E. S. Hamilton
VFW Post 9876
Pattaya City, Thailand
Surgeon's Corner
A Stroke?
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E. S. Hamilton Pattaya City, Thailand |
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| As we age, we inevitably begin to ponder our own mortality. One of the maladies that people seem to fear the most is a stroke that might leave them unable to move or communicate. Stroke is the common name for the loss of brain function. Just where and how much of the brain is affected determines how bad the stroke is. There are two very different types of stoke, but the end-result is the same = death of brain cells. In addition to some of the cells dying, other cells nearby can be injured. These can recover function with time. Hence, the ability to recover some form a stroke. One type of stroke is caused by a blockage of the blood vessels that feed the brain. The larger the clot, the larger the vessel, the larger the down stream area = the greater the damage. The longer the area is starved of oxygen and nutrients, the greater the likelihood of cell death. Current medical interventions can greatly reduce the overall damage. The other type of stroke is the rupture of a blood vessel in the brain. Brain cell death occurs as a result of the added pressure that the blood causes in the brain. In addition, the blood itself is toxic when it makes direct contact with the brain’s cells. Here again, fast action is needed to stop the bleeding and reducing the pressure in the brain. A hemorrhagic stroke is most often related to uncontrolled high blood pressure. The threat of a stroke is one of the most important reasons to have one’s blood pressure checked and, if high, lowered. With either type of stroke, the faster the person gets to an Emergency Room, the better. There is an internet message currently circulating that purports to assist the layman in determining if someone has had a stroke. It suggests that you have the person perform three simple tasks. If he can do them then it is unlikely that a stroke has occurred. These follow the mnemonic S.T. R. for Smile, Talk and Raise. If indeed, the subject can smile, he shows that the muscles of the face are working. If he can repeat a simple sentence, then his higher brain functions and vocal areas are also unimpaired. Lastly, if he can raise both arms then he has no paralysis. Loss of speech, paralysis of large or small muscles are all common problems immediately following a stroke. While this is all true, what does it gain you? If you are concerned that an individual of any age has had a stroke and are asking him to Smile, Talk and Raise and he has trouble doing these, then something is seriously wrong. These are not the kind of things that one does routinely. Let’s assume that you find someone, collapsed and semi-conscious. Chances are reasonable that he has had a stroke, but not necessarily. He may have suffered a period of reduced heart function, an arrhythmia. During an attack like this the heart is unable to pump a sufficient amount of blood to the brain. The patient faints. As he wakes up asking him to Smile, Talk and Raise is not inappropriate, but call 911 first! Whether or not he has had a stroke, an arrhythmia or some other medical problem, he has had a serious problem that needs medical attention. Just knowing that he hasn’t had a stroke does help to fix whatever it was he did have! By the way, this internet story about Smile, Talk and Raise is true, as far as it goes. There is another one that tells you how to perform CPR on yourself. This one is an urban myth and not useful. Don’t believe everything you see or hear, especially off of the internet. There is a website that has a pretty good record of leading you to useful and easily read (non-technical) medical information. It is: http://www.mammahealth.com./ . |