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Stroke

Stroke

Stroke is caused by blockage of blood supply to the brain. Reduced blood flow leads to insufficient oxygen and nutrient supply and hence damage or even death of brain cells. As a result, there is loss of certain brain function such as control over limb movement and speech. After stroke, many patients become dependent on others in daily activities and self-care.

There are two main types of stroke 
-    Haemorrhagic stroke: a brain blood vessel ruptures as a result of diseases like hypertension or haemangioma. 
-    Ischaemic stroke: occlusion of brain vessel by a blood clot (embolism) or narrowing and occlusion of brain vessel by atherosclerosis (thrombosis). 

Presentation of stroke 
-    The presentation of stroke depends on the location of the blood vessel as well as the degree of damage. It also varies with the individual. Common symptoms include: 
-    local numbness e.g. on face, one limb or one part of body 
-    weakness of limbs and body, usually on one side 
-    sudden loss of balance 
-    slurred speech, drooling of saliva, difficulty in swallowing, deviated angle of mouth 
-    loss of visual field, uncontrollable eye movement, double vision 
-    drowsiness, coma 
-    others: e.g. sudden onset of severe headache, persistent dizziness 

Prevention of stroke 
Stroke is the third killer in Hong Kong after cancer and heart disease. The incidence in elderly people is higher, mainly due to atherosclerosis of brain blood vessels. Studies have shown that by reducing the risk factors of stroke, we can reduce the chance of stroke. 
-    Quit smoking. 
-    Do regular and appropriate exercise. Manage stress. 
-    Follow a balanced diet. Avoid high cholesterol and high animal fat diet. 
-    Avoid excessive alcohol. 
-    Patients with hypertension, diabetic mellitus, heart disease or previous history of stroke should have regular medical follow-up and receive appropriate treatment so as to control the blood pressure and blood glucose level. 
-    Patients with history of stroke or ischaemic heart disease requiring preventive medicine should have regular follow-up and comply with the drug treatment. 

Nursing care of stroke--aims: 
-    Improve patient's quality of life: pay attention to both physical and psychological aspects. 
-    Enhance the patient's self-care ability: learn appropriate skills in restoring normal daily activities and minimize dependence. This can slow down the aging process and reduce carers' burden. 
-    Maintain limb and body function to avoid bed sore, chest infection, aspiration and frozen shoulder. 
-    Stroke can be a debilitating condition. However, with appropriate treatment and will, many patients can regain part of their function. Seek help from professionals.

Source: 
Department of Health - Elderly Health Service