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Stroke has become a global epidemic. In Russia, mortality from stroke remains one of the highest. On the eve of World Stroke Day, we turned to experts to find out how to prevent this terrible disease and how to diagnose it in time.
At the end of October, World Stroke Day is celebrated. On October 29, 2004, stroke was declared a global epidemic. An epidemic that claims the lives of thousands of people only because they were not provided with medical assistance in time. Therefore, we turned to our experts with the question: what are the main signs of a stroke? How to recognize it in yourself and your loved ones in time?
Our experts:
Yana Orlova – cardiologist, MD, Deputy Director of the Medical Research and Education Center of Moscow State University named after M.V. Lomonosov;
Mikhail Sinkin – neurologist, neurophysiologist, candidate of medical sciences, head of the OFD of City Clinical Hospital No. 11.
How does this happen?
Up to a certain point, most people think that this problem does not concern them. However, the statistics are relentless: every 1,5 minutes in Russia, someone is diagnosed with a stroke. According to the journal “Basic Research”, the annual death rate from stroke in Russia remains one of the highest in the world: 374 people per 100 population. But the timely detection of stroke symptoms can not only save a person’s life, but also minimize the consequences of this disease. Studies show that about 80% of people who have had a stroke become profoundly disabled for the rest of their lives. Most often, strokes occur in the elderly, since most cardiovascular diseases are associated with the aging process of the body. From the age of 50, a person is included in the so-called risk group.
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Why is this disease so dangerous? The fact is that during a stroke, for one reason or another, the flow of blood to the brain stops, which causes damage to its tissues. “As a result, there is a lack of nutrition in some part of the brain, and the part of the body for which it is responsible ceases to obey its owner,” explains Yana Orlova. – Paralysis develops, that is, pronounced muscle weakness. In this case, a person cannot move his fingers or the entire limb, one side of his face sags, speech may be disturbed. And, as a rule, this cannot go unnoticed both for the patient himself and for those around him.
Strokes are divided into ischemic and hemorrhagic. “Ischemic stroke is also called a “brain infarction” – a blood clot forms on an atherosclerotic plaque and blocks the artery,” explains Yana Orlova. – In a hemorrhagic stroke, a blood vessel in the brain can rupture and cause an intracerebral hemorrhage. The causes may be genetic in nature, be the result of congenital or acquired pathology. If the diagnosis of intracerebral bleeding is made, it is urgent to operate the patient. Timely intervention can save the patient from death and significantly reduce the consequences of a stroke.
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Risk Factors
Unfortunately, stroke cannot be predicted in advance. Everything happens very quickly. “Strictly speaking, before the development of a stroke, it is impossible to say for sure that it will develop,” Mikhail Sinkin warns. “Terrible signs can be very high blood pressure, severe headache, impaired consciousness – this may indicate an acute violation of cerebral circulation.” But these signs are very relative. “Even if the patient has cardiac arrhythmia, it is impossible to predict when a stroke will occur – maybe in a week, or maybe never,” adds Yana Orlova. – But if they were, then 15 minutes before the stroke it is already impossible to do anything. It must be prevented in advance, that is, to deal with risk factors.”
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What are the risk factors? According to the World Health Organization (WHO), they all have to do with our lifestyle choices. The most important factors are:
- smoking and other tobacco use;
- improper diet;
- lack of physical activity.
Incorrect lifestyle choices can lead to three serious physical health problems:
- high blood pressure (hypertension);
- high sugar content (diabetes);
- high cholesterol in the blood (hyperlipidemia).
In addition, you need to be attentive to the work of your heart and, if necessary, be examined by a cardiologist. “Heart rhythm disturbance – atrial fibrillation – in itself is not life-threatening,” comments Yana Orlova. “But this process can be compared to the flow of a river: it is fast and direct, but there are backwaters where the water stagnates, and algae grows there and mud collects. It is the same here – the rhythm is disturbed, the blood flow changes. And due to this, blood clots develop, which can fly off to the brain. The main thing to remember is that there can be no independent treatment in this case! Any use of medications is possible only strictly according to the testimony of a doctor. Everything else is in our hands: to have a normal weight, be physically active, quit smoking, control blood pressure, cholesterol and sugar levels. If a person has at least two of the three risk factors, as well as poor heredity, then the likelihood of heart attacks and strokes increases significantly.
