When a blood clot causes stroke

Dear doctor,

What does the medical term clotting mean, and how does it lead to stroke?

Alnashir D Walji

Dear Alnashir,

A clot is a semi-solid gel like mass formed when certain parts of the blood thicken. Clots are usually formed to plug an injury and stop blood loss. However, a clot can also be formed inside a blood vessel where there is no obvious injury. Once the clot forms, it can obstruct blood flow through that blood vessel, leading to tissue damage and death (such as heart attacks, stroke ...) or a small bit of it, called an embolus, can break off and travel to another part of the body and block the blood vessels such as pulmonary embolism, where there is blockage of blood flow to lung tissue.

There are tests done to diagnose blood clots and treatment is usually given urgently to prevent complications and/or protect from further damage. It may take weeks or months for a clot to resolve with treatment and sometimes someone may be put on medication for a while after this, depending on the type of clot they had. Despite treatment, the clot may not resolve completely and routine follow-up is needed. Having a clot within the blood vessels anywhere in the body is a medical emergency. This is because a bit of the clot can break off and get stuck in the lungs, causing difficulty in breathing, a fast heart rate, cough, chest pain, dizziness, excessive sweating, change in skin colour, loss of consciousness and even death. Anyone with a clot should visit the hospital urgently for relevant tests, possibly a CT scan of the chest and doppler scans of the limbs, admission and immediate medical care.

What causes my fingers and feet to swell? I sit a lot at work. Also, what causes my hands to shiver and what makes me loose concentration when I am hungry?

Josephine.

Dear Josephine,

The swelling of the fingers and feet may be as a result of a problem with fluid circulation due to hormonal changes, heart disease, liver disease, kidney disease, low blood level, hormonal disorders, some types of growths or cancer, or due to some medications/treatments. Sitting a lot can contribute to swelling of the feet and this can be managed by elevating and exercising the feet, moving from your seat every half an hour or using compression stockings to improve circulation; reducing salt intake and maintaining a healthy weight. It is advisable for you to be reviewed by a doctor for evaluation to pinpoint the underlying causes and treat them.

When you are hungry, your body exhibits some symptoms as cues to notify you that the blood nutrient levels are low and they need to be restocked. These symptoms include stomach growling or gnawing, abdominal pain or cramps, shaking, headache, poor concentration, feeling tired or dizzy and irritability. These are normal symptoms of hunger and they usually resolve after feeding. These symptoms only become a problem if they are severe, for instance resulting in fainting or loss of consciousness, or if you are feeling hungry too frequently, which may be a symptom of having diabetes. To avoid experiencing these symptoms, have regular meal times and take adequate amounts of nutritious foods, and avoid skipping meals.

Epilepsy, autism and dyslexia are disorders of the nervous system.

Are they treatable? Alnashir D Walji

Dear Alnashir,

Epilepsy is a problem of the brain where there is abnormal nerve signals/brain activity leading to seizures (uncontrollable muscle movements or loss of muscle control) or abnormal sensations, behaviour and sometimes loss of awareness. It can happen due to genetics or as A result of head trauma, brain infections, stroke, brain tumour, liver or kidney failure, or damage to the baby’s brain during pregnancy or at birth. It can be managed using medication and avoiding triggers. Autism is a developmental disorder where there are problems with social skills, communication and there is repetitive and fixated behaviour. The symptoms may range from mild to very severe and they are usually noticed by the time the child is two to three years old. It cannot be cured but can be managed, especially if help is sought early.

Dyslexia is a learning disorder that affects the area of the brain that processes language. Someone with dyslexia has normal intelligence, but has difficulty with speech sounds and how they relate to words, leading to difficulty with reading. It can be present throughout someone’s lifetime, but it is easiest to diagnose in children. Dyslexic children may have delay in speech, have trouble learning and remembering words, and may have difficulty understanding what they hear, especially if it is said fast, and mixing words. They have difficulty getting the right word to give an answer and difficulty reading. With assistance, these children can succeed academically and as they grow, the symptoms may be less apparent.

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