Home | What's New | Our Services | Events & Activities | Career Opportunities | 4all.my | About Us | Contact Us
Encyclopaedia ->
Health Topics
First letter
Body System
Dictionary The Cardiovascular System


Synonyms :  Apoplexy; Cerebral Infarction; Cerebral Vascular Accident, Cerebrovascular accident

Clinical features, Diagnosis, Management, Prognosis, Nutrition, Herbs,

    Cerebrovascular accident (stroke) refers to damage to brain tissue due either to cerebral infarction (80-85%) or cerebral haemorrhage (15-20%). Stroke is uncommon below the age of 50 and affects males more often than females. It is one of the commonest causes of death in developed countries and also a prominent cause of disability, particularly in the elderly. The most common vascular disorder underlying stroke is atherosclerosis affecting intracranial and extracranial arteries, less common causes are embolism and aneurysms (pouch-like dilations) of major arteries. 

    The major risk factors for stroke:


           cigarette smoking

           diabetes mellitus

           hyperlipidaemia (hypercholesterolaemia)

           cardiac arrhythmias, history of myocardial infarctions (risk for intracardial thrombosis)

           positive family history 

    Mechanisms of stroke:

           Cerebral infraction (ischaemic stroke). Thrombosis at the site of atheromatous degeneration in a major cerebral vessel is probably the commonest mechanism, but embolism of thrombotic or atheromatous material from the heart or an extracranial artery is also frequent. Cardiac emboli (arising from mural thrombus after myocardial infarction, or associated with atrial fibrillation) tend to be large and cause usually major strokes. By contrast, emboli arising from the carotid artery are more often smaller, and cause minor strokes or transient cerebral or ocular symptoms (transient ischaemic attacks). Once completely deprived of blood supply cerebral tissue undergoes infarction within a few minutes, the resultant cerebral oedema causes more damage by compressing blood vessels and further impairing cerebral blood flow.

           Cerebral haemorrhage. The primary cause of cerebral haemorrhage is hypertension. About half the strokes caused by cerebral haemorrhage are due to subarachnoid bleeding, and the other half due to intracerebral bleeding into the brain tissue. Intracerebral bleeding is usually caused by rupture of small intracerebral arteries or arterioles weakened by hypertension and/or atheromatous degeneration. This type of stroke is more likely to occur during physical exertion or emotional stress when blood pressure is increased. On the other hand spontaneous (non-traumatic) subarachnoid haemorrhage usually results from a ruptured aneurysm of one of the major cerebral arteries or their branches, or inborn arteriovenous malformation (a mass of tangled, dilated blood vessels in which small arterioles flow directly into venules without a capillary network in-between). Aneurysms can be saccular (berry) which are thought to arise as a result of congenital defects in the media (muscle layer) of arteries at branch points and fusiform (spindle-shaped) which are a result of atherosclerotic weakening of blood vessel walls. The saccular aneurysms can be found in approximately 1% of the general population when they cause no problems until they burst, when no obvious precipitating factor is usually apparent. Haemorrhage from ruptured fusiform aneurysms often occurs during exertion (e.g., physical activity, sexual intercourse) when blood pressure is increased.

Clinical features:  < BACK TO TOP >

           Strokes usually evolve rapidly over a few minutes, and reach maximum disability within an hour or two.

           The precise features of a stroke depend on the vascular territory involved and mechanism of stroke.

           The majority of patients with ischaemic stroke exhibit greater or lesser degrees of hemiplegia (paralysis of the limbs and trunk on the contralateral side of the body), dysphasia (impaired coordination of speech - if the left hemisphere is involved), with hemianaesthesia (loss of sensation on the contralateral side of the body) and homonymous hemianopia (loss of vision in either the whole left or the whole right half of the visual field) in some.

           Initially the paralysed limbs may be flaccid and reflexes can be decreased, but after a few days, tone usually increases and reflexes become hyperactive on the affected side (the signs of upper motor neuron damage).

           Headache is a common feature and it is due to secondary brain oedema and increase of intracranial pressure.

           Epileptic seizures, vomiting and depressed consciousness may also occur, the latter usually indicating a severe lesion and marked increase of intracranial pressure.

           The brain stem lesions may also show dysphagia (difficulty in swallowing), facial numbness/weakness on the same side as the lesion, and often loss of consciousness because of damage to the reticular activating system.

           In some patients the symptoms worsen gradually or in a step-wise fashion over a matter of hours or days (‘evolving stroke?/i>).

           In most patients with brain infarction consciousness is preserved in contrast to haemorrhage in the brain when the patients suddenly develop signs of increased intracranial pressure, including severe headache (with neck pain and stiffness in subarachnoid haemorrhage), nausea and vomiting, and rapid loss of consciousness.

           Localising neurological signs in cerebral haemorrhage may be present but are often difficult to detect in the setting of a massive elevation in intracranial pressure and coma.

