A stroke occurs when part of the brain suddenly goes without blood supply . Without oxygen and nutrients, nerve cells begin to die in just a few minutes. This is very dangerous: in 2017, a stroke occurred in 428 thousand Russians, 136 thousand people died from it.
The probability of surviving and maintaining health after a stroke depends on how quickly the person was helped. Doctors even have a special concept – the “therapeutic window”. This window is “open” for 3-6 hours.
If the victim is delivered to the hospital within 3 hours after the first symptoms of a stroke, there is less risk that he will remain a severely disabled person. If later – the effectiveness of treatment may be lower.
According to statistics, 15% of ischemic strokes occur in young people and adolescents.
- A stroke is a violation of the blood supply, due to which part of the brain cells can die. This is a deadly disease, the survivor runs the risk of remaining disabled.
- Everyone should be able to recognize the signs of a stroke. Usually, with this disease, one half of the face is immobilized, it is not possible to raise and hold hands, a person can not speak or gets confused in words.
- The main thing to do with a stroke is to call a doctor as soon as possible. The faster treatment begins, the higher the chances of a full recovery.
- It is impossible to guarantee that a stroke will not happen. But you can reduce its likelihood, for this it is enough to lead a healthy lifestyle and control chronic diseases.
- Recovery is a long process that starts from the first days after a stroke and takes up to two years. Most often, the patient all this time can not do without the help of relatives.
The risk of a stroke depends on the heredity, age, gender and lifestyle of a person. And also from whether he had strokes before or not. Every fourth stroke is repeated .
According to the National Association for the Fight against Stroke (NABI) , 8% of Russians return to normal life after a stroke, 20% can no longer walk independently, and 31% require special care.
Five facts about a stroke
- In the world, another stroke occurs every 40 seconds , one person dies from it every 4 minutes.
- Stroke is not a “senile” disease. It can happen to anyone at any time , including adolescents, children, newborns, and even unborn children.
- A stroke that happened in youth (when a person is between 18 and 65 years old) can have a stronger effect on the patient’s life than what happened in old age (when a person is over 65). Long-term rehabilitation is associated with serious costs and loss of habitual wages.
How and why strokes happen
We already know that a stroke occurs when blood ceases to flow to a part of the brain. This is always the result of problems with the vessels. Blood vessels are similar to water pipes: they too can either clog or leak.
Ischemic stroke
Ischemic strokes occur when a blood vessel in the brain becomes clogged. Clog the vessel can either thrombi (most often these are cholesterol plaques that occur with atherosclerosis), or emboli: blood clots that pop up from the heart during atrial fibrillation and can enter the brain. This happens most often: in 80% of cases .
Risk factors:
- Age : over 40 years old.
- Diseases : heart disease, diabetes, obesity.
- Health condition : high blood pressure, high blood cholesterol, atrial fibrillation.
- Life story: strokes or thromboses have already occurred in the past.
- Lifestyle : inactivity and lack of exercise.
- Bad habits : smoking, drug use.
- Heredity : a family history of heart disease or stroke.
- Recent birth.
- Some medicines : for example, estrogen preparations for hormone replacement therapy.
Hemorrhagic stroke
Hemorrhagic strokes occur due to “leakage” or rupture of a blood vessel in the brain. The vessel may be affected due to high blood pressure, head injury, clotting or aneurysm – a congenital defect in the vascular wall.
Risk factors:
- Health condition : high blood pressure.
- Bad habits : smoking, addiction to cocaine and meth.
- Use of blood-thinning drugs like warfarin.
What precedes a stroke
Sometimes strokes occur in those who did not even suspect the presence of risk factors. For example, most people with aneurysms before a stroke did not know that they had problems with their vessels.
However, this is the exception rather than the rule. Most often, strokes occur either in people who have one or more obvious risk factors, or for those who have already heard an “alarm bell”: a transient ischemic attack, or TIA.
A transient ischemic attack is a “temporary” stroke, the symptoms of which disappear after a few minutes or hours. Any person who has ever had a TIA will soon be at risk of getting a “full” stroke, so it’s very important to learn how to recognize it.
Signs of transient ischemic attack
- Weakness in arms or legs.
- Numbness of the face, hands or feet.
- Problems with speech : it becomes slurred or a person, in principle, can not speak.
- Vision problems : double vision or fog appears in the eyes.
With TIA, there may be either all the symptoms, or only a part. If you observe such symptoms – immediately call an emergency ambulance.
Remember! A person with TIA should be taken to a specialized clinic as soon as possible, even if the symptoms have already passed. You cannot let a person with TIA go to the hospital alone. Allowing him to drive is the same.
Be sure to wait for the doctors – they know in which particular institution they can help with this problem, and they know how to properly move the person so as not to provoke a stroke.
How to understand that a person has a stroke
Sometimes a stroke occurs immediately, without warning. In order not to get confused and correctly help a person, remember the English-language abbreviation FAST, which describes the 3 main signs of a stroke and the correct algorithm of actions:
Face – face. Half of the face becomes uncontrollable: a person cannot smile, “hangs” the corner of his mouth or eyes.
