Stroke due to Atrial Fibrillation

With an Arrhythmia such as Atrial Fibrillation, the natural rhythm of the heart is disturbed. The disruption of the regular electrical impulses from the Atria to the Ventricles in Atrial Fibrillation affects the hearts ability to contract. When this happens, the blood cannot fully empty into the Ventricles. Blood is therefore left behind in the Atria, which can lead to the formation of blood clots. When a clot dislodges, it can be carried in the bloodstream to the brain, where it could occlude a blood vessel, i.e. the middle Cerebral Artery. The obstruction of normal blood flow leads to a shortage of Oxygen delivery, causing an Ischemic Stroke. Further information regarding Atrial Fibrillation can be found in our article.

A stroke leads to persistent disruption of brain function, triggered by a sudden shortage of blood supply to the brain. This causes certain areas (those receiving their blood supply from the affected blood vessel) to not receive adequate Oxygen and other nutrients. When this happens, the surrounding tissue dies. These areas are therefore either temporarily or permanently unable to perform their normal functions. This causes long-term effects such as speech and vision disturbances, or paralysis of the limbs and/or facial musculature.

There are two main types of Stroke, both due to disturbances in circulation to the brain:

• Ischemic Stroke: obstruction via a Blood clot (Embolus) or Vascular calcification (Arteriosclerosis)
• Hemorrhagic Stroke: Bleeding in the brain

In 80% of cases, the cause is due to an ischemic event, stemming from the occlusion of a blood vessel. If the associated symptoms resolve within 24 hours, it is called a Transient Ischemic Attack (TIA). Nonetheless, one should immediately call 112 at the first sign of stroke symptoms. A TIA is a precursor to stroke—10% of those who suffer from a TIA will also experience a Stroke, often in the next few days, but up to five years later. The risk of stroke is very high, and the potential associated long-term effects are significant.

If a stroke is due to bleeding in the brain, it is known as a Hemorrhagic Stroke. 15-20% of Stroke cases fall into this category. With both types, Ischemic and Hemorrhagic stroke, the symptoms are similar when the same region of the brain is affected.

270,000 people in Germany suffer from Stroke yearly. More than 80% of those affected are over 60 years old; however, Stroke can also affect younger adults and even children.

The symptoms of a Stroke vary greatly based upon which region of the brain is affected, and its severity. Some possible symptoms include:

• Facial numbness
• Drooping of the mouth or paralysis of half of the face
• Difficulty of speech (unclear speech, repetition of words or syllables, long pauses, or loss of speech altogether)
• Diminished expressiveness (unable to name objects/wishes, or to express oneself meaningfully)
• Difficulty understanding (improperly follows instructions)
• Disturbance of vision (blurry, double or reduced vision)
• Paralysis or numbness of one side of the body
• Severe dizziness
• Difficulty walking
• Severe headache (sudden onset, typically associated with bleeding in the brain, often in combination with nausea and vomiting)
• Loss of consciousness

If a stroke is suspected in either yourself or someone else, Emergency personnel should be notified immediately, so that the long-term effects can be minimized.

The factors that increase the risk of Stroke are based not only upon genetics and age, but also upon lifestyle and other medical disorders. The risk increases with inactivity, poor nutrition and smoking.

• Age (80% of stroke victims are older than 60 years old)
• Genetic disposition
• Diabetes Mellitus
• Hypertension(high blood pressure)
• Elevated cholesterol level
• Obesity
• Certain types of Migraine
• Excessive alcohol consumption

You can influence your health and decrease your risk of stroke by leading a healthy lifestyle.