           Progression of the condition is associated with evidence of brain stem compression, including deep coma; irregular, intermittent respirations (Cheyne-Stokes respiration); bradycardia and hypertension; dilated, unresponsive pupils; and spasticity of skeletal muscles.

           Transient ischaemic attack (TIA) is an episode of focal neurological dysfunction due to cerebral ischaemia in which symptoms last less than 1 hour, often only a few minutes. It is due to minor embolism from the extracerebral arteries (carotid and vertebral) and less commonly from mural thrombi that develop in heart chambers. Certain patients present with vertigo (dizziness), diplopia (seeing in duplicate) and ataxia (loss of motor coordination commonly presenting as unsteady gait); in others symptoms and signs are similar to completed stroke only milder and transient. TIAs are important because they may herald a completed stroke (approximately one third of patients with TIAs develop clinically significant strokes within 5 years).

Diagnosis:  < BACK TO TOP >

           The clinical diagnosis of stroke is usually straightforward, but can not help in identifying the cause.

           CT scanning and MRI scanning provide the only reliable method of distinguishing cerebral infarction from haemorrhage, and are the most commonly used.

           Angiography may exacerbate the symptoms of stroke caused by infarction and intracerebral haemorrhage and is done only when the diagnosis is in doubt or surgical intervention is likely to result; on the other hand if subarachnoid haemorrhage is proven, urgent cerebral angiography is usually indicated, followed by neurosurgery to repair the bleeding site.

           Lumbar puncture will usually reveal uniformly blood-stained CSF in subarachnoid haemorrhage or intracerebral haemorrhage that extends into the subarachnoid space.

           Echocardiography (ultrasound examination of the heart) is sometimes performed if there is a suggestion of a cardiac source of embolism causing stroke.

           Carotid Doppler ultrasound scanning can reveal alteration of blood flow due to atheromatous and thrombotic lesions.

Management  < BACK TO TOP >

           No specific treatment is available which can reverse the brain damage.

           Immediately airway maintenance, adequate oxygen, intravenous fluid to maintain nutritional and fluid intake, careful nursing to prevent bed sores and physiotherapy to prevent joint contractures are needed.

           Recombinant tissue plasminogen activator [Actilyse, Rapilysin] given within few hours of symptom onset can improve the outcome in certain ischaemic stroke patients; anticoagulation with heparin may be beneficial to patients with evolving stroke.

           Sometimes inhibitors of platelet aggregation (aspirin) can be used for stroke prevention, especially in patients suffering frequent TIAs.

           Treatment of stroke caused by intracerebral haemorrhage is similar, except that thrombolytics, anticoagulants and antiplatelet drugs are contraindicated; rarely surgical evacuation of large haemorrhages (intracerebral haematoma) is attempted with high mortality rate, but subarachnoid haemorrhage must be treated surgically, with very high success rate.

           Most patients who survive show some degree of recovery which is maximal in first 6 months; usually no significant improvements can be expected after 1 year.

           Rehabilitation to restore mobility is planed and carried out, and this is usually a very long process.

Prognosis  < BACK TO TOP >


Nutrition < BACK TO TOP >

Nutrition that alleviate or prevent Stroke :-

Herbs < BACK TO TOP >

Herbs that alleviate or prevent Stroke :-

(source : -)

search this site the web

search engine by freefind


Powered by visit montaine home page

Thank You visiting MONTAINE

Welcome To Montaine
action activity adventure aerobic aerobics after age air alternative medicine amateur areas arthritis athletes backpack backpacking backpacks bad bag barbeque basecamp based bay before beginners being benefit best bike biking blonde bmi body bodybuilder bodybuilding brand building BUY calculate calculated calculation calculator calculators calories camp camping camps cardiorespiratory cardiovascular center centers centre centres certification chat chi circuit climb climbing club clubs college competition competitor components conservation consumed consumption count courses day http://www.montaine.com.my/dictionary.htm definition download education environmental equipment erotica excercise exercise exercises exercising explore euro 2004 event famous fat female figure find fires fit fitness fittness for force franchise free gallery gay get getfit given glutes green greatest group groups guide guides gym gyms health height hikers hiking home homepage how human ideal idealweight in increasing index injures injuries instructions intermediates iron is kl knowing layout link locations loosing male man map maps mass massage masseur maximuscle me measure metabolism miss model models morning mount mountain mountaineering mountains mt multiple multistage muscle muscular music naked natural therapy national near new night noon nutrition occupational of online olympics or out outdoor outdoors page pages Pain park parks people per personal phisical photo photos physical picture pictures pilates porn program programs rafting rainbows reaction real recommendations recreation recreational rehab rehabilitation rentals requirements results rock rooms running school schools sclerosis scoliosis sex sexy should site sites source spinal sport sports stars state statistics studio studios student swedish swim swimsuit team techniques test testing tests the therapeutic therapist therapy time tips to top trail trails trainer trainers training trip trips ultimate university visitor watching water web weekend weekends weigh weight what white whitewater women womens workout world your yout
Tsunami online Donations and Information Tsumani online Donations and Infomation We are closed from Feb 9 to Feb 13, 2005 and will resume business on Feb 14, 2005

