“What is Stroke?”

A stroke is an illness in which part of the brain is suddenly severely damaged or destroyed. The result is loss of function of the affected part of the brain. It usually causes weakness, paralysis of the arm and leg on either the left or right side of the body, twisting of the face, and in some cases other effects which may include loss of balance, and difficulty in swallowing.

In very severe cases, there is a loss of consciousness or confusion of thought. The damage in the brain is caused by a blood clot or haemorrhage. If the clot is very big or if it affects a vital part of the brain, the patient may die. In less severe cases partial or complete recovery occurs.

“What causes a stroke?”

Most strokes occur in the second half of life and are caused by damage to the blood vessels – and sometimes to the heart – which has been building up slowly for many years. The actual stroke takes place either when a blood clot forms in a damaged vessel and blocks the flow of blood to part of the brain, or when a damaged blood vessel in the brain bursts and blood pours from the brain itself.

In at least half of all strokes the reason why the blood vessels become damaged in the first place is because they have been exposed to high blood pressure. If in addition the patient smokes, drinks heavily, is overweight, takes too much salt in his diet, or has heart disease or diabetes the risk of stroke is increased. A number of other factors are suspected, but there is no single cause of stroke.

Unfortunately anyone can suffer a stroke at any time, although the risks can be substantially reduced by a healthy life style, including the avoidance of smoking, and especially by having blood pressure checked and if it is too high, ensuring that it is kept under control by treatment.

“Is stroke due to overwork or stress?”

No. Almost everyone who has ever had a stroke could be said to have been under stress or to have been overworking at some time before the onset of the stroke. So could almost anyone who has not had a stroke. It is natural to think of stroke and stress as being related -they even sound alike- but this is not so, and indeed many strokes occur during sleep. However, there is a relationship between stress and high blood pressure. It is almost impossible to take the stress out of life, but it is possible to reduce high blood pressure.

“Is the brain affected by stroke?”

Yes. A stroke is to the brain what a coronary thrombosis is to the heart, and the brain is always damaged in a stroke, just as the heart is always damaged in a coronary. All the symptoms of a stroke are due to brain damage. But this does necessarily mean that patients with a stroke lose their ‘brains’ in the ordinary sense of the word.

If the brain damage is very extensive or affects special areas there may be impairment of memory, concentration and learning ability or some confusion of thought. Control of the bladder and bowels may be lost. Patients may be slower to grasp new ideas and relatives have to learn to make allowances for these changes.

Some patients are vague or unrealistic, or have impaired judgement in their assessment of their own capabilities or in their relationships with other people. But in most cases, even when paralysis is severe, there is no discernible effect on the intellect and memory, and the patient’s ‘brain power’ is as good as ever.

“What symptoms do varicose veins cause?”

Varicose veins can cause a whole spectrum of disease including pain, itching, swelling, heaviness and fatigue. In the most severe cases they can bleed or cause ulceration (skin tears) which can be quite difficult to heal.

“What causes varicose veins?”

The main cause of varicose veins is a genetic connective tissue disorder that causes the veins to bulge. Obesity, a sedentary lifestyle, prolonged standing, constipation and pregnancy may also be contributing factors. So-called secondary varicose veins can also develop as a result of previous thrombotic events of the deep venous system.

“What can be done to prevent the symptoms from varicose veins?”

Aside from weight loss, there really is no way to prevent varicose veins. The symptoms however are quite easily treated with simple compression stockings. These come in a variety of sizes, shapes and colors and can be either prescription or over the counter. Only knee high compression stockings are needed in the vast majority of patients and they only need to be worn during the day. Being vigilant with them is oftentimes enough to improve symptoms and prevent them from worsening

“How are affected veins treated?”

Conservative treatment of varicose veins comprises elastic compression therapy and the use of phlebotropic drugs. There are also a number of interventional procedures to choose from, depending on the structure and location of the vein to be treated. A preliminary consultation with a vein specialist is therefore vital to assess the vein and select and explain the best treatment for the patient. This is the concept of “tailor-made treatment” in action.

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