Arms – hands. The patient cannot raise both hands and keep them raised, feels weak or numb in one of the hands.
Speech – speech. Cannot speak or confuse words. In some cases, she doesn’t understand what you are telling him.
Time – time. Act quickly – call a doctor!
Signs of a stroke in women
Sometimes women have unique symptoms that are not found in men:
- loss of consciousness;
- general weakness;
- panting or shortness of breath;
- nausea or vomiting
- hiccups;
- cramps
- strong excitement;
- hallucinations;
- confused consciousness, disorientation – a woman does not understand the speech addressed to her;
- sudden change in behavior – a woman forgets what she did and where she was going.
What to do if you see a person with signs of a stroke
If the person is conscious, take him to a safe place and sit him down. If unconscious – try to ensure safety, but do not touch it.
Urgently call emergency care. Tell the operator that you see signs of a stroke in a person and state the address. Stay with the victim until the doctors arrive.
Sometimes people wake up in the morning and see that their relative cannot get up, does not answer questions. Or they call a relative – and he picks up the phone, but is not able to answer the question or does not understand what he is being asked.
To act in this situation, you need to do the same: urgently call a doctor.
How to avoid a stroke
The best way to prevent a stroke is to identify your personal risk factors . Yes, it’s impossible to cope with some of them – but others are quite manageable if we are involved in prevention and health promotion.
1. Lifestyle Risk Factors: Overweight, Inactivity, Alcohol and Drugs
Follow the principles of healthy eating. You probably know them: more colorful fruits and vegetables in the diet, less fast food and prepared foods with added sugar. The best sources of protein are seafood, lean meat, poultry, eggs, legumes, nuts and seeds.
Move more. Ideally, if you will be doing exercises of medium intensity 2.5 hours a week: walking fast, cycling, swimming. In general, any activity is suitable: walking, sports, dancing.
Try to quit smoking. If you have risk factors for a stroke, you need to tie it with cigarettes – smoking increases blood coagulation, increasing the risk of blood clots. About how to get rid of cravings for nicotine, we wrote in our ultimate guide.
Try to reduce your alcohol intake. Of course, it’s better not to drink at all. But if it doesn’t work out, try to drink alcohol moderately during the holidays: no more than two drinks per day for men and one drink for women. (One alcoholic drink is 0.35 liters of beer, a glass of wine, 45 ml of liquor.)
2. Risk factors associated with health problems: diabetes, smoking, high cholesterol, heredity
Monitor your blood pressure. The ideal pressure is 120/80. Healthy people staying within these boundaries helps a healthy diet and physical activity. People with vascular diseases should regularly take medications that a doctor should prescribe.
Monitor atrial fibrillation. Atrial fibrillation is an irregular heartbeat. Most often, this problem occurs in people with diabetes, high blood pressure, heart disease, and also in people over 65 years old. With atrial fibrillation, it is important to take medications prescribed by your doctor regularly.
Monitor your cholesterol. In healthy people who eat right and move a lot, cholesterol is usually normal, that is, does not exceed 5.0 mmol / L. People with diseases (for example, with atherosclerosis) have their own norms , a doctor should help to keep cholesterol in your individual norm. Sometimes with the help of drugs that are important to take according to the established scheme.
Control diabetes. In diabetics, strokes are four times more common. To reduce the risk, it is especially important for people with diabetes to eat, move and control their blood insulin levels with medication.
How to restore health if a stroke still happened
Stroke affects people in different ways. Someone will notice a significant improvement in the hospital, but usually months or even years are needed for a full recovery .
Recovery from a stroke goes in several stages. There are two recovery periods: early and late. The early period begins from the first days after a stroke, while still in the hospital, and the late period continues in the rehabilitation center and at home. The late recovery period can last up to two years.
In the rehabilitation center, the patient is helped to re-master the speech and return to social life: they are taught to independently move and serve themselves.
Often a stroke patient needs help not only from a neurologist, but also from a psychologist, speech therapist, and kinesiotherapist. Recovery can be more expensive than treatment.
But even after completion of rehabilitation, it is important to take preventive measures so that a repeated stroke does not occur after 3-6 months.
Secondary stroke prevention includes:
- maintaining optimal pressure;
- blood glucose and cholesterol control;
- maintaining a healthy lifestyle: balanced nutrition, optimal physical activity, giving up alcohol and smoking, reducing stress;
- taking drugs that normalize heart rhythm and blood circulation.
The treatment and rehabilitation method depends on the type of stroke. As a rule, with an ischemic stroke, the patient is taught to sit down almost from the first day. With a hemorrhagic patient, on the contrary, bed rest is required. Nevertheless, without the help of relatives a stroke patient can not do.
When disaster strikes a person, we neurologists work not only with him, but also with his relatives. We teach loved ones how to properly care for the patient: we explain how to wash, turn, sit, put on his feet.
After a stroke, the patient often responds better to a loved one, and not to the attending physician. Therefore, the help of relatives is very important – not only in the early days, but also later, after discharge, when the patient will be treated and restored at home.