Donation Drive:The New Straits Times, Berita Harian, TV3, 8TV Malaysian Tsunami Disaster Fund The Star Earthquake/Tsunami Relief Fund Subang/USJ Disaster Fund theSun Tsunami Emergency Supplies Fund Asian Tsunami Disaster Fund - by the Foreign Ministry Yayasan Sultanah Bahiyah Buddhist Maha Vihara - 123 Jalan Berhala, Brickfields 50470 KL -Tel: 03 2274 1141, Fax: 03 2273 2570

Chinese New Year 2005
3 days post Chinese New Year detox programme
Local News & Info: Missing Persons E-mail Appeals Tsunami Penang Blog iPenang Screenshots The Star Bernama Project Petaling Street TV Smith's Tsunami InTech: Bloggers fill the void

 sWorkshop探 访 各 类 癌 症 的 真 相10 June 2004 7:30am-8:30pmCall (603) 2713 9288 to reserve a seat
Charting Your Way to Success workshop Organised by JCI

Venue : Montaine Menara Weld Level 4 |

 Date  : 30th July 2004 Friday (6:30pm -8:00pm)

Organizer : JCI Kuala Lumpur |

 Contact    : Kelly 012-320 3350 & Ang 012-296 5138

 speaker Mr NgThian Watt the Principal Trainer from Napoleon Hill Associates MalaysiaDetails www.kljuniorchamber.org
Montaine's Health and Weight Management Programme
Call 012 201 8020 or 03 5636 6788 NOW

January, February, March, April, May, June, July, August, September, October, November, December
April Promotion
(Gift Voucher Available)
 - Spa Gateway - Beauty Gateway
Usual RM293 Now RM138

Queen of The Day  RM138 (2 hours)

          Full Body Exfoliation worth RM68 (30 minutes)

          Full Aromatherapy Massage worth RM128 (60 minutes)

          Full Body Detox Treatment worth RM128 (30 minutes)

   All For RM138Additional RM68 – Make Over (Evening Make Up)ecretary's Day Gift, Secretarie

Call 012 201 8020 or +603 5636 6788


Massage or Reflexology Package Buy 7 get 3 Free  (First 50 Customers or till 31 October 2004 Only, Hurry call 03 7710 5593 now!!)

