TOPIC Stroke ACADEMIC LEVEL Doctoral DISCIPLINE Biology DOCUMENT TYPE Research Paper SPACING DOUBLE CITATION STYLE Oxford

1. Running Head: STROKE 1
STROKE
Student’s Name
Course
Professor’s Name
Institution
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2. STROKE 2
Stroke
Stroke can be devastating to families and individuals denying them their freedom. Each
year, a large number of people are affected by the disease with majority succumbing from the
disease. According to the World Health Organization (WHO), 795,000 Americans are affected
each year with 16000 succumbing to the disease. Stroke is a cardiovascular disease that results1
when blood fails to circulate to the brain. Decreased blood and oxygen flow in the brain can
result in the death of the brain cells. Stroke can be grouped into two major categories based on
the mode of occurrence. Stroke resulting from blockage of blood flow due to a clot is referred to
as ischemic stroke while one resulting from bleeding in the brain is referred to as hemorrhagic.
Treatment and preventive methods exist to prevent the devastating effects of stroke. In this case,
therefore, the determination of stroke action in the body, causes, preventive measures, treatment,
and the groups mainly affected are determined and discussed.
Action in the body
The brain is a complex body organ that functions as the central nervous system in
connection with the spinal cord to control various body functions. It contains two spheres that are
connected by fiber in the nerves corpus callosum. The onset and occurrence of stroke inhibit
blood flow to certain regions of the brain that control a particular body function. This inhibits
normal body functions. Depending on the region of impact, stroke affects various systems of the
body such as the nervous system, digestive system, respiratory systems, circulatory systems, and
reproductive systems. Damage to the left side of the brain and body muscles weakens brains and
Johnson, W., Onuma, O., Owolabi, M., & Sachdev, S. (2016). Stroke: a global response is1
needed. Bulletin of the World Health Organization, 94(9), 634.

3. STROKE 3
paralysis is likely to occur on the right side of the brain. Weak body muscles do not support the
body resulting in problems in body balance and movement. Problems of movement resulting in
stroke may result in blood clots in the deep blood vessels of the legs and are likely to impact the
lungs when they break loose.
The action of a stroke on the right side of the brain may result in loss of memory where
an individual fails to recognize objects and faces that are familiar and also loss of attention. This
may also lead to misjudgment of spaces and depths and minimize the ability to see clearly. The
impact of stroke in the frontal part of the brain may result in changes in personality traits,
thinking patterns and may result to change in logic and intelligence movement . Once it strikes2
the body, the enteric nervous system may be affected that helps to control the bowel and urine
movement. This may result in inconsistence that is; a loss of control over bowel functions and
frequent urination. Nerves may be affected and the coordination of the hand-eye may be
impaired. The action of a stroke may cause swelling in the brain when fluid builds up in the3
skull and the brain or in the brain cavities.
When a stroke occurs it primarily affects the brain which is the central nervous system.
The brain consist of three distinct parts; the cerebrum, cerebellum, and the brain stem. The three
parts are affected differently based on the stroke impact. Therefore stroke action occurs since the
brain controls all the body functions such as thinking, movement, reasoning, and communication.
Kaneko, Fuminari, Shinichiro Shindo, Masaki Yoneta, Megumi Okawada, Kazuto Akaboshi,2
and Meigen Liu. "A Case Series Clinical Trial of a Novel Approach Using Augmented Reality
that Inspires Self-body Cognition in Patients with Stroke: Effects on motor function and resting-
state brain functional connectivity." Frontiers in systems neuroscience 13 (2019): 76.
Ibid3