Disturbing signs
In social networks, a memo is very popular, urging you to remember the main signs by which you can recognize a stroke. According to our experts, these signs are easily recognizable. Moreover, if at the initial stages of the development of a stroke the patient does not have speech disorders, he himself can detect them in himself and ask for help. Several types of such memos can be found on the Internet, but neuropathologist Mikhail Sinkin considers the scheme called “BLOW” to be the most convenient for use.
U is a smile. After a stroke, the smile comes out crooked, asymmetrical.
D is movement. Raise both arms and both legs up at the same time – one of the paired limbs will rise more slowly and lower.
A is articulation. Say the word “articulation” or a few phrases – after a stroke, diction is disturbed, speech sounds slow or just strange.
R is the solution. If you find violations in at least one of the points (compared to the normal state), it’s time to make a decision and call an ambulance. Tell the dispatcher what signs of a stroke (IMPACT) you have found, and a special resuscitation team will arrive quickly.
Another scheme, also approved by experts, helps to identify the signs of a stroke in the patient himself.
- Sudden weakness or numbness in the face, arm, leg, or side of the body.
- Sudden decrease or loss of vision.
- Sudden difficulty speaking or understanding speech.
- Sudden severe headache for no apparent reason.
- Sudden dizziness, nausea, vomiting, unsteadiness when walking, loss of balance for no apparent reason.
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“Weak signs are rare – when, for example, only two or three fingers on the hand cease to function. I met this only once, – says Yana Orlova. “Most of the time, a stroke does not present any diagnostic difficulty.” The main thing to remember is that you should not hesitate to call an ambulance. Unfortunately, disability after a stroke is inevitable, but its degree depends, among other things, on how quickly assistance was provided.
Rehabilitation after a stroke
The consequences of a stroke can be extremely different: from almost complete recovery to complete immobilization and the development of the “locked-in syndrome”, when the patient can only blink and move his eyes. The severity of the consequences of a stroke depends on where in the brain the blood supply was interrupted. Impairment of functions is more pronounced immediately after the onset of a stroke, and then they can partially recover. However, according to studies, in Russia no more than 20% of patients return to work after a stroke, and 1/3 of stroke patients are people of working age.
“Methods of rehabilitation are now very diverse and often allow you to put a person on their feet and return them to a fairly active life,” says Mikhail Sinkin. – But I want to note that drugs that “restore” the lost brain function, unfortunately, have not yet been invented. The “vascular” and “metabolic” drugs that are widely used in our country have no effect on recovery.” Rehabilitation after a stroke consists in various forms of training, relieving muscle spasm and other physical effects. With speech disorders, classes are held with a speech therapist. “Today in Moscow there are several institutions dealing with this problem. A department of rehabilitation treatment will soon open in our center,” says Yana Orlova. “But rehabilitating such patients is difficult and costly. Full recovery is a rarity. Stroke prevention is essential. This task should be set by both the state and doctors.”
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Eliminate stressful situations
Stress itself does not cause a stroke. However, indirectly, it can become one of the factors in the occurrence of this disease. Stress is the response of the body to a strong stimulus, accompanied by the release of adrenaline. It also increases blood pressure – one of the main risk factors for stroke. Dangerous as a sudden rise in pressure, and chronic stress, leading to increased cholesterol, blood sugar and, as a result, atherosclerosis of cerebral vessels – the strongest risk factor for stroke.
Books about it:
A. S. Kadykov, L. S. Manvelov, N. V. Shakhparonova “Step by step after a stroke”
JB Taylor “My stroke was a science to me. The story of his own illness, told by a neuroscientist”
1 http://orbifond.ru/insult/about/test/ Interregional Fund for Assistance to Relatives of Stroke Patients.
2 http://www.rae.ru/fs/?section=content&op=show_article&article_id=9999599
3 http://whqlibdoc.who.int/publications/2005/9244546728_rus.pdf