Over the years, the stroke menace has remained a significant health risk across the globe. In the UK, stroke is the third most killer despite substantial improvements in diagnostic practices. A stroke occurs following a disruption of blood supply to the human brain. Factors such as clotting, blockage, or even bleeding within the blood vessels can lead to the occurrence of a stroke. Generally, victims of the condition experience varied symptoms including sudden weakness in the arm, face, or leg. Furthermore, other conspicuous signs are problems with comprehending speech, confusion, and difficulty in speaking. In addition, the patient may further encounter dizziness, improper coordination, and loss of body balance. There are majorly two types of strokes namely; hemorrhagic and ischemic stroke. People who suffer from stroke usually lose their ability to function accordingly thus they require immediate treatment and rehabilitation to facilitate quick recovery toward regaining their functions. According to research, approximately 113,000 individuals suffer from the condition annually in the UK [1]. By properly understanding the pathophysiology of stroke, its management, and pharmacological treatments, people can easily reduce the mortality rate associated with the condition.
Generally, there are several processes and physical changes that occur in the human body during and after the stroke. The pathophysiology of stroke is complicated and is majorly influenced by the respective type of stroke the victim is experiencing. According to Kuriakose and Xiao [2], a stroke is a sudden neurological burst due to the impaired flow of blood through the blood vessels to the brain. When the perfusion process experiences issues such as blockage or difficult passage, the ability of the blood to reach the brain reduce causing the stroke. Based on the authors, when there is a limited flow of blood to the brain, the organ will have an inadequate supply of oxygen leading to ischemic stroke. On the other hand, in case of leaking or bleeding blood vessels, an individual experiences hemorrhage.
Ischemic stroke is more prevalent and causes a significant number of casualties compared to hemorrhagic. Ischemic mainly occurs the blood has difficulty reaching a given part of the brain following blockage of the blood vessel by a possible clot. In most cases, the clots can either forms within the blood vessels located in the brain or outside the brain and then go to the organ. The former condition results in embolic stroke while the latter is known as thrombotic stroke. Embolic stroke reduces the blood flow to the brain depriving the organ of receiving adequate oxygen to sustain the cells. When there is a limited supply of oxygen, the cells die making the plasma membrane swell and leak the contents of organelle into the extracellular space causing neuronal dysfunctions. Similarly, in the case of thrombotic stroke, atherosclerosis causes the narrowing of the blood vessels thus affecting the overall blood flow. In general, over 80% of stroke casualties are caused by the ischemic condition [3]. The figure implies that ischemic stroke is lethal and can easily result in the death of the patient.
On the other hand, hemorrhagic stroke is caused by the rapture or injury of the blood vessels due to pressure. The condition then causes infarction as a result of the toxic effects released. Factors such as aneurysms and high blood pressure are the most common causes of the bursting. Hemorrhagic is categorized into two distinct classes namely; subarachnoid and intracerebral hemorrhagic [3]. The subarachnoid condition occurs when there is blood accumulation in the subarachnoid of the brain as a result of cerebral aneurysm whereas; intracerebral is caused by abnormal blood accrual in the brain due to rapture of the vessels. The burst is mostly due to issues such as thrombolytic agents, hypertension, continuous usage of anticoagulants, and disrupted vasculature.
Over the years, several researches have been conducted to determine the most effective medical approach to managing stroke. However, despite the effort and dedication towards the investigations, there are no simple means that have been established to facilitate the clinical treatment of stroke. Even though there is no specific approach, physicians perform an array of measures to facilitate the management of strokes effectively. Before undertaking the control processes, doctors usually take into consideration three critical factors namely; the age of the patient, the type of stroke the individual is suffering from, and the health status of the person [4]. In most cases, the focus of stroke management is to facilitate the restoration of blood flow to the various parts of the affected organ to reduce brain damage. When the process is successful, the recovery process is attained and the patient neuronal functions resume accordingly.
In the case of hemorrhagic stroke, the initial management approach is to reduce excessive bleeding through the usage of medication controls. For instance, when the blood vessels rupture, the sick individual is subjected to surgery to replace or repair the damaged tissue. Through the process, it will be easier to stop the oozing of blood and thus stabilize the patient’s condition. In addition, blood transfusions can be performed to enable the patient to obtain lost blood. Mentioned procedures are regarded as emergency medical treatments since they are aimed at stabilizing the condition of the sick person.
Similarly, ischemic strokes can be managed by taking clot-bursting drugs such as Tenecteplase, Alteplase, and Reteplase. The mentioned medicines break the clot in the blood vessels that are preventing the flow of blood to the brain [5]. Thrombolytics are essential in facilitating the quick passage of blood and oxygen to the affected parts of the organ. For the medications to work effectively, they must be administered within the shorted time possible after diagnosis. In addition, when the drugs are less effective, mechanical thrombectomy is applied. The process involves the removal of the blood clot in the vessel through a surgical approach.
