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Stroke, Research Paper Example

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Introduction

Maintaining good health represents a challenge that is often impacted by poor behaviors, genetic risks, and other conditions that influence quality of life in many different ways. Many adults face a risk of stroke due to a variety of health-related concerns that influence their quality of life, including activities that are preventable in nature. Strokes are a cardiovascular condition that pose a serious threat to human health and require immediate treatment in order to minimize the damage that may occur within patients. There are several different types of strokes, including thrombotic, embolic, and hemorrhagic versions, each of which requires further evaluation and focus in order to better understand their causes and the possible treatments that may have an impact on quality of life for patients. Identifying the different types of strokes will have a significant impact on treatment alternatives and recovery in cases where these events are serious and lead to further complications. This process requires expert knowledge in areas that include prevention and in understanding the primary causes of strokes in order to address these risks as best as possible. In addition, understanding the risk factors that are related to the development of strokes and the overall areas of prevention will be effective in advancing the objectives of stroke education within the affected populations. Due to the potential mortality risk associated with strokes, there must be a greater emphasis on the development of new techniques and strategies that will enhance quality of care for patients and which will aim to prevent long-term complications.

Body

The challenging nature of stroke-related events, including their formation, symptoms, and physical complications, is a significant health concern in the modern area, particularly since strokes are often very difficult to predict prior to onset and therefore, may cause significant concern for patients in a variety of ways, some of which may lead to fatal complications if left untreated or when these events cause substantial and irreversible damage. It is often very difficult to recover from strokes do the potential brain damage that may sustained as related to the condition, thereby creating difficulties for patients who require care and treatment at different levels. As a result, diagnosing the stroke is a necessary step that must be immediate in order to prevent further complications for these patients. It is important for healthcare providers to explore the different means of diagnosing strokes, to distinguish between the different types, and to develop strategies for care and treatment that will have lasting benefits for patients. In addition, recognizing the risk factors for strokes is a critical factor that requires significant attention and focus in order to be successful in treating the condition effectively and without additional complications that could impact patients for the rest of their lives.

Comparison and Contrast

Type of Stroke	Symptoms	Treatment	Progression
Thrombotic	A type of stroke whereby a blood clot forms in the blood vessels that are located inside the brain; this type of stroke may cause irreversible damage to the brain, as well as organs and systems (Johns Hopkins Medicine, 2015). Prior to the primary stroke event, there may be warning signs known as transient ischemic attacks (TIAs), which are a form of mini-stroke that serves as a signal that a larger stroke event may be coming (Johns Hopkins Medicine, 2015).	Many stroke-related treatments are conducted in an effort to treat the ruptured blood vessel or to open the blockage with the blood vessel that has occurred (American Stroke Association, 2015). For these patients, there is a higher rate of survival than in previous years, but in order to treat the stroke at an optimal level, treatment must begin as early as possible (American Stroke Association, 2015). Patients who face a high risk of stroke may significantly benefit from the application of different treatments that may include drugs to address high blood pressure, such as antihypertensives and anticoagulants to reduce these levels (American Stroke Association, 2015). Other treatments may include a carotid endarectomy to remove plaque from arteries via surgery, and angioplasty to open up blood vessels and allow blood to flow more normally (American Stroke Association, 2015).	Thrombotic strokes are often characterized by smaller stroke-type events that occur prior to the larger event, which are also known as transient ischemic attacks, or TIAs (American Stroke Association, 2015). These mini-strokes represent a significant warning sign for patients that a larger event is likely to occur; therefore, they must pay attention and seek immediate treatment in order to prevent further risk through medication administration and possible hospitalization as necessary. Another type of thrombotic stroke that may occur is the lacunar infarct, which is often indicated in patients who have hypertension or diabetes and who struggle with these diseases on a regular basis (American Stroke Association, 2015).
Embolic	A type of stroke that is characterized by blood clots that block blood flow to the brain, typically known as an embolus (University of Washington, 2015). These strokes are also characterized as ischemic strokes, and brain tissue that is deprived of a blood supply due to a clot in a given area of the body may contribute to cell death within the brain (University of Washington, 2015).	Treatment for patients with embolic strokes are similar to those presented for thrombotic and hemorrhagic stroke types, including medications, surgery, or a combination thereof to treat the affected blood vessels and any areas where clotting has occurred.	The most common symptoms associated with embolic stroke include weakness in the face, leg or arm and numbness that may affect one side of the body; confusion; difficulty speaking; loss of balance; dizziness; severe headache; and difficulty with vision (University of Washington, 2015). This type of stroke may be caused by risk factors that include heart disease, hypertension, elevated cholesterol, smoking, diabetes, and generally poor nutrition and limited physical activity (University of Washington, 2014). Diagnosing a stroke of this nature requires testing such as an EKG, physical examination, blood draws, MRIs, CT Scans, angiogram, and transcranial Doppler, among others (University of Washington, 2014). Patients who have been diagnosed with embolic strokes may also experience seizures, swelling in the brain, pneumonia, fatigue, and depression, among other complications (University of Washington, 2015).
Hemorrhagic	A type of stroke that is characterized by the rupture of a blood vessel that has been weakened over time; this type of stroke may cause aneurysms and arteriovenous malformations (American Stroke Association, 2015). In addition, this type of stroke is typically caused by excessive hypertension over a period of time (American Stroke Association, 2015).	This type of stroke event may also be treated in a similar fashion to other stroke types, which include medications, surgery as necessary, and other interventions that are designed to minimize risk as best as possible.	When a blood vessel has ruptured, it is likely that there will be significant complications that include a lack of oxygen to cells and tissues within the brain, along with high levels of pressure and subsequent swelling within brain tissue (Johns Hopkins Medicine, 2015). Hemorrahagic strokes are typically comprised of either intracerebral hemorrhage, or bleeding in the brain’s blood vessels; or subarachnoid hemorrhage, which is a collection of blood within the subarachnoid space that may include aneurysms and arteriovenous malformations (AVMs) (Johns Hopkins Medicine, 2015).

