Have you ever wondered what could happen if a small blood vessel in our brain suddenly becomes blocked? That's what a serious condition called MCA stroke (Middle Cerebral Artery Stroke) is. The name sounds a little scary, doesn't it? But don't worry. We'll talk about everything in a simple way that you can understand. It's like having your best friend or family member explain something to you.
What is MCA Stroke?
Simply put, an MCA stroke is a condition of paralysis caused by a blockage in a blood vessel in your brain called the Middle Cerebral Artery (MCA) . Think of it this middle cerebral artery is one of the main blood vessels that supply blood to our brain. To be precise, it is connected to the carotid artery in our neck and supplies blood to the parts of the brain that help us use our senses, move our bodies, and speak. Most strokes occur in this blood vessel called the MCA.
So, how does this MCA stroke occur? The reason for this is that a blood clot gets stuck inside this middle cerebral artery. Just like when a piece of dirt gets stuck in a water pipe, the water stops flowing, when this blood vessel gets blocked, the blood stops flowing to the relevant parts of the brain. Then the cells in those parts start to die. That's what causes the stroke.
What are the symptoms of MCA stroke?
There are several symptoms of MCA stroke. These often come on very suddenly. See if these symptoms sound familiar to you:
- Weakness or numbness on one side of the face or body: You may feel as if one side is numb. Or you may not be able to move that side at all.
- Sudden loss or decrease in sensory function: Senses such as vision, hearing, smell, taste, and touch may suddenly disappear or become impaired.
- Slurred speech or stuttering (dysarthria): Inability to pronounce words clearly.
- Difficulty speaking or complete loss of speech (aphasia): Difficulty finding words, or the inability to speak at all, may occur.
- Neglect: This is usually the left side that is forgotten in this way. That is, things on the left side go unnoticed, and there is no concern for that side.
- Loss of balance or difficulty moving (ataxia): Staggering when walking, difficulty grasping things.
Now look, our brain is divided into two sides, left and right. This MCA artery also branches and supplies blood to both sides of the brain. The important thing is that one side of the brain controls the other side of the body. That means, if the stroke affects the left side of the brain, the symptoms will appear on the right side of the body. If the right side of the brain is damaged, the symptoms will appear on the left side of the body.
Many people who have paralysis on the left side of their brain may experience difficulty speaking (aphasia) . Paralysis on the right side may cause neglect of the left side of the body.
What are the warning signs of MCA stroke?
Because MCA strokes can have a variety of symptoms, it is important to remember the acronym BE FAST to recognize when you or a loved one is about to have a stroke.
- B - Balance: Check for sudden loss of balance .
- E - Eyes: Check for sudden loss or changes in vision in one or both eyes.
- F - Face: Smile and see if one or both sides of your face droop .
- A - Arms: Raise both arms. If you have paralysis, you may not be able to raise one arm, or it may be so weak that it will fall down.
- S - Speech: See if the speech is slurred or if it is difficult to choose the right words .
- T - Time: Time is of the essence - get help as soon as possible! If possible, remember the time your symptoms started by looking at your watch, phone, or other timekeeping device. Telling a doctor when your symptoms started can help them choose the best treatment.
Important: If you see any of these BE FAST signs, call an ambulance (in our country, 1990) or go to a hospital immediately, without delay. Because in a stroke, time is life!
Transient Ischemic Attack (TIA)
Sometimes a transient ischemic attack (TIA) can occur. Some people call this a "mini-stroke." This is like a stroke, but the symptoms go away after a while. However, this is a very serious warning sign . A person who has had a TIA is at high risk of having a full-blown stroke in the near future. Therefore, a person who has had a TIA should also receive emergency medical treatment as soon as possible.
What are the causes of MCA stroke?
MCA strokes are a type of ischemic stroke . As mentioned earlier, they occur when your middle cerebral artery (MCA) becomes blocked by a blood clot. There are some health conditions that increase your risk of developing blood clots. These include:
- High cholesterol (hyperlipidemia): Increased cholesterol levels in the blood.
- Clotting disorders: Some people have a tendency for their blood to clot easily.
- Atherosclerosis: Fat deposits in the walls of blood vessels, causing them to narrow and harden.
- Atrial fibrillation: An irregular heartbeat in the heart's atria. The risk is higher if this condition is caused by sleep apnea.
- Heart defects: For example, conditions such as atrial septal defect and ventricular septal defect .
What are the risk factors?
Anyone can develop a stroke , but some groups are at higher risk. These include:
- People who smoke or use other tobacco/nicotine products (e.g. vaping).
- People over 65 years of age.
- People who use recreational or non-prescribed drugs.
- People who have difficulty accessing regular healthcare services.
- If someone in the family has had a stroke before.
- People who don't get enough physical exercise.
Also, the risk of paralysis increases if you have certain health conditions:
- High blood pressure (hypertension)
- High cholesterol (hyperlipidemia)
- Covid-19 (COVID-19) infection
- Diabetes
- Alcohol use disorder
- Obesity
How is MCA stroke diagnosed?
A doctor diagnoses an MCA stroke by performing a neurological exam , a physical exam, and several other tests. If you are brought to the emergency room by ambulance, the doctors there can also diagnose the stroke.
Your doctor will use tests like these to confirm whether you have had a stroke:
- CT scan
- CT angiogram
- Electrocardiogram (EKG)
- MRI
- Magnetic resonance angiogram (MRA)
- Cerebral angiogram
- Blood tests
What are the treatments for MCA stroke?
