25% of deaths after stroke will occur in the first year itself following a stroke.
You need to watch out for the following signs:
In a Hemorrhagic Stroke:
- Excessive bleeding inside the brain.
- This will be due to leaks from the blood vessels.
- This will be about 15% of all strokes.
In an Ischemic Stroke:
- Lesser blood supply to the brain.
- Usually due to blockage of the vessels (Carotid artery).
- This will be 85% of all strokes.
A narrowing (Stenosis) will cause blood to jet stream towards the brain and Emboli (small particles of clots) flow towards the brain and may cause a Stroke.
In a TIA:
- Symptoms (Speech slur, Weakness, gait (Walking) problems, tingling in limbs etc with complete recovery inside 24 hrs.
- Symptoms will come rapidly and last for 2 – 15 minutes only.
In an Amaurosisfugax:
- Transient one-sided loss of vision
- Shadows appearing one-quarter, half, whole eye vision.
The above-mentioned deficit can persist after 24 hours.
What Causes Stroke?
1. Plaque = Hard fat+ calcium deposit leading to obstruction.
2. Thrombus = Clot that remains where it was made, this can further decrease blood flow to the brain.
3. Emboli = Clot particle made in the plaque but shoot towards the brain.
4. Internal carotid goes to the brain and external carotid towards the face.
Stenosis of carotid artery can Cause a Stroke
You might want to know what a Carotid Artery is. It is a blood vessel that supplies blood to your brain and narrowing of carotid can cause a stroke. Of 100 strokes 85 will be ischemic and 30% of these will have stenosis of the carotid. This is the reason why Carotid revascularization (Unblocking of the carotid stenosis) is the MOST COMMONLY PERFORMED VASCULAR SURGERY PROCEDURE.
Who are the right candidates for carotid revascularization?
Not all stenosis are for revascularization. If you have survived the first onslaught of TIA, Amaurosisfugax, Stroke, then our primary aim is to stop the recurrence of stroke. Also, candidates who have a:
- 70% or more blockage with or without symptoms.
- 50% - 70% blockage with symptoms
What is the procedure of Revascularization?
It is done by:
- Carotid endarterectomy: Surgical removal of the block
- Endovascular procedures: Guidewire based widening and stent (frame support placement)
There are specific indications and guidelines for best indications of each procedure. You need to visit your vascular surgeon for best results.