Risk Factors for Stroke

There are a number of risk factors associated with strokes that must be addressed in order to be successful in preventing these conditions and their complications. To be specific, “The contribution of age, sex, and racial and ethnic background on the risk of incident and recurrent stroke continues to vary across populations; furthermore, the influence of these factors may potentially be mediated through a variety of complex hereditary mechanisms of disease specific to each of the demographic categories” (Goldstein et.al, 2011). These risk factors are not easily modified; however, there are risk factors that may be modified through human behaviors in order to improve health and wellbeing as best as possible, such as eliminating cigarette smoking and reducing high blood pressure levels for patients (Goldstein et.al, 2011). It is important for healthcare providers to understand the complex nature of stroke risk factors in order to be effective in treating these conditions and in advancing the objectives of specific protocols that may have a lasting impact on patients (Goldstein et.al, 2011). Patients who have been diagnosed with diabetes mellitus may face an additional level of risk; however, this condition may not serve as the key contributing factor to the condition, since improved control of the hypertensive state is likely to have a significant impact on patients, in spite of the risks associated with diabetes for all patients (Goldstein et.al, 2011). It is necessary to develop a greater understanding of these risk factors in order to take the steps that are necessary to improve health and to reduce risks for all patients as best as possible.

It is also important to address the risk factors that are associated with culture and ethnicity within different patient populations, as some cultures may experience a higher risk of stroke than others. For example, cardiovascular-related incidents among Hispanics and Latinos contribute to high mortality rates within these populations; therefore, understanding the key risk factors associated with these events, such as acculturation and socioeconomic status, may represent a means of advancing education and prevention strategies to minimize these risks (Daviglus et.al, 2012). Therefore, factors that include blood pressure levels, high serum cholesterol levels, obesity, cigarette smoking, and diabetes/hyperglycemia may represent a means of understanding the key areas of risk that may be further exacerbated in patients who are Hispanic or Latino (Daviglus et.al, 2012). Therefore, it is important to address these findings and to support an expanded set of approaches that will have a more significant impact on patients within these and other population groups. Although stroke risk factors may be higher in Hispanics and Latinos, these factors are not exclusive to this population, as there are many groups that experience similar risks, such as African Americans and Caucasians, depending upon other contributing risks that influence these events. Therefore, a comprehensive approach must be considered that will be beneficial in supporting the needs of the patient population and in determining what steps are required to address these risks on an individual basis and as part of a larger research framework to support improvements in the prevention and treatment of strokes in the future.

Prevention of Stroke

The American Heart Association and other organizations have established and modified guidelines in recent years that support a greater understanding of how to prevent strokes, using a multidisciplinary approach. A sample of these guidelines are provided as follows: “(1) screen patients early for risk of incident stroke, (2) in those patients with higher risk of stroke from non-modifiable factors, focus in particular on rigorous control of their modifiable risk factors, (3) do a better job in modifying the lifestyle factors and the major treatable factors such as hypertension using all of the possible targeted treatments available with the goal of gaining control over them” (Goldstein et.al, 2011). This reflects the importance of developing strategies that will expand the attention and focus on stroke prevention in order to improve quality of life for patients and to provide them with opportunities for growth and development that will have lasting benefits over the long term.