Your doctors will try to restore normal blood flow to your brain as quickly as possible to reduce the risk of permanent brain damage and death.
Doctors take steps to break up or remove the blood clot.
- You may be given thrombolytic medications , such as tissue plasminogen activator (tPA) .
- You may also need surgery (often a mechanical thrombectomy) to break up and remove the blood clot.
- Doctors will also prescribe medication to control your blood pressure.
Very important: If you think you are having a stroke, seek emergency medical attention immediately. Some treatments (like tPA) can only be given within a certain amount of time after the stroke begins.
Your doctors will tell you exactly what treatments are best for you and what to expect.
Rehabilitation after middle cerebral artery stroke
Rehabilitation is a very important part of stroke treatment. You need rehabilitation to help you adjust to the changes in your brain and body after a stroke. You may need help to regain your previous abilities or to adjust to your new disability. This may involve a combination of:
- Cognitive rehab: Helps improve memory, attention, and other mental abilities.
- Speech therapy: Helps regain or improve language and speaking skills, as well as control the muscles that help you speak, breathe, eat, and swallow.
- Occupational therapy: Helps you safely perform daily tasks, especially tasks that require fine body movements.
- Physical therapy: Helps strengthen muscles, improve balance, and regain use of arms and legs.
What is the life expectancy after an MCA stroke?
It is difficult for experts to accurately estimate the survival rate after an MCA stroke. A stroke can be fatal, cause permanent disability, and affect how long you will live (life expectancy). However, there is no one-size-fits-all recovery schedule or outlook.
Prognosis of middle cerebral artery stroke
What you can expect (prognosis) after an MCA stroke depends on several factors:
- How quickly you received treatment.
- Your overall health.
- your age.
Most people take at least a few months to recover. Your doctor will tell you what to expect. They will help you set goals and expectations for your recovery that are appropriate for your health and condition.
Can middle cerebral artery stroke be prevented?
The best way to reduce your risk of MCA stroke is to maintain good overall health. In general, try to do these things:
- Quit smoking.
- Control your blood pressure, cholesterol, and any health conditions you may have.
- Eat healthy foods and maintain a healthy weight.
- Do regular physical exercise.
See a doctor every year (or as your doctor recommends). Many health conditions that can cause MCA stroke develop over time. Some may not cause you to notice any symptoms. For example, many people with high cholesterol or high blood pressure don't feel anything until they're diagnosed. Your doctor can help you recognize and manage any warning signs before they increase your risk of stroke.
Recovery and rehabilitation after a stroke is a lot of work. Once you and your doctor have finalized a treatment plan, follow it as closely as possible. In general, you should do the following:
- Take your medications correctly. Taking your medications as your doctor tells you will help your body heal.
- Go to your rehab and other treatment appointments. Tell your therapists if anything makes you feel unsafe or uncomfortable. Rehabilitation is hard, but you don't have to be in pain or uncomfortable all the time.
- Think about your mental health too. Depression and anxiety are very common after a stroke. Feeling sad or frustrated does not make you weak or a quitter. Your emotional health is just as important as your physical health. If you feel like you need help talking about something during your recovery, talk to your doctor or a mental health counselor .
When should I go to the Emergency Department (ETU) ?
If you think you are having another stroke , call 911 (or your local emergency number) immediately. Another stroke is more likely to be fatal or cause serious complications. Don't delay in seeking help.
People who have had a stroke are also at higher risk of developing other serious complications. Examples:
- A blood clot in the lungs (Pulmonary embolism)
- Heart attack
- Seizures
- Pneumonia
- Deep Vein Thrombosis (DVT)
If you think you have symptoms of any of these complications, you should call emergency services or go to the emergency room immediately.
What questions should I ask my doctor?
- What other medications do I need and how do I take them?
- What other types of rehabilitation do I need?
- What is my risk of having another stroke in the future?
- Are there any support services or resources you recommend?
What is the difference between MCA stroke and ACA stroke?
MCA stroke and ACA (Anterior Cerebral Artery) stroke are both types of strokes. The difference is in the blood vessel in the brain that is affected. The MCA is your middle cerebral artery. It branches off on both sides of your brain. Your Anterior Cerebral Artery (ACA) is located in the front of your skull. "Anterior" is the medical term for front. Unlike MCA stroke, ACA stroke can affect the control and use of your legs.
Both types of stroke can have the same causes and symptoms, and both can be fatal. You won't be able to tell the difference between the two until a doctor can use imaging tests to determine which blood vessel is blocked or damaged. If you think you have symptoms of either type of stroke , call 911 immediately.
Finally, an important message
The middle cerebral artery (MCA) is one of the largest blood vessels that carries fresh blood to your brain. That's why a stroke that blocks it can be so damaging. But you can recover. Even if you have to adapt to a new disability or relearn some movements that you used to be able to do, you're still yourself.
Rehabilitation after any stroke is a lot of work. Some days will be easier than others, but remember to celebrate your progress. Even small victories are still victories. Talk to your doctors or therapists about how your recovery journey is going. They can help you reflect on how far you've come on a difficult day, and they're there to support you. Don't worry, you're not alone!
` MCA stroke, brain blood vessel blockage, stroke symptoms, stroke prevention, BE FAST Sinhala, middle cerebral artery, stroke recovery Sinhala
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