Jobs vacancy
Customer Service Exec at Montaine centre

Salary RM1000 - RM4000 Female is preferable call KC at 012 201 8020

MONTAINE Centre of Health and Wellness
kl, jb, jp, au, Africa Antarctica Arctic Asia Caribbean Europe North America Oceania South America Afghanistan Kabul Albania Tirana Algeria Algiers Andorra Andorra la Vella Angola Luanda Antigua and Barbuda St. John's Argentina Buenos Aires Armenia Yerevan Australia Canberra Austria Vienna Azerbaijan Baku a port on the Caspian Sea Bahamas Nassau Bahrain Al-Manámah Bangladesh Dhaka Barbados Bridgetown Belarus Mensk (Minsk) Belgium Brussels Belize Belmopan Benin Porto-Novo Bhutan Thimphu Bolivia Sucre ; Administrative capital: La Paz Bosnia and Herzegovina Sarajevo(unofficial) Botswana Gaborone Brazil Brasília Brunei Darussalam Bandar Seri Begawan Bulgaria Sofia Burkina Faso Ouagadougou Burundi Bujumbura Cambodia Phnom Penh Cameroon Yaoundé Canada Ottawa Ontario Cape Verde Praia Central African Republic Bangui Chad N'Djamena Chile Santiago China Beijing Colombia Santafé de Bogotá Comoros Moroni Congo, Republic of Brazzaville Congo, Democratic Republic of the Kinshasa Costa Rica San José Côte d'Ivoire Yamoussoukro (official) Croatia Zagreb Cuba Havana Cyprus Lefkosia (Nicosia) (in government-controlled area) Czech Republic Prague Denmark Copenhagen Djibouti Djibouti Dominica Roseau Dominican Republic Santo Domingo East Timor Dili Ecuador Quito Egypt Cairo El Salvador San Salvador Equatorial Guinea Malabo Eritrea Asmara Estonia Tallinn Ethiopia Addis Ababa Fiji Suva (on Viti Levu) Finland Helsinki France Paris Gabon Libreville Gambia, The Banjul Georgia Tbilisi Germany Berlin (capital since Oct.) Ghana Accra Greece Athens Athens Grenada St. George's Guatemala Guatemala City Guinea Conakry Guinea-Bissau Bissau Guyana Georgetown Haiti Port-au-Prince Honduras Tegucigalpa Hungary Budapest Iceland Reykjavik India New Delhi Indonesia Jakarta Iran Teheran Iraq Baghdad Ireland Dublin Israel Jerusalem Italy Rome Jamaica Kingston Japan Tokyo Jordan Amman Kazakhstan Astana(formerly Aqmola; capital since ) Kenya Nairobi Kiribati Tarawa Korea, North Pyongyang Korea, South Seoul Kuwait Kuwait Kyrgyzstan Bishkek (formerly Frunze) Laos Vientiane Latvia Riga Lebanon Beirut Lesotho Maseru Liberia Monrovia Libya Tripoli Liechtenstein Vaduz Lithuania Vilnius Luxembourg Luxembourg Macedonia Skopje Madagascar Antananarivo Malawi Lilongwe Malaysia Kuala Lumpur Maldives Malé Mali Bamako Malta Valletta Marshall Islands Majuro Mauritania Nouakchott Mauritius Port Louis Mexico Mexico City Micronesia Palikir Moldova Chisinau Monaco Monaco Mongolia Ulaan Baatar Morocco Rabat Mozambique Maputo Myanmar Rangoon (Yangon) Namibia Windhoek Nauru Yaren Nepal Kathmandu The Netherlands Amsterdam (official) ; The Hague (administrative capital) New Zealand Wellington Nicaragua Managua Niger Niamey Nigeria Abuja Norway Oslo Oman Muscat Pakistan Islamabad Palau Koror Palestinian State (proposed) Undetermined Panama Panama City Papua New Guinea Port Moresby Paraguay Asunción Peru Lima The Philippines Manila Poland Warsaw Portugal Lisbon Qatar Doha Romania Bucharest Russia Moscow Rwanda Kigali St. Kitts and Nevis Basseterre (on St. Kitts) St. Lucia Castries St. Vincent and the Grenadines Kingstown Samoa Apia San Marino San Marino São Tomé and Príncipe São Tomé Saudi Arabia Riyadh Senegal Dakar Serbia and Montenegro Belgrade Seychelles Victoria Sierra Leone Freetown Singapore Singapore Slovakia Bratislava Slovenia Ljubljana Solomon Islands Honiara (on Guadalcanal) Somalia Mogadishu South Africa Pretoria; Legislative capital and largest city: Cape Town; Judicial capital: Bloemfontein . No decision has been made to relocate the seat of government. South Africa is demarcated into nine provinces consisting of the Gauteng Northern Province Mpumalanga North West KwaZulu/Natal Eastern Cape Western Cape Northern Cape and Free State. Each province has its own capital Spain Madrid Sri Lanka Colombo; Legislative and Judicial capital: Sri Jayawardenepura Kotte Sudan Khartoum Suriname Paramaribo Swaziland Mbabane Sweden Stockholm Switzerland Bern Syria Damascus Taiwan Taipei Tajikistan Dushanbe Tanzania Dar es Salaam ; Official capital: Dodoma Thailand Bangkok Togo Lomé Tonga Nuku'alofa Trinidad and Tobago Port-of-Spain Tunisia Tunis Turkey Ankara Turkmenistan Ashgabat Tuvalu Funafuti Uganda Kampala Ukraine Kyiv (Kiev) United Arab Emirates Abu Dhabi United Kingdom London United States Washington DC Uruguay Montevideo Uzbekistan Tashkent Vanuatu Port Vila Venezuela Caracas Vietnam Hanoi Western Sahara (proposed state) El Aaiun Yemen Sanaá Zambia Lusaka Zimbabwe Harare




Health check and health consultation

Power health talks and seminars

Beauty and treatment sessions

Relaxation and sport massages

Weekly family bonding activities

Montaine outdoor activities

Fitness, self defence & leisure classes available

Fully equipped gym sets, steam, sauna, Jacuzzi

Personal trainers available.

Health drinks available.


Relaxation / Swedish Massage Remedial / Deep Tissue Massage Physiotherapy, Sport / Work-Related Injuries Stress / Anxiety Management Acupuncture, Shiatsu Aromatherapy / Essential Oils Reflexology Slimming and Weight loss Beauty and treatment sessions Ions Detox, Ozone Spa More....... Corporate Massage Mobile/home visit Hotels Montaine Center Massage Courses Montaine outdoor activities www.montaine.com.au

 Tel :  (+603) 5636 6788 www.montaine.com.my
 No 16, 1st Floor, Jalan PJS 11/28, Bandar Sunway, 46150, Selangor, Malaysia
Tel : (612) 9264 4567 www.montaine.com.my 23/203 Castlereagh St, Sydney, NSW 2000, Australia