What Is a Stroke, Why Does It Happen?

 Stroke, a serious illness that can result in loss of bodily freedoms, is also known as a stroke. Stroke diagnosis and treatment are vital. So, what causes a stroke, what are the symptoms? Here are the unknowns about stroke...

WHAT CAUSES A STROKE?

It basically happens for two reasons. It may be due to bleeding due to bursting of vessels in the brain. However, it is more often caused by the occlusion of the fine cerebral vessels, and the interruption of blood flow to the area fed by that vessel.

Clogging of the cerebral vessels occurs for two reasons: A clot formed in the heart rushes to the brain and when it reaches a vessel that is too small to pass through, it blocks the vessel. Another reason is the narrowing of the jugular veins that feed the brain, and the sebaceous and calcified structures that make up the stenosis break off and block thinner veins in the future.

STROKE RISK FACTORS

Carotid artery occlusions occur due to a disease called atherosclerosis. It is no different from occlusions of the heart vein or leg vein. Genetic predisposition is one of the most important reasons. You are at risk if your close relatives have had a stroke or heart attack, or have had a bypass or stent. Smoking, high blood pressure, diabetes, obesity, and a sedentary lifestyle are other risk factors.

WHAT ARE THE SYMPTOMS OF STROKE?

Unfortunately, carotid artery stenosis often does not give any symptoms. The first symptom may be a stroke. Inability to hold one arm or leg, sometimes both, inability to speak, sudden blindness occurs due to stroke. Sometimes these symptoms occur and resolve in a short time, we call this situation "Transient ischemic attack". If carotid artery stenosis is detected as a result of the examinations performed on these patients, the stenosis should be removed as soon as possible with a stent or surgery.

HOW IS A STROKE DIAGNOSED?

Carotid artery occlusion is an easily diagnosed disease. Diagnosis of stenosis and the degree of stenosis are visualized completely from the neck surface with ultrasound, which we call Doppler. However, if the stenosis is 70 percent or more, an angio imaging should be performed without surgery. A classical angio can be performed, as well as a virtual angiography with computed tomography.

Carotid artery stenosis is treated with angio, stent insertion or surgery, as in cardiovascular stenosis. In this surgery, unlike the heart bypass surgery, a new vessel is sewn ahead of the occluded vessel and the stenosis is not bypassed. The clogged vessel is opened, the obstruction is cleared, and the vessel is widened and sutured with a patch.

HOW IS STROKE TREATED?

Stent placement while removing the occlusion of the carotid artery is more risky than surgery in terms of throwing a piece of the brain and developing a stroke due to the procedure. The stenosis is passed with a guide wire under angio imaging of the stent. A balloon is advanced over this wire and the stenosis is opened by inflating at the stenosis part. During all these processes, a piece of the fat and lime structure we call 'Plaque', which creates the narrowing, can break off and throw it into the thin brain vessels. In the operation, the flow is interrupted in two clean parts of the vessel that do not have stenosis, and the entire plaque is cleared by opening the part that creates the stenosis. Therefore, the probability of ejecting particles is very low.

More than half of people with occluded carotid artery also have cardiovascular occlusion. For this reason, we have these people undergo pre-operative cardiac angiography in order to diagnose heart disease early and to eliminate the risk of heart attack during carotid artery surgery. When there is a situation where we need to operate on both, we plan a two-stage operation by choosing which side of the stenosis is more critical and, if possible, primarily carotid artery surgery.

Stroke is a disease that will leave you disabled for life. Carotid artery occlusions are insidious diseases that do not cause complaints. The good side is that it can be diagnosed easily and painlessly. With an operation before you develop a stroke, you can live a healthy life without any permanent disability.