A stroke occurs when the blood supply to your brain is interrupted or reduced. This deprives your brain of oxygen and nutrients, which can cause your brain cells to die.
A stroke may be caused by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to their brain (transient ischemic attack, or TIA).
About 85 percent of strokes are ischemic strokes. Ischemic strokes occur when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia). The most common ischemic strokes include:
A thrombotic stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain.
An embolic stroke occurs when a blood clot or other debris forms away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries.
Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels, including uncontrolled high blood pressure (hypertension), overtreatment with anticoagulants and weak spots in your blood vessel walls (aneurysms).
A less common cause of hemorrhage is the rupture of an abnormal tangle of thin-walled blood vessels (arteriovenous malformation) present at birth.
Types of hemorrhagic stroke include:
In an intracerebral hemorrhage, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the leak are deprived of blood and also damaged.
High blood pressure, trauma, vascular malformations, use of blood-thinning medications and other conditions may cause an intracerebral hemorrhage.
In a subarachnoid hemorrhage, an artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull. This bleeding is often signaled by a sudden, severe headache.
A subarachnoid hemorrhage is commonly caused by the bursting of a small sack-shaped or berry-shaped outpouching on an artery known as an aneurysm.
Emergency treatment for stroke depends on whether you're having an ischemic stroke blocking an artery — the most common kind — or a hemorrhagic stroke that involves bleeding into the brain.
To treat an ischemic stroke, doctors must quickly restore blood flow to your brain
Emergency treatment with medications. Therapy with clot-busting drugs must start within 3 hours if they are given into the vein — and the sooner, the better. Quick treatment not only improves your chances of survival but also may reduce complications.
Mechanical clot removal. Doctors may use a catheter to maneuver a tiny device into your brain to physically break up or grab and remove the clot. However, recent studies suggest that for most people, delivering medication directly to the brain (intra-arterial thrombolysis) or using a device to break up or remove clots (mechanical thrombectomy) may not be beneficial.
Other procedures. To decrease your risk of having another stroke or transient ischemic attack, your doctor may recommend a procedure to open up an artery that's narrowed by fatty deposits (plaques). Doctors sometimes recommend the following procedures to prevent a stroke. Options will vary depending on your situation:
Emergency treatment of hemorrhagic stroke focuses on controlling your bleeding and reducing pressure in your brain. Surgery also may be performed to help reduce future risk.
Migraine is a complex condition with a wide variety of symptoms. For many people the main feature is a painful headache. Other symptoms include visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraine attacks can be very frightening and may result in you having to lie still for several hours.
The symptoms will vary from person to person and individuals may have different symptoms during different attacks. Your attacks may differ in length and frequency. Migraine attacks usually last from 4 to 72 hours and most people are free from symptoms between attacks. Migraine can have an enormous impact on your work, family and social lives.
Distinguishing between different types of headache can be difficult. You can experience different types of headaches at different times of your life for varying reasons. For example, if you have migraine you may also experience other types of headache. Keeping a migraine or headache diary is really useful and can be invaluable in trying to identify a specific headache type.
Most people who have a migraine attack begin by treating themselves with over-the-counter medications. Sufferers sometimes consult a doctor as symptoms become more severe and disabling, but more than half of all migraine sufferers are never diagnosed. Migraine is a diagnosis of exclusion – it’s diagnosed by a process of elimination because there’s not yet a test or biomarker to show it’s present.
The complex nature of migraine means that the treatments available are varied and differ from person to person. There is currently no cure for migraine.
There is no known cause for migraine, although most people with it are genetically predisposed to migraine. If you are susceptible to migraine there are certain triggers which commonly occur. These include stress, lack of food, alcohol, hormonal changes in women, lack of sleep and the environment
While what triggers a migraine is different for everybody, the most common food culprits out there contain tyramine or phenylethylamine, two amino acids found in chocolate, aged or fermented cheese (including cheddar, blue, Brie, and all hard and “moldy” cheeses), soy foods, nuts, citrus fruits, and vinegar (both red and balsamic).
Muscle or ligament sprain/strain and facet joint sprain due to minor injury or postural stress is the most common cause of spinal pain. Fortunately, most episodes of spinal sprain/strain are uncomplicated requiring only minimal therapy. However, more complex conditions cause spinal pain including from herniated discs, spondylolisthesis, failed back surgery and whiplash. These conditions require a more comprehensive clinical management strategy. For the over 60 age group degenerative changes in the discs and joints of the spine are often a source of pain potentially leading to spinal stenosis. Bone demineralization and fractures (osteoporosis) as well as spinal muscle de-conditioning are other common sources of pain.