4. STROKE 4
Causes
Stoke affect the brain in different ways and can be caused by different factors based on
the type of stroke.
Ischemic
Ischemic stroke occurs when a blood clot blocks oxygen and flow of blood to the brain.
The blood clots normally occur in regions where the blood arteries are narrowed or blocked over
some time by deposits of cholesterols known as plaques. This process is referred to as
atherosclerosis. Arteries may naturally become narrow as one age but narrowing can be
accelerated by factors such as hypertension, high levels of cholesterol in the body, excessive
alcohol consumption, obesity, and diabetes . Ischemic stroke can also result due to irregular4
heartbeat a condition referred to as atrial fibrillation. Atrial fibrillation refers to a condition of the
heart causing an abnormally fast and irregular heartbeat. The blood clot may result in the heart
breaking apart.
Hemorrhagic
Hemorrhagic stroke also referred to as intracranial hemorrhages result when the arteries
in the skull break and blood flow around and into the brain. The arteries are weakened by high
blood pressure in the brain leading to the rupture of these vessels. Pressure builds up in the
surrounding area of impact resulting in irritation and swelling which in turn may result to brain
Chen, Zhili, Poornima Venkat, Don Seyfried, Michael Chopp, Tao Yan, and Jieli Chen. "Brain–4
heart interaction: cardiac complications after stroke." Circulation research 121, no. 4 (2017):
451-468.

5. STROKE 5
damage. The pressure of the blood can be accelerated by smoking, lack of exercise, excessive5
alcohol consumption, and obesity. Abnormal blood vessel formation and expansion in the brain
can result in a stroke. Chewing and smoking raise the odds of stroke since nicotine causes the
blood pressure to rise. Nicotine also thickens the blood making it easier for clotting to result.
Preventive measures
Many positive ways can be employed to reduce the risk of stroke. These conditions
include change of lifestyle, medication while others are hereditary and may be difficult to
change. Being a cardiovascular disease, keeping the heart and the blood vessels healthy is an
essential preventive measure.
Regular medical checks on diseases such as high blood pressure, elevated levels of
cholesterol, and heart diseases are required for regular monitoring by a physician regularly.
Stroke is associated with these conditions which can be changed or at minimum, controlled by
proper intake of medication with appropriate lifestyle and diet as directed by a medical
practitioner. Heart valve disorders, heart attack, and atrial fibrillation need to be checked as they
increase the chances of stroke.
Blood pressure control-The recommended blood pressure level is between 90/60mmHg
and 120/80mmHg.Blood pressure is a major factor contributing to stroke and any slight deviation
from normal poses a great risk to stroke. Atherosclerosis is contributed by elevated blood
pressure which results into the rupture of the vessels at weak regions. Blood pressure can be
Chen, Zhili, Poornima Venkat, Don Seyfried, Michael Chopp, Tao Yan, and Jieli Chen. "Brain–5
heart interaction: cardiac complications after stroke." Circulation research 121, no. 4 (2017):
451-468.

6. STROKE 6
controlled through medication, management of stress, consumption of low-sodium diet, and
control of body weight . The elderly are at high risk of blood pressure and sudden rise or fall of6
blood pressure may result in a stroke. Therefore, hypertension treatment of the elderly may
require small doses of medication at a tie to ensure graduation pressure management.
Exercise-The level of fats in the body increases with increase with age and, therefore,
regular exercise is important to keep the cholesterol levels at their minimum. High levels of
cholesterol deposits block the blood vessels increasing the blood pressure hence stroke.
Atherosclerosis reduces with an increase in the level of exercise. 20-30 minutes of aerobic
exercise four to five times a week is recommended to reduce and achieve the level of body
fitness.
Healthy weight maintenance- The blood vessels and the heart are strained as a result of
high body mass index (BMI) and this results in high blood pressure. Obesity is associated with
high blood pressure and diabetes that are both contributors to stroke.
Stress reduction- Stress increases the level of blood pressure and is therefore directly
linked to stroke. Persistent and longtime stroke result in high blood pressure hence stroke. Stress
can be managed through counseling, exercise, and employing relaxation techniques. These
techniques are vital in treating high blood pressure thus reducing the chances of stroke.
Huang, Yining, Vijay K. Sharma, Thompson Robinson, Richard I. Lindley, Xiaoying Chen,6
Jong Sung Kim, Pablo Lavados et al. "Rationale, design, and progress of the ENhanced Control
of Hypertension ANd Thrombolysis strokE stuDy (ENCHANTED) trial: an international
multicenter 2× 2 quasi-factorial randomized controlled trial of low-vs. standard-dose rt-PA and
early intensive vs. guideline-recommended blood pressure lowering in patients with acute
ischaemic stroke eligible for thrombolysis treatment." International Journal of Stroke 10, no. 5
(2015): 778-788.

