Romania is among the first places in terms of mortality due to stroke. Stroke (stroke) or stroke occurs when a part of the brain no longer receives the necessary blood and oxygen, which may be the rupture or blockage of one of the blood vessels supplying the brain.
Stroke is classified in.
- ischemic strokes: they occur when the blood vessel becomes blocked, by a clot developed at the level of an artery that irrigates the brain, or by a clot that can migrate from any part of the body. It is the most common.
- haemorrhagic strokes: occur when a blood vessel breaks, blood accumulates and compresses the surrounding cerebral tissue. This type of stroke is less common.
Causes that cause stroke.
Among the causes that determine the installation of an ischemic stroke are:
- atherosclerosis is the main cause of stenosis and obstruction of the cerebral vessels;
- vascular embolism;
- direct trauma to the cervical vessels;
- vessel compressions;
- blood clotting disorders;
- cardiac arrhythmias;
- mitral valve prolapse;
- myocardial infarction;
- some surgeries: they may cause the formation of a blood clot, which can migrate and cause a stroke.
Causes that cause a hemorrhagic stroke:
- high blood pressure;
- cerebral aneurysm: there is always a risk that the dilated vessel may rupture;
- vascular malformations;
- head trauma;
- inflammation of blood vessels;
- coagulation disorders;
- irradiation in the case of localized cancers of the head.
Risk factors encountered in stroke:
- age: the risk of producing a stroke increases with age;
- sex: men are most commonly affected, but after the age of 75, women become the ones with the most frequent stroke;
- high blood pressure;
- various disorders of the heart: disorders of the heart valves, cardiomyopathies, endocarditis, atrial fibrillation;
- coronary artery disease: responsible for the occurrence of a stroke or a myocardial infarction;
- the existence of a stroke, or the presence of a stroke in the family;
- various drugs: such as oral contraceptives, anticoagulants, corticosteroids;
- excessive alcohol consumption;
- drug use.
Symptoms of a stroke
Symptoms that appear in the case of a stroke usually develop suddenly, without warning, may progress gradually or worsen over time.
Symptoms that can occur in a stroke include:
- severe headaches,
- confusion, dizziness,
- walking / speech / understanding / vision / balance disorders,
- abnormal taste,
The consequences of a stroke can vary from person to person, some people may remain with different physical and mental disorders. The most common problems that occur after a stroke are: memory / walking / perception / behavior / speech disorders, emotional disorders, inability to feed yourself.
How to recognize a stroke
Stroke is recognized on the following clinical criteria:
- rapid installation (in a few seconds, minutes, hours or rarely in 1-2 days) of a neurological deficit;
- the evolution of the disorders that appear towards stabilization or regression;
- the presence of risk factors.
Establishing the diagnosis of stroke
To establish the diagnosis the first step that the doctor must do is to perform an anamnesis as detailed and accurate. The doctor will obtain information: from the patient if he can communicate, or from relatives – regarding the symptoms present, how to install the suffering, the risk factors present, the conditions that the patient presents or which suffered, at the diseases existing in the patient's family.
He will perform a physical examination of the patient and will recommend a series of investigations to establish the diagnosis including,
- CT: allows the rapid establishment of the diagnosis, helping to choose the most effective treatment method
- MRI (MRI): helps as the CT in establishing the diagnosis and treatment
- Doppler ultrasound or ultrasonography: allows observation of blood flow
- lumbar puncture: is used in cases where it is suspected that there is a bleeding in the brain that is responsible for the installation of a stroke.
- cerebral angiogram: useful in identifying obstructions of the cerebral vessels
- electrocardiogram or Holter electrocardiographic monitoring if it is suspected that a heart condition may be the cause of stroke.
- electroencephalography (EEG)
- blood tests: hemolithogram, blood glucose, tests to evaluate the function of the kidneys, liver
If some of the symptoms of a stroke are present, it is very important to call for medical help as time is of the essence for recovery.
In the case of strokes, treatment must be done urgently. That is why it is very important for the patient, family or relatives to recognize as early as possible the signs and symptoms of a stroke and ask for specialized help.
Depending on the type of stroke, the area that affected it, the results of the paraclinical investigations can be chosen for:
- Medical treatment or surgical treatment.
- Medical treatment can be given to patients who do not have a surgical indication or to those who refuse surgery:
- Thrombolytic therapy: uses plasminogen activators, such as streptokinase
- Antiplatelet therapy: Aspirin, Clopidogrel, Dipiridamol,
- Anticoagulant therapy: heparin, warfarin
- Diuretic therapy
- Treatment of high blood pressure
- Treatment of seizures
- Treatment of fever
- Blood glucose control medication
- Surgical treatment
In the case of a hemorrhagic stroke, it is tried to control the bleeding and decrease the intracranial pressure and if this does not succeed, it is called for surgery.
Prevention of stroke
Preventing a stroke or recurrence is done by correcting the risk factors:
- body weight control;
- blood pressure control and keeping it within normal limits
- regular blood glucose control and diabetes treatment
- keeping cholesterol within normal limits, or administering drugs that will lower cholesterol levels
- treating heart disease
- quitting smoking or at least reducing the number of cigarettes smoked daily
- performing physical exercises
- reducing alcohol consumption
- avoiding the administration of oral contraceptives
- avoiding drug use
Regular visits to the doctor can identify a number of health problems (atherosclerosis) that do not cause any symptoms or cause minimal symptoms and can endanger our lives. Changing the lifestyle and adopting a healthy lifestyle protects the body not only from a celebratory stroke but from other conditions.
Important! If some of the symptoms of a stroke are present, it is very important to call emergency medical help as time is of the essence for recovery.