Tag Archives: stroke

The Changing Field of Stroke Medication

Strokes are the fifth leading cause of deaths in North America. If one is fortunate enough to survive a stroke, the rehabilitation process is long and painful depending on the amount of damage done to the brain. There are two types of strokes – ischemic and hemorrhagic. Ischemic strokes are the result of a clot forming in an artery and preventing blood flow, whereas hemorrhagic strokes are the result of an artery bursting and and the brain literally bleeding out.

Many researchers have worked towards improving and developing treatments to reduce the amount of brain damage a patient suffers during a stroke. One of the events that takes place during a stroke is called excitotoxicity, where brain cells literally excite themselves to death.

Receptors like NMDA as well as calcium are key culprits in causing damage to brain tissue. NMDA is a protein that is present on nerve cells and binds to the neurotransmitter glutamate. When a stroke occurs, nerve cells release large amounts of glutamate which bind to these NMDA receptors. The binding of glutamate to an NMDA receptor causes it to open. Calcium which is present in excess on the outside of the nerve cell, enters the cell. The calcium alongside with glutamate go on to wreck havoc in the nerve cell ultimately leading to its death. 

Courtesy of Khashayar.

Dr. Nicolas Weilinger investigated what happens at a cellular level during a stroke and the mechanism which works to damage brain cells. While researching, Dr. Weilinger discovered a new signalling pathway that had broad reaching implications for brain physiology and pathology.

YouTube Preview Image Courtesy of Harnoor Shoker

The findings of this study are important because current treatments in place to protect the brain during and after a stroke are not as effective as they should be. One of the main findings of Dr. Weilinger’s paper was that another channel much bigger than NMDA called pannexin gets activated during a stroke. Pannexin is physically connected to the NMDA receptor so when the NMDA receptor opens it signals pannexin to open as well. The opening of another channel therefore allows more calcium and glutamate to enter at an even faster pace. Using this information, a new drug was designed that would prevent the NMDA receptor from communicating with pannexin – in other words it would block the physical connection between the two proteins.

The wider implications of Weilinger’s paper is to hopefully improve stroke treatment. Future research into Dr. Weilinger’s findings could potentially be the first step in discovering a new drug type that can be used to reduce brain damage suffered during a stroke.

**We would like to thank Dr. Nicholas Weillinger for his time and the SCIE 300 team for guiding us and providing feedback.**

Harnoor, Khashayar, Matthew.

The causes, symptoms and treatment of Stroke

Did you know that stroke is the fourth leading cause of death in Canada?

Stroke occurs when cells do not receive enough oxygen and nutrients, thus blood supply to the brain is interrupted or reduced. It most likely affects a person if they have a personal or family history of stroke, overweight, aged 55 or more, does not exercise much, drink heavily, or use illicit drugs. There are three main kinds of stroke: ischemic stroke, hemorrhagic stroke and Transient Ischemic Attack (TIA).

Illustration of ischemic stroke: Wikimedia commons by National Heart Lung and Blood Institute (NIH)

Illustration of ischemic stroke: Wikimedia commons by National Heart Lung and Blood Institute (NIH)

Ischemic stroke is the most common kind of stroke – at least 88% of strokes occurred are this type. As you can see from the image to the left, ischemic stroke happens due to the blockage or narrowing down of arteries that connect to the brain, resulting in low blood flow to the brain. The blockage is caused by blood clots, which can form in the arteries or even further away before the blood enters the narrower part of arteries within the brain.

Illustration of hemorrhagic stroke: Wikimedia commons by National Heart Lung and Blood Institute (NIH)

Illustration of hemorrhagic stroke: Wikimedia commons by National Heart Lung and Blood Institute (NIH)

On the other hand, hemorrhagic stroke is less common than Ischemic stroke. Although, only 15% consists of hemorrhagic stroke, 40% of the death occurs due to this type of stroke. As you can see from the image to the right, it takes place when a blood vessel ruptures causing blood to accumulate in the tissue surrounding the rupture. Pressure on the brain is produced as a result, as well as loss of blood to certain areas.

Transient Ischemic Attack is very different from the other two types of stroke. The flow of blood to the brain is only disrupted for a short period of time. However, it is similar to Ischemic stroke due to the fact that it is often caused by blood clots. This type of stroke serves as a warning signs for future strokes, indicating that there is a partially blocked artery or clot source in heart. Over one third of the people who experience this have a major stroke within a year, and between 10-15% will have a major stroke within three months.

Some symptoms of stroke include confusion, trouble with speaking and understanding, headache, possibly with altered consciousness or vomiting, numbness of the face, arm or leg at one side of the body, trouble with seeing in one or both eyes, trouble with walking, dizziness and lack of coordination.

When should you see the doctor? An easy way to tell if a person has any of the signs or symptoms of a stroke is by remembering the acronym FAST:

F – face drooping

A – arm weakness

S -speech difficulty

T- time to call 911

Call 911 or your local emergency number immediately as soon as you feel the symptoms. Every minute counts, as the potential for brain damage increases, the longer you wait.

Stroke must be treated within 4.5 hours after the events start. There are different types of treatment for each type of stroke. If you are having an ischemic stroke, a drug called tissue plasminogen activator (TPA) is given to break up the blood clot. Aspirin or other blood thinners are also given to the patient before surgery.

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-Shayini Kanageswaran