7. STROKE 7
Oral contraceptives- Most contraceptives contain high levels of estrogen content and
they increase the level of a blood clot. Women over the age of 30years are at high risk of stroke
relating to oral contraceptives due to continuous use. This risk is higher with women who smoke
due to the addition of nicotine. Alternative methods of family planning are required to avoid the
risk of stroke.
Diet improvement-Consumption of a diet rich in fats, cholesterol, and high salts pose a
risk of high blood pressure leading to stroke. High sodium levels in the diet are associated with
hypertension. Iodized table salt contains dietary sodium and canned foods also contain levels of
sodium. High sodium content is contained in sodium nitrate and disodium phosphate-rich foods.
Natural foods tend to contain low levels of sodium and therefore are recommended for
consumption. Avoidance of excessive fats is an essential way to preventing stroke especially
saturated fats. Cholesterol and dietary fats can be reduced by reducing oils and fats added in
cooking and the use of low or non-fat daily products. Boiling and baking food rather than frying
may contribute to low fats in the diet. Smokers and alcoholics are at high risk of stroke. Young
adults who are heavy smokers and alcoholics are prone to stroke. Nicotine leads to high blood
pressure while carbon dioxide produced when smoking reduces the level of oxygen carried by
the blood to the brain.
Treatment
Treatment of stroke is based on the type of hemorrhagic or ischemic. Treatment of
ischemic stroke focuses on blood flow restoration to the brain.
Ischemic

8. STROKE 8
Treatment can occur through the administration of tissue plasminogen activator (t-PA)
through an injection which helps dissolve a blood clot restoring the blood flow to the brain. If
administered as soon as the stroke occurs, it can help recover from a stroke. Administration of
this injection is recommended within the first three hours of occurrence since no benefits beyond
this time has been reported . Before administration, a brain scan is recommended to confirm the7
presence of ischemic stroke since t-PA can worsen and accelerate the bleeding resulting from
hemorrhagic stroke.
Aspirin and anti-platelets are offered to reduce the formation of another clot. Clopidogrel
is a blood thinner that enables smooth blood flow through the veins. This lowers the chances of a
blood clot. Anticoagulants are administered to avoid the occurrence of a new blood clot in the
future. This is achieved through the transformation of the blood chemical composition thus
reducing clot formation. Edoxaban and warfarin are regular anticoagulants that have been in use
for a long period. Anticoagulants are administered when there is atrial fibrillation, deep vein
thrombosis (DVI), and presence of blood clot history.
The procedure can also be performed in the restoration of blood flow to the brain a
procedure referred to as thrombectomy. In this case, a thin tube and a tiny cage are used to
remove the blood clot, or suction is used under the control of anesthesia. Thrombectomy is
effective when administered soon after a stroke especially in large blood vessels in the brain.
Hemorrhagic
Zhao, Yue, Yan Jiang, Wei Lv, Zhongyuan Wang, Lingyan Lv, Baoyan Wang, Xin Liu et al.7
"Dual targeted nanocarrier for brain ischemic stroke treatment." Journal of Controlled
Release 233 (2016): 64-71.

9. STROKE 9
Patients with hemorrhagic stroke are offered medication to lower their blood pressure and
to further reduce the future occurrence of stroke. Treatment is needed to reverse the effects of
medicines if an individual was on anticoagulation before the onset of stroke. This helps reduce
bleeding chances that may be accelerated through medication.
Surgery- Craniotomy is a surgical procedure that is conducted to remove blood from the
brain and help repair any burst blood vessel in the brain. During the surgery, part of the skull is8
removed to get access to the source of bleeding. After removal of the blood clot, an artificial
metal plate is used to replace the removed part of the skull.
Hydrocephalus can also be conducted. Hydrocephalus refers to the presence of
cerebrospinal fluid in the brain cavity. This results in lack of body balance, headaches, and
sickness. A tube referred to shunt is inserted in the brain cavity to drain out the excess fluid from
the body.
Support treatment is needed after treatment is done to prevent future occurrence of stroke
and ensure total recovery. The stroke rehabilitation program is necessary to help in regaining
skills that were lost during this time. Medication can also be administered to control conditions
such as hypertension and atrial fibrillation.
Prone group
Stroke is high among the elderly as a result of a decrease in the immune system and high-
fat deposits that increase with age and may result in deaths or total disability but can also affect a
Shah, Aatman, Saleh Almenawer, and Gregory Hawryluk. "Timing of decompressive8
craniectomy for ischemic stroke and traumatic brain injury: a review." Frontiers in Neurology 10
(2019): 11.

