INTRODUCTION

Stroke is a disorder in which the arteries to the brain become blocked

or rupture, resulting in death of brain tissue. According to the World Health
Organization (WHO), it is a clinical syndrome consisting of rapidly developing
signs of focal (or global) disturbance of cerebral function lasting more than 24hrs. or
leading to death, with no apparent cause other than of vascular origin.
In the Philippines, it is one of the leading causes of death of the Filipinos
(2002).In the year 2008, stroke affects 486 out of 100,000 Filipinos or
roughly half a million Filipinos. It usually occurs among men aging 60-70, but as of
year 2008, stroke occurs inpatients as young as 30-40 years old because of the
change in lifestyle.
There are two types of stroke: ischemic and hemorrhagic. About 80% of
strokes are ischemic due to a blocked artery. Brain cells, thus deprived of their blood
supply, do not receive enough oxygen and glucose (sugar), which are carried by
blood. A transient ischemic attack (TIA), sometimes called a mini stroke, is often an
early warning sign of an impending ischemic stroke. TIAs are caused by an
inadequate blood supply to part of the brain but only for a brief time. Because
the blood supply is restored quickly, brain tissue does not die, as it does in
a stroke.
The other 20% of strokes are hemorrhagic due to bleeding in or around the
brain. In this type of stroke, a blood vessel ruptures, interfering with normal
blood flow and allowing blood to leak into brain tissue. Blood that comes into direct
contact with brain tissue irritates the tissue and can cause scarring, leading to
seizures.
The major risk factors for both types of stroke are atherosclerosis (the
narrowing or blockage of arteries by patchy deposits of fatty material in the walls of
arteries) high blood pressure, diabetes, and smoking. Atherosclerosis is a
more important risk factor for ischemic stroke and high blood pressure is a
more important risk factor for hemorrhagic stroke. Other risk factors for
hemorrhagic stroke include use of anticoagulants, cocaine, or amphetamines,
aneurysms in arteries within the skull, blood vessel (arteriovenous) malformations and
vasculitis.

The most common early symptoms of an ischemic stroke are sudden

weakness or paralysis of the face and leg on one side of the body, slurred
speech, sudden confusion with difficulty speaking or understanding speech,
sudden dimness or loss of vision, particularly in one eye, loss of balance and
coordination, leading to falls, sudden severe headache and abnormal
sensations or loss of sensation in an arm or a leg or on one side of the body.
Symptoms of a hemorrhagic stroke are largely the same as those of
an ischemic stroke but may also include sudden severe headache, nausea and
vomiting, temporary or persistent loss of consciousness and very high blood
pressure.