Stroke: how to avoid and protect against it

O Strokealso called cerebral thrombosis or cerebral embolism, is one of the leading causes of death and morbidity in our country.

Every year in Portugal, approximately 25,000 people suffer a stroke. Every hour, three people suffer a stroke, one of them does not survive and half of the others have after-effects.

Stroke: risk factors, symptoms and treatment

Ischemic stroke is a sudden injury to the brain that damages brain cells and occurs because of a lack of blood flow to a part of the brain due to a blockage or stroke.

Although less common, there is also hemorrhagic stroke, which is caused by the rupture of a blood vessel, resulting in extravasation of blood and damage to brain tissue.

In the event of a stroke, prompt medical attention is essential to avoid the greatest number of sequelae or even death. Therefore, if you suspect that someone is suffering from a stroke, you should immediately contact the emergency medical service. 112.

Risk factors

Like most diseases, stroke also has risk factors that make this health problem more likely to occur in some people than in others.

Some of these factors are modifiable (i.e., they can be changed), while others are nonmodifiable (i.e., they cannot be changed).

Modifiable risk factors

Non-modifiable risk factors

• Genetics;
• Heredity;
• Age;
• Race;
• Sex.

Symptoms

The manifestations of this disease depend on the area of the brain affected and the damage caused by the stroke. Yet three symptoms are considered warning signs of a stroke. They are also known as 3F:

• TalkSpeech impairment, i.e., difficulty expressing yourself or understanding what you are told;
• Face: face drooping to one side, commonly described as “mouth to the side” ;
• StrengthLoss of strength on one side of the body or in one arm, for example.

If this occurs, you should lay the patient on his or her side in a safe position, making sure that the patient is breathing normally.

At the same time, you should contact the national medical emergency number 112 and thus activate the “green pathway” to stroke. In this way, it accelerates the process of medical assistance to the patient, which may increase his or her chances of a full recovery.

During the call, if you know, you should indicate when the patient began to show the first warning signs and if the patient has any risk factors, other diseases and is taking any specific medications.

Treatment

The treatment of a stroke depends on its origin and cause. Early intervention to clear blood vessels blocked by thrombus in time can make a big difference in the prognosis of the patient with ischemic stroke.

In the first phase, fibrinolytic therapy is performed, which consists of the intravenous administration of a substance capable of breaking up the thrombus. When this is not sufficient, mechanical thrombectomy, i.e. mechanical removal of the thrombus, is necessary.

Stroke can result in motor, cognitive, behavioral, or sensory sequelae. The most common are as follows.

Motor sequelae

• Lack of strength;
• Spasticity (excessive stiffness) on one side of the body;
• Loss of coordination of limb movements;
• Loss of gait;
• Dysphagia.

Cognitive sequelae

• Slowing of mental processes;
• Memory and concentration problems;
• Aphasia (difficulty with speech and comprehension).

Behavioral sequelae

Sequelae of the sensory system

• Loss of sensation in a part of the body;
• Neuropathic pain;
• Changes in sphincter control.

Rehabilitation

The acute phase of the disease is followed by complex rehabilitation work that may be more or less long and more or less intense.

This rehabilitation process may include physical, speech and occupational therapy. All of these interventions are aimed at the maximum recovery of the patient’s abilities, namely motor, cognitive and language recovery.

Especially at this stage, the support and cooperation of the patient and his or her family or friends is of great importance. Even in the case of irreversible sequelae, the patient is advised to reintegrate into family, social and professional life.

There are also small changes that can make daily life easier for the stroke patient, such as

• Adapting certain rooms in the home, such as the bathroom and bedroom, for example;
• Buy shoes that close with Velcro instead of laces;
• Replace zippered pants with elastic waistband pants;
• Wear shirts with springs instead of buttons.

Along with rehabilitation, it is important to prevent the STROKE recurrent. Thus, in addition to the recommended preventive care for the general population, it may be indicated:

• Taking an antiplatelet agent, such as acetylsalicylic acid, to prevent thrombus formation;
• Taking an anticoagulant, such as warfarin, to prevent clot formation, in patients with cardiac arrhythmias;
• Treating stenosis (narrowness) of arteries to the brain, such as carotid arteries, to ease circulation and prevent the release of small emboli;
• Follow all recommendations of the treating physician.

How to prevent strokes

While there are known risk factors for stroke, avoiding them is an effective way to reduce the likelihood of suffering from this health problem. Thus, certain steps should be taken:

• Do not smoke;
• Don’t drink alcohol in excess;
• Combat high blood pressure (including taking medications prescribed by a physician and engaging in behaviors that counteract this disease);
• Keeping diabetes under control (by taking medication and testing blood sugar regularly);
• Avoid obesity by controlling your weight;
• Fight a sedentary lifestyle by reducing the number of hours you spend sitting each day and by making exercise a part of your daily routine;
• Keep cholesterol levels low by eating a balanced diet low in salt, sugars and saturated fats;
• Keeping an eye out for heart disease, such as atrial fibrillation, for example.