10. STROKE 10
young age due to lifestyle and diet. The number of the elderly over 65 years has increased
significantly in the developed world and this has been attributed to improved medical care. This9
group of people, however, are prone to stroke as they have a high deposit of fats that increases
with advanced age. This, therefore, blocks the inner walls of the blood vessels increasing in
blood pressure hence stroke. There has been an increase in drug abuse among the young
generation which makes them susceptible to stroke. This includes high alcohol consumption and
other substances are rich in nicotine such as tobacco. These drugs are injected intravenously
while others are chewed and smoked increasing the level of harmful substances in the body.
They result in elevated blood pressure and vasospasm and this may lead to a ruptured mycotic
aneurysm.
Females are more susceptible to stroke as compared to males. This is a result of the
production of high levels of the hormone estrogen which is likely to cause a blood clot. This may
limit most women an opportunity to use contraceptive pills containing estrogen. Pre-eclampsia
and gestational diabetes during pregnancy may increase susceptibility to stroke. These
conditions, therefore, need to be addressed during antenatal care to avoid risking the mother and
the child's life.
Stroke is not a hereditary disease but is associated with hereditary factors and conditions
such as high blood pressure (HBP), diabetes, and heart diseases. These conditions tend to run
through family history and they are major contributors to stroke. Genetic variability may also
lead to risks of stroke.
Johnson, Walter, Oyere Onuma, Mayowa Owolabi, and Sonal Sachdev. "Stroke: a global9
response is needed." Bulletin of the World Health Organization 94, no. 9 (2016): 634.

11. STROKE 11
Stroke was a major cause of disabilities and deaths in Sweden in the 19th Century. This
was attributed to poor methods of treatment and a lack of proper medication. Stroke in Sweden
was distributed across both genders and age with high cases recorded between ages 30-65
years. Sweden has experienced a steady decrease in stroke cases. The long term rate of survival10
has improved significantly. There has been a general increase and improvement in life
expectancy in Sweden and this might have contributed to a decrease in the number of stroke
cases. During the 21st Century, a declining trend of stroke has been realized and this has been
attributed to improvement in secondary prevention after acute stroke and its long term effects in-
unit treatment such as carotid and endarterectomy. This decline shows that both primary and11
secondary preventive measures have been impactful in reducing cases of stroke. In a wider
perspective, improvement in the management of other diseases such as heart diseases, diabetes,
and cancer may have a long term influence on survival trends for patients suffering from a
stroke.
In conclusion, stroke is a cardiovascular disease that causes deaths, partial and permanent
disabilities. Two major categories of stroke are known which includes ischemic which occur as a
result of a blood clot in the brain and hemorrhagic that result from rupture of the blood vessels.
These conditions lead to death and damage to the brain cells. Stroke is majorly caused by diet
and lifestyle such as high consumption and intake of alcohol and nicotinic products, lack of
Bergström, Lisa, Anna-Lotta Irewall, Lars Söderström, Joachim Ögren, Katarina Laurell, and10
Thomas Mooe. "One-year incidence, time trends, and predictors of recurrent ischemic stroke in
Sweden from 1998 to 2010: an observational study." Stroke 48, no. 8 (2017): 2046-2051.
Eriksson, Marie, Eva-Lotta Glader, Bo Norrving, Birgitta Stegmayr, and Kjell Asplund.11
"Acute stroke alert activation, emergency service use, and reperfusion therapy in Sweden." Brain
and behavior 7, no. 4 (2017): e00654.

