This paper provides a comprehensive overview of stroke as a medical condition, examining its physiological basis, classification into ischemic and hemorrhagic types, and the body systems it affects. It discusses the major causes and risk factors of stroke, including high blood pressure, atherosclerosis, and atrial fibrillation, as well as hereditary and environmental contributors such as CADASIL and familial risk patterns. The paper further explores how stroke manifests clinically, its potential complications, prevention strategies, and available treatment options. Finally, it addresses the physical, emotional, and spiritual effects of stroke on both victims and their families, emphasizing the importance of rehabilitation and support systems in recovery.
Stroke is widely regarded as one of the leading causes of death in the United States. Recent statistical figures paint a grim picture with regard to the number of people who suffer a stroke each year. In basic terms, strokes are triggered by an interruption of blood flow into the brain. This paper examines the physiological processes associated with stroke, including a definition of the disease and the body systems it affects, its causes, manifestation, and complications. It also discusses the hereditary and familial factors commonly associated with stroke.
In basic terms, stroke is defined as "an abrupt onset of neurological functions caused by a sudden reduction of cerebral blood flow, which is due in turn to either an ischemic occlusion or a hemorrhagic episode" (Gulini, Gianelli, Quaglia, and Marrucci, 2000, p. 239). As a medical emergency, stroke occurs when blood flow to the brain is interrupted. To function normally, cells in the brain need a constant supply of oxygen. A stroke occurs when the supply of oxygen-rich blood to some portions of the brain is interrupted, triggering the rapid death of brain cells.
Essentially, strokes are classified into two main types: hemorrhagic stroke and ischemic stroke (Mohr et al., 2011). Ischemic stroke happens when a blood vessel in the brain is plugged or blocked by a blood clot or other obstruction. A hemorrhagic stroke, on the other hand, happens when a blood vessel breaks and causes sudden bleeding into the brain, and it is this bleeding that damages brain cells. Both ischemic and hemorrhagic strokes can be further divided into two subtypes — embolic stroke and thrombotic stroke in the case of ischemic stroke, and intracerebral hemorrhage and subarachnoid hemorrhage in the case of hemorrhagic stroke.
There is also a condition known as a transient ischemic attack (TIA). Commonly referred to as a "mini-stroke," a transient ischemic attack, as Smeltzer, Bare, Hinkle, and Cheever (2010) explain, results when there is a brief blockage of blood flow to a certain portion of the brain. Based on the duration of the blockage, the damage to brain cells is not permanent. In most cases, the symptoms of a stroke are manifested in those parts of the body controlled by the dead or damaged brain cells. Some of the most common symptoms include a sudden severe headache of unknown cause, sudden loss of balance, sudden loss of coordination, and feelings of numbness, among others (Smeltzer, Bare, Hinkle, and Cheever, 2010).
Many medical conditions can trigger or significantly increase the risk of stroke. Some of the conditions known to cause hemorrhagic stroke include arteriovenous malformations, aneurysms, and high blood pressure. While the first two causes involve the weakening of blood vessels, high blood pressure, according to Huether and McCance (2012), is more often than not associated with both the weakening and the narrowing or clogging of blood vessels. It has been reported that approximately 77% of those who have a first stroke, as Mohr et al. (2011) note, "have blood pressures higher than 140/90 mm Hg." When high blood pressure is not controlled, the likely result is the weakening of brain blood vessels, which then burst and cause a hemorrhagic stroke.
Brain aneurysm could also increase the risk of hemorrhagic stroke. A brain aneurysm is the ballooning of a brain blood vessel. When the aneurysm ruptures or leaks, there is likely to be a sudden draining of blood into the brain. Arteriovenous malformations, meanwhile, result from a tangle of blood vessels that bypasses normal brain tissue. It is the absence of a capillary bed that brings about the "dilation of the arteries and veins and eventual rupture" (Smeltzer, Bare, Hinkle, and Cheever, 2010, p. 1911).
One of the conditions known to cause or increase the risk of ischemic stroke is large artery atherosclerosis (Mohr et al., 2011). This condition results from the buildup of plaque in the inner walls of the arteries. In addition to narrowing the arteries, plaque also hardens them, which can lead to the rupturing or cracking of the affected artery. The formation of blood clots at the site of injury can result in the full blockage of the artery. One condition that results from plaque buildup in the carotid arteries is carotid artery disease, which Reiser, Semmler, and Hricak (2007) regard as a prominent cause of ischemic strokes. Other heart conditions can also trigger a stroke, including atrial fibrillation (Eisenberg, Glueckauf, and Zaretsky, 1999). With regard to high blood pressure specifically, it should be noted that weakened blood vessels are more susceptible to blockage.
Other common risk factors for stroke include age, sex, family history of the disease, obesity, diabetes, uncontrolled alcohol intake, and cigarette smoking. With regard to age and sex, an individual's risk of suffering a stroke increases with age. As Eisenberg, Glueckauf, and Zaretsky (1999, p. 529) note, "strokes increase dramatically with age and tend to double with each decade after age 55." Strokes also tend to affect a significantly lower number of Caucasian and African-American males than females (Eisenberg, Glueckauf, and Zaretsky, 1999). Birth control pills have also been linked to an increased risk of stroke in women.
With regard to race and ethnicity, Mohr et al. (2011) point out that Asians or Pacific Islanders have a lower risk of suffering a stroke than Native Americans. Mortality rates for stroke, however, are higher for African Americans than for Native Americans.
Strokes are widely regarded as medical emergencies. In the words of Reiser, Semmler, and Hricak (2007), "the clinical presentation of stroke is variable, but will primarily manifest itself in the form of acute neurological deficits" (p. 311). These deficits include modifications in consciousness levels, gait and speech difficulties, visual problems, and paralysis (Reiser, Semmler, and Hricak, 2007).
"Paralysis, aphasia, memory loss, and other complications"
"Risk control, hereditary disorders, and environmental contributors"
"Interventions for ischemic and hemorrhagic stroke"
"Impact of stroke on body, mind, and faith"
Smeltzer, C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth's Textbook of Medical-Surgical Nursing (12th ed.). Lippincott Williams & Wilkins.
Urden, L. D., Stacy, K. M., & Lough, M. E. (2013). Critical Care Nursing (7th ed.). Elsevier Health Sciences.
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