Life 74 _ Stroke _ Causes, signs, prevent and treat
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STROKE

Stroke is a serious brain disease that occurs when the blood supply to the brain is interrupted by various causes such as a blockage or rupture of a blood vessel in the brain. At this point, the amount of oxygen and nutrients that supply the brain cells is severely deficient. After only a few minutes of deprivation of this oxygen and nutrients, brain cells will begin to die and serious complications will begin to occur, with the patient’s life directly threatened.
If the patient is not treated in time, if the duration of a stroke is prolonged, the number of dead brain cells will increase and thus lead to more serious, difficult or even irreversible consequences, directly related to the ability to move, to feel, to feel, to think, etc … and the worst possible consequence is death.

So how do you recognize a stroke? Here are some important signs and symptoms that can help you recognize a stroke early on, whether it happens to you, your loved one, or anyone you see.

WARNING SIGNS OF A STROKE

3 important signs to remember :

There are many signs that you can have a stroke, but here are the three most important and easy to remember that you should be aware of if it does occur:

Deformed face :

Unusual facial disproportion. If the patient has abnormal facial asymmetry, especially the mouth is deformed, the nasolabial folds are deviated to one side, etc., you should immediately think that this is a sign of stroke and that ‘it is necessary to take preventive and treatment measures.

Paralyzed hand :

Mobility is suddenly reduced or even stopped. Specifically, the limbs are numb, difficult to move while one side of the body is numb.

Sudden lisp:

Numbness in the mouth, difficulty pronouncing words, abnormal lisping

If there are 3 of these signs, you should immediately think about the risk of stroke and urgently call an ambulance and take the patient to the medical center as soon as possible.
In addition, other signs can also help you better determine your risk of stroke:

Other signs

Visibility decreased.

Visual acuity is reduced, i.e. blurred vision, blurred vision, etc. However, in reality, the manifestations related to vision are often not obvious, so they can make patients unrecognizable.

Impaired memory, thinking, and expression

Memory is disturbed, perception and thinking are difficult, there is a feeling of ambiguity, speech is blurry, scrambled or even meaningless.

Severe headache

The headache can come on quickly and cause nausea or vomiting, etc.

Please note that depending on the health of each person, the signs of a stroke are different.
Additionally, a person may suffer from a condition medically known as a “transient ischemic attack” with symptoms similar to those of a stroke, but which do not occur until a few minutes later.
A transient ischemic attack is a warning sign of an impending stroke, perhaps in a few days or a month. However, such signs of stroke can come and go so quickly that the patient cannot pay attention and take precautions.
Therefore, you must learn to listen to your body, when you see these signs appearing, you must take the initiative to see a doctor as soon as possible to be checked.
Treatment for stroke should be started immediately and as quickly as possible. Every minute that a stroke lasts, damage to the nervous system worsens, with nearly 2 million neurons dying every minute. Again, if you see any of the warning signs of a stroke, contact your doctor or nearest emergency services immediately.

MAIN TYPES OF STROKE

There are 2 types of stroke that occur most often, ischemic stroke and hemorrhagic stroke, more specifically:

The first type _ ischemic stroke:

Caused by a blockage in an artery, it accounts for about 85% of all strokes. Among the types of ischemic stroke, the following two are the most common:

Thrombotic stroke:

A blockage caused by the formation of blood clots (also called a thrombus) or by fatty deposits in the arteries of the neck or brain.

Vascular stroke:

Blockage by blood clots that form somewhere in the body (usually the heart) and travel to the brain. The most common cause is an abnormal rhythm in the upper two chambers of the heart (atrial fibrillation), which can cause blood clots to form.

Fortunately, preventative therapies are effective for all types of ischemic stroke.

The second type _ Hemorrhagic stroke:

Hemorrhage means bleeding. This type of stroke is caused by a leak or crack in an artery in the brain or on the surface of the brain. These cracks can be caused by an aneurysm in a thin, weak area of the arterial wall, or by a malformation of the cerebrovascular system. About 15% of strokes are hemorrhagic.