12. STROKE 12
exercise, and stress. These conditions trigger and impact the brain leading to high blood pressure,
heart diseases, and diabetes hence stroke. Stroke impacts the cerebrum, cerebellum, and the brain
stem leading to dysfunction of their related body organs and parts. Stroke has an impact across
both gender and ages but with much impact on the elderly. The elderly tend to have a low
immune system and high deposits of fats that block the smooth flow of blood in and out of the
brain. Stroke is preventable through proper lifestyle activities such as a reduction in alcohol and
nicotine consumption. Reduction of body weight in case of high BMI and engaging in exercise
may prevent cases of stroke. Treatment can be performed through surgery to remove the blood
clot and proper medication to dissolve the clot. Further research is required to determine the
trend of stroke between the developed and the developing countries.

13. STROKE 13
References
Bergström, Lisa, Anna-Lotta Irewall, Lars Söderström, Joachim Ögren, Katarina Laurell, and
Thomas Mooe. "One-year incidence, time trends, and predictors of recurrent ischemic stroke
in Sweden from 1998 to 2010: an observational study." Stroke 48, no. 8 (2017): 2046-2051.
Eriksson, Marie, Eva-Lotta Glader, Bo Norrving, Birgitta Stegmayr, and Kjell Asplund. "Acute
stroke alert activation, emergency service use, and reperfusion therapy in Sweden." Brain
and behavior 7, no. 4 (2017): e00654.
Kaneko, Fuminari, Shinichiro Shindo, Masaki Yoneta, Megumi Okawada, Kazuto Akaboshi, and
Meigen Liu. "A Case Series Clinical Trial of a Novel Approach Using Augmented Reality
that Inspires Self-body Cognition in Patients with Stroke: Effects on motor function and
resting-state brain functional connectivity." Frontiers in systems neuroscience 13 (2019): 76.
Zhao, Yue, Yan Jiang, Wei Lv, Zhongyuan Wang, Lingyan Lv, Baoyan Wang, Xin Liu et al.
"Dual targeted nanocarrier for brain ischemic stroke treatment." Journal of Controlled
Release 233 (2016): 64-71.
Shah, Aatman, Saleh Almenawer, and Gregory Hawryluk. "Timing of decompressive
craniectomy for ischemic stroke and traumatic brain injury: a review." Frontiers in
Neurology 10 (2019): 11. Huang, Yining, Vijay K. Sharma, Thompson Robinson, Richard I.
Lindley, Xiaoying Chen, Jong Sung Kim, Pablo Lavados et al. "Rationale, design, and
progress of the ENhanced Control of Hypertension ANd Thrombolysis strokE stuDy
(ENCHANTED) trial: an international multicenter 2× 2 quasi-factorial randomized
controlled trial of low-vs. standard-dose rt-PA and early intensive vs. guideline-

14. STROKE 14
recommended blood pressure lowering in patients with acute ischaemic stroke eligible for
thrombolysis treatment." International Journal of Stroke 10, no. 5 (2015): 778-788.
Chen, Zhili, Poornima Venkat, Don Seyfried, Michael Chopp, Tao Yan, and Jieli Chen. "Brain–
heart interaction: cardiac complications after stroke." Circulation research 121, no. 4
(2017): 451-468.
Huang, Yining, Vijay K. Sharma, Thompson Robinson, Richard I. Lindley, Xiaoying Chen, Jong
Sung Kim, Pablo Lavados et al. "Rationale, design, and progress of the ENhanced Control of
Hypertension ANd Thrombolysis strokE stuDy (ENCHANTED) trial: an international
multicenter 2× 2 quasi-factorial randomized controlled trial of low-vs. standard-dose rt-PA and
early intensive vs. guideline-recommended blood pressure lowering in patients with acute
ischaemic stroke eligible for thrombolysis treatment." International Journal of Stroke 10, no. 5
(2015): 778-788.
Johnson, Walter, Oyere Onuma, Mayowa Owolabi, and Sonal Sachdev. "Stroke: a global
response is needed." Bulletin of the World Health Organization 94, no. 9 (2016): 634.

15. STROKE 15