TALA COMMUNITY NEWS: STROKE - CAUSE - SYMPTOMS

Filenews 18 March 2023

What is a stroke?

Stroke is caused by the sudden inhibition of blood flow to the brain either by obstruction (ischemic stroke), or by the rupture (cerebral haemorrhage) of a cerebral vessel. Ischemic strokes make up about 85% of total strokes, while the remaining 15% make up cerebral haemorrhages.

Depending on the part of the brain affected, there is also the corresponding neurological symptomatology such as aphasia (partial or total loss of language abilities), dysarthria (disorder of speech articulation), loss of sensation, muscle weakness and vision disorders.

Stroke is the second most common cause of death and the third most common cause of disability worldwide.

Every year about 15 million of our fellow human beings around the world will suffer a stroke. About 5.5 million of them die and another 5 million remain permanently disabled. It is estimated that one in four people will suffer a stroke during their lifetime. There are currently about 80 million survivors in the world after a stroke.

Ischemic strokes

The causes of ischemic strokes are roughly divided into 5 major categories:

Disease of the large vessels, such as carotid artery stenosis
Small vascular disease, which is mainly caused by cardiovascular risk factors, such as hypercholesterolemia, arterial hypertension and diabetes mellitus
Cardioembolic, such as atrial fibrillation
Other specific (rare) causes, such as rare genetic syndromes
Unspecified causes ("cryptogenic")

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It is worth noting that a relatively recent study showed that about 90% of strokes are associated with 10 potentially modifiable risk factors and therefore predictable. These factors are arterial hypertension, smoking, obesity, diabetes mellitus, excessive alcohol consumption, lack of physical activity, diet, psychosocial stress, depression as well as hyperlipidemia.

How to recognize a stroke

In English-speaking countries there is an information campaign with the acronym FAST, where F = face (falling angle of the mouth), A = Arm (paralysis of the upper extremity), S = Speech (difficulty speaking) and T = Time (immediate transfer to the hospital). In Greek we use the acronym APLA.

Just think

An easy way to remember and be able to recognize the symptoms of stroke is the acronym SIMPLY:

ACRO: Is there weakness in the upper or lower extremities? Ask the person to raise both hands and observe if one falls.
PROSOPO: Ask the person to smile and notice if half the side of the face is crooked.
LOGOS: Ask the person to repeat a simple sentence. Is speech difficult, incomprehensible or even impossible?
AMEDIA: If you notice any of these symptoms, then there is a strong suspicion of stroke and you should call an ambulance immediately.

Treatment of strokes

The treatment of strokes should ideally be done in organized spaces such as the special stroke units.

Treatment of ischemic strokes can be done within 4.5 hours with intravenous thrombolysis, i.e. the administration of a strong anticoagulant substance into the blood in order to dissolve the thrombus. In case of obstruction of a large vessel, mechanical thrombectomy can be performed, that is, the removal of the thrombus through an intravascular catheter. Mechanical thrombectomy should ideally be performed within 6 hours of the onset of symptoms, while in rare cases the intervention window can be extended up to 24 hours.

In stroke every minute 2 million brain cells die and for this reason time is of paramount importance (time is brain)

In cases of cerebral haemorrhage, treatment depends on the causes as well as the severity of the bleeding. The treatment may be surgical with the removal of the hematoma or in cases of aneurysm or vascular malformations can be done with endovascular treatment or embolization.

The role of stroke units)

The stroke unit is an organized inpatient unit with the aim of specialized management of patients with strokes. The stroke unit consists of a multidisciplinary team, which includes neurologists, interventional neuroradiologists, neurosurgeons, vascular surgeons, cardiologists, physiotherapists, speech therapists, occupational therapists as well as support from a social worker. According to clinical studies, patients are more likely to survive and become independent when hospitalized in the context of a stroke unit.

In Cyprus, strokes are the second leading cause of death. Our goal is to create an innovative stroke centre at Apollonion Private Hospital, aiming at the integrated treatment of the patient with stroke.