Bleeding inside brain tissues

Hemorrhage can occur in the brain, that is, bleeding inside brain tissue, for many reasons, such as rupture of a cerebral artery which sheds blood to surrounding tissue, hemorrhage intraparenchymal, that is, bleeding into brain tissue, or intraventricular hemorrhage bleeds into the ventricular system of the brain.

Subarachnoid hemorrhage

Additionally, bleeding can also occur outside of the brain tissue but always inside the skull, especially between the arachnoid and the soft membranes – (which is the innermost thin layer of the 3 meninges that surround the brain). Therefore, this form of bleeding is also called “subarachnoid hemorrhage”.

In addition to the two main types of stroke mentioned above, patients can also experience another type of stroke called “transient ischemic attack” as mentioned above.

Transient ischemic attack (TIA)

Often called mini-stroke, they are actually brief episodes of stroke symptoms that usually only last a few minutes.
Although a transient ischemic attack is caused by a temporary decrease in the blood supply to part of the brain, it does not have significant long-term effects. But this type of small stroke is considered a warning sign of a higher risk of stroke and should be examined and evaluated by a specialist.
So what is the risk of stroke?

RISK FACTORS FOR STROKE

Among the risk factors that can cause stroke, there are those that cannot be changed, or factors that cannot be controlled, and those that can be changed and controlled, specifically:

Factors that cannot be changed :

  • Age. People of all ages are at risk for stroke, however, older people have a higher risk of stroke than younger people. After age 55, every additional 10 years, the risk of having a stroke doubles.
  • Sex. Men have a higher risk of stroke than women.
  • Family story. People whose loved ones have had a stroke or suffered from a myocardial infarction or transient ischemic attack have a higher risk of stroke than the general population.
  • Race. African Americans are almost twice as likely to have a stroke as whites.

Controllable factors :

  • History of stroke. People with a history of stroke have a higher risk of having a recurrent stroke, especially in the first few months. This risk lasts about 5 years and decreases over time.
  • Diabetes. Problems associated with diabetes can increase the risk of stroke.
  • Heart disease. People with cardiovascular diseases such as heart failure, atrial fibrillation, heart infections, arrhythmias, etc. are more likely to have a stroke than the general population.
  • Arterial hypertension. High blood pressure puts increased pressure on the artery walls, over time causing damage to the artery walls resulting in brain hemorrhage. In addition, high blood pressure also creates conditions for blood clots to form, which hinders blood flow to the brain. Therefore, examining the blood pressure is also one of the steps to find the cause of stroke.
  • Cholesterol. Blood fats, including high levels of bad cholesterol in the blood, can build up on the walls of the arteries, forming obstacles that block blood vessels in the brain.
  • Overweight, obesity. People who are overweight or obese can easily be the cause of many diseases such as high blood pressure, fat in the blood and heart disease. Increased risk of stroke.
  • Smoke. Studies have shown that smokers are twice as likely to have a stroke as non-smokers. Smoking damages the walls of blood vessels, speeding up the process of hardening of the arteries. Smoking also damages the lungs, causing the heart to work harder, causing high blood pressure. The good news is that if you quit smoking today, within two to five years, your stroke risk will drop to that of someone who has never smoked.
  • Unhealthy lifestyle. One of the causes of stroke is an unbalanced diet, an insufficient balance of nutrients, inactivity.
  • In addition, stroke is also believed to be linked to the use of stimulants such as cocaine and methamphetamine, excessive consumption of alcohol, beer, use of oral contraceptives, and hormone replacement therapy with estrogen, etc.

And, a person has had a luckily saved stroke, what are the possible consequences afterwards?