The prevention of strokes also requires an approach that is grounded in the development of new perspectives regarding basic behaviors that may have a significant impact on human health and wellbeing. For example, it is necessary to consider behavioral modifications that strongly emphasize diet as a critical component of this process: “Guidelines stress the importance of lifestyle modifications. Lifestyle interventions associated with BP reduction include weight loss; the consumption of a diet rich in fruits, vegetables, and low-fat dairy products; a Mediterranean-type diet; reduced sodium intake; regular aerobic physical activity; and limited alcohol consumption” (Kernan et.al, 2014). From this perspective, it should be noted that lifestyle modifications may appear to be somewhat simplistic on the surface, but they are actually life-altering and require a significant level of commitment and focus in order to achieve the desired outcomes. Healthcare professionals must serve in a capacity to offer guidance and support to patients so that they are able to manage the demands of these lifestyle modifications, as it is necessary to engage patients in understanding how these behaviors could be transformative in nature and preserve their quality of life.

Patients who face a high risk of stroke must gain support and knowledge through active educational programming and guidance that is designed to encourage healthier habits that may include a reduction of blood pressure, weight loss, and greater control over cholesterol levels. These factors each demonstrate a high level of risk in patients who may already have a personal history of cardiovascular disease or within their families. Therefore, it is important for healthcare providers to provide specific guidelines and examples for patients to follow so that they are better prepared to manage the risks that they face with respect to strokes throughout their lives. There must be a significant emphasis on the development of healthy habits that will have a positive impact on patients and that will encourage them to explore positive and meaningful behaviors that will impact their lives in positive ways. By encouraging patients to be receptive to lifestyle behavioral changes, it is possible that they could significantly reduce their risk factors associated with strokes and subsequently limit their potential of developing a stroke at some point in their lives. This is an important step towards the discovery of new ideas and approaches to emphasize the importance of stroke prevention as part of the process of achieving optimal health and wellbeing for patients. The emphasis must be on recognizing the different types of strokes, the symptoms that are likely to occur, and an overall understanding of the complications of strokes that could be permanent in nature if proper treatment is not received in a timely manner.

Conclusion

Strokes are a common yet preventable cardiovascular condition that may have lasting or even fatal complications for patients. Strokes occur in several different types, including thrombolytic, embolic, and hemorrhagic varieties, and each type of stroke event is a product of different causes and symptoms. There must be a greater emphasis on understanding the nature and causes of strokes in order to be effective in treating patients and in enabling them to take steps to prevent strokes from taking place. These factors must support a comprehensive educational strategy and plan of care to support patients who face a high risk of stroke due to lifestyle factors, genetic makeup, and other issues. Preventable risk factors are particularly relevant because they require patients to be educated regarding factors such as cigarette smoking, high blood pressure, high cholesterol, poor nutrition, and obesity, among others. These factors require further analysis and understanding in order to enable patients to make positive and meaningful decisions regarding their health and wellbeing that will have positive and lasting benefits throughout their lives.

However, if strokes occur, they must always be treated as an emergency and require immediate medical attention in order to best manage the condition in order to avoid significant complications. Since there are a variety of symptoms of stroke, recognizing these factors plays a role in shaping an environment in which there are positive and lasting outcomes associated with this diagnosis. When the prevention of strokes is not possible because the physiologic actions have occurred and have led to the formation of a cardiovascular event within the brain, all possible treatments must be considered in order to prevent patients from experiencing complications that could lead to significant complications for patients that may include death in some cases. Therefore, it is important for healthcare providers to be apprised of the latest news and techniques regarding stroke risk factors, prevention, and treatment in order to ensure that patients receive the best possible support in this regard and under which healthcare providers are able to guide patients in all areas of stroke treatment and prevention that will aim to minimize complications as best as possible.

References

American Stroke Association (2015). Stroke treatments. Retrieved from http://www.strokeassociation.org/strokeorg/AboutStroke/Treatment/Stroke-Treatments_UCM_310892_Article.jsp#.ViuY_fmrTIU

Daviglus, M. L., Talavera, G. A., Avilés-Santa, M. L., Allison, M., Cai, J., Criqui, M. H., … & Stamler, J. (2012). Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. Jama, 308(17), 1775-1784.

Goldstein, L. B., Bushnell, C. D., Adams, R. J., Appel, L. J., Braun, L. T., Chaturvedi, S., … & Pearson, T. A. (2011). on behalf of the American heart Association stroke Council, Council on cardiovascular Nursing, Council on epidemiology and prevention, Council for high blood pressure Research, Council on peripheral Vascular disease, and Interdisciplinary Council on quality of Care and Outcomes Research. Guidelines for the primary prevention of stroke: A guideline for healthcare professionals from the American heart Association/American stroke Association. Stroke, 42(2), 517-584.

Johns Hopkins Medicine (2015). Types of stroke. Retrieved from http://www.hopkinsmedicine.org/healthlibrary/conditions/nervous_system_disorders/types_of_stroke_85,P00813/

Kernan, W. N., Ovbiagele, B., Black, H. R., Bravata, D. M., Chimowitz, M. I., Ezekowitz, M. D., … & Wilson, J. A. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(7), 2160-2236.

University of Washington (2015). Embolic stroke. Retrieved from http://www.uwmedicine.org/health-library/Pages/embolic-stroke.aspx