Furthermore, other essential stroke management practices involve rehabilitation to enable the affected person to become active again. In most cases, the condition leaves individuals with disabilities either short or long-term. In such situations, activities including walking are interfered with significantly. Through the rehabilitation process, the patient’s independence is reinforced. Various therapies including physical, cognitive, and even occupational are undertaken to facilitate the process. Furthermore, other activities such as training of legs and arms may allow sick individuals to regain their physical ability after suffering a stroke [6]. For the whole process to be effective, the patient’s relatives should be involved to provide necessary supportive services to the victim to facilitate quick recovery.
Currently, there are several pharmacological treatments given to stroke patients to enable them to recover from the condition. Most of the medications are given based on the risk factors of the patient. The treatments are provided to facilitate early treatment of the stroke condition. In the case of ischemic stroke, anticoagulants and antiplatelets medications are always prescribed. For instance, physicians may opt to use anticoagulants such as Heparin to make the patient’s blood to be thinner [7]. When the medication is given, blood easily passes through the vessels without clotting hence reducing the risk of impaired flow to the brain. The drug is either injected or infused into the vein. Other anticoagulant brands include pradaxa, warfarin, apixaban, rivaroxaban and edoxaban. The medications are used wisely to treat the condition especially acute ischemic to avoid cases of excessive bleeding.
Similarly, antiplatelet medications such as aspirin, cilostazol, and clopidogrel are commonly prescribed to patients in situations where thrombolytic therapy cannot be utilized. Generally, the clotting of blood is caused by the fragments of tiny cells known as platelets [8]. The clumping together of the cells in the vessels blocks the passage of blood to the parts of the brain. By taking antiplatelets, the clotting process is reduced and thus the blood easily travels to the brain effectively. Even though the treatment is effective, antiplatelet does not dissolve clotted blood. In addition, in cases whereby two of the drugs are used together, there is a likelihood of experiencing bleeding in the brain. Furthermore, continued use of a combination of antiplatelets may limit their ability to prevent the occurrence of another stroke. Therefore, clinicians need to prescribe the required therapy to minimize risks that might be associated with antiplatelet medications.
In addition, taking drugs that lower blood pressure is an emerging strategy that allows people to prevent strokes. Generally, high blood pressure is a common factor that can easily cause brain damage. When the blood flows at high speed within the veins, it is possible to experience tissue rapture thus leading to hemorrhagic stroke [9]. Taking medications such as beta blockers and angiotensin-converting enzyme (ACE) inhibitors, the individual blood pressure will be controlled hence the risk of experiencing stroke minimized as well. When ACE is taken into the body, it prohibits the production of angiotensin II thus the blood vessels remain wide enough for the effective passage of blood. The medication has the potential of preventing occurring of stroke because it ensures limited pressure that can cause the bursting of blood vessels.
Moreover, most doctors prescribe statin drugs to persons having high levels of cholesterol in their bodies. The medications are useful in lowering lipids and fats by limiting the enzymes that produce cholesterols. Generally, when an individual has high-fat content, they are more likely to suffer a stroke. Therefore, taking statins such as pitavastatin, simvastatin, fluvastatin, atorvastatin, and rosuvastatin allows people to reduce the fats in their bodies. Even though statins are linked to several side effects including liver damage, muscle pain, and mental fuzziness, the drugs are effective in preventing the liver from making a large amount of cholesterol. Therefore, clinicians must prescribe the right dose to individuals to lower associated negative impacts.
To lower the cases of deaths and disabilities due to the prevalence of stroke, it is necessary to prevent and manage the condition in the future. There are several strategies that can be utilized to effectively reduce the occurrence of stroke. First, individuals should be made aware of the condition including its early signs and symptoms [10]. When people are well informed, they can easily seek medical attention before the disorder become acute. Therefore, providing public awareness through educating people will facilitate the prevention of stroke accordingly.
Second, the UK government should increase access to stroke care. For instance, there should be adequate professionals responsible for managing the condition in the primary care system. Such an approach will make it easier to reduce the prevalence of the problem, especially among the people who are unable to afford better healthcare. When such platforms are established, individuals will have the ability to access proper medication that can help in managing stroke.
Lastly, people should focus majorly on the primary prevention of stroke. In other words, individuals and governments should strive to prevent the stroke from occurring instead of waiting to treat them. To achieve this aspect, several factors that are more likely to cause the condition must be addressed effectively. For instance, engaging in thorough physical exercise, practicing healthy eating habits, and avoiding smoking can help lower the possibility of experiencing a stroke [10]. Therefore, in the future people consider focusing on risk facets to enable them to overcome the problem.
The stroke prevalence has remained high despite the effort to lower it. The disorder has resulted in a significant number of deaths and disabilities in the country. It is caused by ruptured blood vessels leading to disrupted flow of blood into the brain. Various aspects including hypertension are common risk factors contributing to the occurrence of stroke. The condition can be managed by taking antiplatelets and anticoagulants such as Heparin. In the future, educating people and focusing on primary prevention are critical approaches to preventing and managing stroke.
References
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