CONSEQUENCES AFTER A STROKE

Recovery from stroke varies from person to person. Some people are able to make a full recovery while others may have a mild, moderate, or severe disability.
The specific consequences for a stroke survivor will depend on the location and extent of the stroke and how quickly the person received first aid and treatment. A stroke in the left hemisphere of the brain can affect communication and memory, as well as mobility on the right side of the body. A stroke in the right hemisphere of the brain can affect spatial and cognitive abilities, as well as mobility on the left side of the body.
In fact, no case of injury or fault can be exactly the same. However, the general physical, cognitive and emotional consequences of these individuals are often:

  • Numbness or weakness: Usually occurs on only one side of the body, including the face and mouth. In particular, the patient may have difficulty swallowing and may lose sense of the existence of the affected side of the body.
  • Visual acuity: Patients may present with marked vision loss, blind spots, or impaired peripheral vision.
  • Reduced ability to understand and express in communication, in particular, the patient may more or less lose the ability to speak, understand, read and write.
  • Emotional disturbances, loss of control over emotions. Patients may have expressions of joy, sadness, laughter, or crying that are unreasonable and uncontrollable. In fact, these symptoms often come and go quickly and may subside over time.
  • Depression. Anxiety disorders are often present in people who have had a stroke with anxiety about a recurrent stroke. It is a condition which can have physiological and psychological causes and is especially painful for those who are overly concerned about a possible stroke in the future and worry about the worst consequences etc. In such cases, the use of medication is necessary to relieve these symptoms of excessive anxiety.

HOW IS A STROKE TREATED?

First, let’s talk about how to provide first aid to someone with a stroke before being hospitalized or before emergency personnel arrive.

First aid for stroke patients

As a reminder, the symptoms of a person suffering from a stroke are a deformed face, paralysis of a leg or an arm, speech disorders or speech disorders, blurred vision, headaches, etc.
Here are some specific notes and first aid methods that can help patients more effectively:

  • The first thing to do is to try to assess the patient’s level of vigilance so that you can both inform the medical staff and intervene directly to save the patient.
  • Place the patient in the safest and most comfortable location to await support from medical personnel.
  • Immediately call an ambulance.
  • In the meantime, you must take care of the patient according to his condition
  • If the patient is still awake, place him in the most comfortable position. You can also cover them with a thin blanket or similar object to prevent heat loss to the patient.
  • Talk to the patient in a calm and positive manner. Always encourage and reassure the patient.
  • Check regularly that the patient is still breathing. If he has trouble breathing, loosen his clothes, especially things like ties, scarves, belts, etc.
  • While waiting for management, it is necessary to monitor closely to quickly detect abnormal changes in the patient’s condition. If necessary, especially if the patient is not awake, lie on their side with their head slightly raised in case they vomit. Keep in mind that the side lying position is also known as the resuscitation position. It is the position to protect the patient’s airway, also the best choice to ensure the safety of the patient.
  • In a comatose patient, when lying on his back, the tongue moves down to the throat, obstructing and blocking the airways. If the patient vomits while lying on his back and the consciousness is not fully awake, it is easy to inhale the vomit into the lungs, causing airway obstruction or respiratory failure, which is very dangerous. Therefore, it is necessary to place the patient on his side to allow the vomit to flow easily.
  • In the event that the patient has a convulsion, the chopsticks wrapped in tissue should be taken to block the patient’s mouth to prevent the patient from biting his tongue. At the same time, make sure that the chopsticks do not prevent the vomit from escaping.
  • The bad situation is that if the patient is in cardiac arrest, you have to perform extra-thoracic cardiac massage.

Please note that when performing on-site stroke first aid, absolutely do not let the patient use any medication or eat anything, and do not arbitrarily interfere with treatment measures if you are not trained. in this domain. Rather, you should keep track of when the patient started to have abnormal stroke symptoms and note any medications the patient is taking or has a prescription to give to medical staff.

Stroke treatment

When a stroke occurs, hospitalization is necessary to determine the cause and type of stroke in order to treat or prevent further complications. Medical treatment as well as surgery may be necessary.
Remember, the longer it takes, the more brain cells die! However, the nerve cells are not able to regenerate themselves. Therefore, the body’s ability to move and think is more affected and difficult to recover, even death. Therefore, people who have had a stroke need immediate medical attention, diagnosis and treatment.

