is usually the next stage or the main of stroke recovery. The goals of rehabilitation are:
- strengthen motor skills
- improve mobility
- limit use of the unaffected limb to encourage mobility in the affected limb
- use range-of-motion therapy to ease muscle tension

Preventing a stroke
The best way to prevent a stroke is to address the underlying causes. This is best done by living healthfully, which means:
- Eating a healthy diet.
- Maintaining a healthy weight.
- Exercise regularly.
- Don't smoke.
- Avoiding alcohol or drink moderately.

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