The stroke of God’s hand on Carol Barnes
The British newsreader Carol Barnes has sadly died, from ‘a stroke’, and the actress Samantha Morton has just revealed a stroke as the reason for her 18 month disappearance from Hollywood.
In English medical vernacular, the term ’stroke’ is usually used to describe a catastrophic Cerebro-Vascular Accident (CVA). In more common English, that means something really nasty and unpredicted (catastrophic and accidental) in your brain (cerebral) to do with your blood vessels or blood supply (vascular).
Quite why we insist on calling them ’strokes’ in the UK is a bit of a mystery, but has something to do with the supposed Stroke of God’s hand, according to the OED.
expand and reduce the OED definition of ‘Stroke’ by clicking here…
In the United States they’re increasingly known as ‘Brain Attacks’, in an attempt to excite people’s attention. Because sometimes they can be treated if caught in time.
The blood supply to your brain can be interrupted in one of two ways (there are a couple of other very rare ways, but they need not detain us here.) Those ways are thrombotic (also known as ‘occlusive’) and haemorrhagic.
It’s not rocket science, or indeed even brain surgery, in its complexity. The arteries supplying the brain with blood (and therefore oxygen and nutrients - the very stuff of life) are little tubes. They can get blocked (by a thrombus, a blood clot) or they can burst - releasing free blood into the brain tissue where it is really not welcome. The latter is often referred to as a brain haemorrhage. But it is also just a slightly different form of ’stroke’.
The tricky bit is deciding quickly enough whether your patient has a tiny blood clot in an artery in their head, or has an artery that has burst. Because while the symptoms can be very similar, the treatment for the two conditions is so different that if you get it wrong you can very quickly make things even worse.
Again, it’s not that difficult to get your head around. Blood clots have to be dissolved. But if you do that to someone who’s just had an artery burst inside their skull, you’re going to fast-track them straight to the pathology out-patient department (that’s jokey medical speak for the morgue.) Just to re-iterate: blood clots need to be dissolved quickly; burst blood vessels need the exact opposite (unfortunately there does not yet exist the medical equivalent of Rad-Weld for brains, but what you should definitely not do in the event of a leaky vessel is make things even worse by making the blood less clottier.)
You can protect yourself to some extent against the clot / occlusion type of stroke by looking after your general health, keeping an eye on your blood pressure, perhaps taking an aspirin tablet every day, that sort of thing. Some also say that your cholesterol levels matter, but you should at least read the Cholesterol Skeptics before worrying too much about that. Protecting yourself against a burst artery inside your brain is, unfortunately, outside most people’s control. As many as a third of us unfortunately have the propensity for this.
As doctors what we can now do is carry out a CT scan of the brain of someone who appears to have had a ’stroke’, to determine whether or not it is safe to give them ‘clot-busting’ drugs, which in the event of an occlusive or thrombotic stroke can dramatically improve the outcome. In the case of Carol Barnes it seems likely that she had a major haemorrhagic stroke (a brain haemorrhage) or else an occlusive/thrombotic stroke that was either too large or too late to respond to treatment.
Discussion Area - Leave a Comment