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Stroke

Ictus a Vall d'Hebron

Stroke is caused by a change in the circulation of blood to the brain. This alteration is due an artery being blocked or cut off, which prevents blood reaching the brain. As a consequence, the brain cells start to die.

Age, lifestyle, genetic factors and cardiovascular risk factors are all influential factors when it comes to having a stroke. Stroke may also be known as “apoplexy”, “brain haemorrhage”, “blood clot on the brain”, or “thrombosis”. 

Description

What is a stroke?

Strokes can be grouped into two categories depending on what causes them:

  • Ischemic stroke: around 80-85% of strokes are ischemic. They occur when an artery supplying blood to the brain becomes blocked.
  • Haemorrhagic stroke: the other 15-20 % of strokes are haemorrhagic. They are caused by a burst blood vessel in the brain. 

The severity of any lasting effects of a stroke will depend on the location and size of the area in the brain affected and the patient’s general health before the stroke. Differing degrees of disability that require rehabilitation may also result from a stroke. In the most serious cases, it can be fatal. 

If you suspect that someone may be suffering a stroke, you must immediately alert the Emergency Medical Services (EMS) by calling 112 or take them immediately to hospital. Acting quickly is vital in order to minimise or avoid lasting effects.

 

Symptoms 

The sudden appearance of one or several of the following symptoms should arouse suspicions of a stroke:

  • loss of strength in one side of the body or face, this is the most frequent symptom of stroke.
  • loss of vision in one eye or partial loss in both eyes.
  • difficulty in speaking, understanding or articulating language.
  • loss of feeling in the face, the arm and/or leg on one side of the body.
  • being unsteady on the feet, lack of balance and unable to walk.
  • intense sudden headache.

 

Who is affected by stroke?

Stroke is the second most common cause of death worldwide. Someone suffers a stroke every two seconds, and unfortunately, there is not always time to save them. In Catalonia, more than 13,000 people a year are admitted to hospital due to a stroke. 75% of cases occur in the over 65 age group, although there are increasingly more cases in the under 45s (15-20%) due to lifestyle. Children may also suffer a stroke.

  

Diagnosis 

If a stroke is suspected, neuroimaging tests must be carried out as soon as possible to determine the type of stroke (ischemic or haemorrhagic), where it originates and the status of the brain injury. The brain tissue at risk can also be assessed, which is useful when deciding the best treatment.

 

Typical treatment 

It is a neurological emergency which must be treated immediately. In the case of ischemic stroke, there are treatments to dissolve the clot and re-establish blood flow to the brain which must be administered as soon as possible (intravenous thrombolysis and endovascular rescue). General measures are controlling arterial pressure, fever, oxygen and glucose levels. Rehabilitation is required for any disability brought about by a stroke.

 

Prevention 

Family history and age are risk factors that cannot be prevented, but there are others that can, such as:

  • High blood pressure
  • Diabetes
  • High cholesterol
  • Atrial fibrillation
  • Obesity
  • Alcohol abuse
  • A sedentary lifestyle

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