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Monday, December 9, 2013

Women and stroke - The Treatments

What is stroke?
Stroke is defined as condition in which the brain function is interrupted rapidly due to the loss of blood supply as a result of the blockage of blood such as thrombosis and arterial embolism, or leakage of blood causes of the death of brain cells, according to the article of Mitochondria, oxidative metabolism and cell death in stroke by Sims NR, Muyderman H (September 2009). Stroke is caused by cholesterol build up in the arteries and high blood pressure. In other words, if cholesterol building up in the arteries is blocking the circulation of blood in any part of the body causing oxygen not to be delivered to the brain, resulting in some cells in the brain to die off and are unable reproduce,
Besides cancer and heart diseases, stroke is the third leading cause of death. Approximate 1/4 of all stroke victims die as a direct result of the stroke or it's complications.

Women and stroke
According to the statistic of the Heart and Stroke Foundation, strokes kill 45% more women than men in Canada. In the study, published in the journal Neurology, researchers from the University of California at Los Angeles monitored 17,000 people over a period of six years. They found the incidence of stroke rising faster among women than men.When women reach the age of 45, the risk of stroke begins to rise rapidly, it may be due to levels of estrogen has dropped significantly at age 45 and onward.
Treatments
Depending to the location of the occurrence
A. Ischemic stroke
1. Thrombolysis
The aims of thrombolysis is to resolve the blood clot to improve the blood flow to prevent further damage to tissue and organs in the body as the medicine break down the blood clot by stimulating fibrinolysis through infusion of a protein involved in the breakdown of blood clots called tissue plasminogen activator.

2. Mechanical thrombectomy
As it name, it is the mechanical to remove the blood clot directly by inserting a catheter, a long, into the large arteries in the thigh, then directing it into the blood vessels supplying blood the brain to dissolve the blood clot thus effectively restoring blood flow., by applying a with a corkscrew-like clot-removing device. The mechanical thrombectomy is used when the patient for what ever reason can not tolerate the thrombolysis.

3. Anticoagulation
According to the study of Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation by Hart RG, Pearce LA, Aguilar MI, researchers found that Adjusted-dose warfarin and antiplatelet agents reduce stroke by approximately 60% and by approximately 20%, respectively, in patients who have atrial fibrillation. Warfarin is substantially more efficacious (by approximately 40%) than antiplatelet therapy.

4. Etc.

B. Hemorrhagic stroke
Since Hemorrhagic stroke involves bleeding within the brain, which damages nearby brain tissue, therefore the use of anticoagulant can make the matter worse. In most cases, it requires neurosurgical evaluation to locate before the cause before it can be treated effectively such as occupational therapy, physical therapy, speech therapy, etc.

Care and rehabilitation
A. The impotant of care and rehabilitation of stroke patient
1. In a study of The Care and Rehabilitation of Stroke Patients One Year Following the Event N. Bentur, M. Davis, J. Brodsky, J. Gindin, B. Habot, Z. Haklai, A. Shemesh, researchers found that
significant differences among wards and hospitals, and highlight the need to develop criteria, standards, and clinical guidelines for the diagnosis and treatment of stroke patients. The brevity of the hospital stay and the small quantity of community rehabilitation services, along with the complexity of stroke, emphasize the need to determine the best discharge destination. The findings of this study were discussed by the National Geriatric Council and served as a basis for discussions in the Ministry of Health. The Ministry has instructed the health plans and hospital directors not to send individuals who need rehabilitation to long-term care institutions, so that patients can maximize their functional potential after stroke. The finding that rehabilitation services in the community are limited, emphasizes a need to examine the reasons for barriers to these services, as well as how to expand them and develop alternative patterns of rehabilitation in the community. The study also identified a need to examine National Health Insurance Law regulations on the rehabilitative services that the health plans are obligated to provide. Thought should be given to the health plans’ activity in this area, so as to ensure that services are appropriate.

2. In a study of The efficacy of self-care education on rehabilitation of stroke patients. Sahebalzamani M, Aliloo L, Shakibi A, researchers found that Self-care education of stroke survivors can improve patient's performance, and change them from a dependent to an independent person.

3. Etc.

B. Post-Stroke Rehabilitation. Clinical Practice Guideline
I will leave this article, for a link where you can find the charter 16 - Post-Stroke Rehabilitation by The Agency for Health Care Policy and Research (AHCPR) was established in December 1989 under Public Law 101-239 (Omnibus Budget Reconciliation Act of 1989) to enhance the quality, appropriateness, and effectiveness of health care services and access to these services.
Since this publication is dated in may -1995, and is provided for historical reference only and the information may be out of date or incorrect.
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