In emergency and stroke treatment, people often say that “time is the brain”, which means that the longer the time, the greater the loss of brain. In fact, for the treatment of stroke in general, it is most effective for patients within the first 3 hours. On the other hand, the hope of survival is very low 6 hours after a stroke. More precisely as:

  • If the patient receives timely medical intervention within the first 1 to 3 hours, he will be able to recover and resume normal life.
  • If the patient receives medical intervention within 4-6 hours, the patient still has a chance of life but can have many serious sequelae.
  • and, if the patient is admitted too late, with medical intervention only after 6 hours, the survival rate is very low.

Therefore, “the golden time in emergency and stroke treatment” is truly precious as patients need to be examined, diagnosed and treated as quickly as possible without missing, avoiding serious brain damage. Poor effectiveness of the intervention leads to high post-intervention complications.
Once the stroke survivor’s condition has stabilized and the nerve cells no longer die from lack of blood supply, the rehabilitation phase begins.
Remember that rehabilitation does not cure a stroke. Instead, it focuses on minimizing permanent damage and increasing adaptation to a body that has been more or less damaged.
Rehabilitation can include active training with various areas including movement, balance, spatial and body awareness, language, and new methods of psychological and emotional adaptation, contact, while controlling the digestive / excretory system etc. …
Such a stroke rehabilitation program involves the concerted efforts of many health professionals.
Up to 80% of stroke survivors with physical, cognitive and language deficits can be helped by rehabilitation. This is a long and expensive treatment process, requiring effort and persistence from yourself and your family, and requires active support from the community in the form of insurance, grants, social resources. or other community resources etc …
So, can we prevent stroke and how to avoid it?

PREVENTING A STROKE

Control controllable factors

To prevent a stroke, the important thing we can and must do is control controllable factors, such as:

  • Early detection and treatment of diabetes. Effective treatment and control of diabetes complications.
  • Detect potential signs of cardiovascular disease, prevent and treat cardiovascular disease early
  • Detect and control hyperlipidemia, high blood pressure, etc.
  • Drink lots of water and fruit juices.
  • Eat a healthy diet with foods that are good for your health in general and especially beneficial for the cardiovascular system in particular. At the same time, avoid foods and harmful foods, which can make the condition worse.

Some foods should be eaten more

Some foods are especially valuable for the cardiovascular system, preventing stroke:

  • Foods rich in omega-3s such as salmon, tuna, mackerel.
  • Lentils, dark green vegetables, asparagus, broccoli, nuts, radishes … are rich in folate.
  • Foods that help lower bad cholesterol like oats, soybeans, almonds.
  • Foods rich in magnesium such as grains, bananas, avocados, legumes, seaweed, raspberries, etc.

Some harmful foods, to avoid :

  • Canned and prepared foods.
  • Foods that are too salty like salted eggplants, pickles, etc. The more salt you put in your body, the more likely your blood pressure is to rise.
  • Limit your intake of fatty meats and fatty dairy products, as they are high in saturated fat, which is not good for heart health.
  • Do not eat a lot of egg yolks and foods containing a lot of cholesterol such as margarine, shrimp, crisps, animal liver, cheese …
  • Limit or stop alcohol, tobacco to prevent the process of atherosclerosis, reduce the risk of recurrence of stroke.

Lifestyle changes to prevent stroke

In addition to the above-mentioned measures, one must-have thing which, if ignored, will make it difficult to successfully prevent a stroke no matter how hard you take the above measures i.e. change your way of life. More specifically, you must:

  • Know the balance between work and rest;
  • Knowing how to control and manage negative emotions, reduce anger and reduce stress;
  • Knowing how to ensure a reasonable and scientific pace of activity, not swimming at night, not staying up too late, etc.
  • Know how to take care of your health, keep your body warm, especially during the changing seasons.
  • and exercise daily with appropriate content and duration

Regular medical check-up

Finally, you need to have regular medical exams. Depending on physical condition, it is possible to carry out an examination every 6 months / once or an annual examination to detect appropriate diseases (cardiovascular diseases, diabetes, etc.). Regular health check-ups allow you to detect the risk of stroke and potential diseases as early as possible. From there, physicians will have proactive interventions to treat and guide effective disease prevention.

About Post Author

Maître VIKUDO

Docteur en Physiopathologie
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