Medical history (history of illness) represents an important component in the diagnosis of apoplexy (stroke). Family history Are there frequent cardiovascular diseases, neurological diseases in your family? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). Was there any loss … Stroke (Apoplexy): Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Hypoglycemia (low blood sugar) [Stroke mimics.] Cardiovascular (I00-I99). Dissection (splitting of the wall layers) of the carotid artery (common cause of stroke in younger people: proportion of 10-25%). Intracerebral hemorrhage (ICB; cerebral hemorrhage). Sinus vein thrombosis (SVT) – occlusion of a cerebral sinus (large venous blood vessels of the … Stroke (Apoplexy): Or something else? Differential Diagnosis
Notice: Immediately make an emergency call! (Call number 112) The occurrence of disorders of consciousness is a mandatory emergency physician indication. Transport with advance notification at the destination hospital. The hospital should be a stroke competent hospital – preferably with stroke unit. General measures In cerebral infarction, the best possible blood flow must be maintained … Stroke (Apoplexy): Therapy
The acute stroke patient is taken to the nearest stroke unit and treated rapidly with an infusion of the drug alteplase (rt-PA) if indicated. As a rule, lysis (drug therapy used to dissolve blood clots) should be combined with mechanical thrombectomy (removal of an embolus or thrombus with a balloon catheter). It is decided on … Stroke (Apoplexy): Surgical Therapy
To prevent apolex (stroke), attention must be paid to reducing individual risk factors.Behavioral Risk Factors Diet Studies show that 10 g salt/day increases the risk of stroke by 23%. This amount corresponds to the usual consumption of table salt in Western countries. Red and processed meat (defined as over 50 g/day), but less whole grains, … Stroke (Apoplexy): Prevention
The leading clinical symptoms of acute stroke are the same in adults and children. Each vessel has a specific supply area in the brain, and each brain region is responsible for different body functions. Therefore, different symptoms may occur with strokes. However, some symptoms may occur independently of the affected vessel or brain region. These … Stroke (Apoplexy): Symptoms, Complaints, Signs
Pathogenesis (development of disease) Ischemic apoplexy In ischemic apoplexy (ischemic insult, cerebral infarction; approximately 80-85% of cases), thrombotic or embolic vascular occlusion occurs. In this case, the apoplexy is usually caused by atherosclerosis (arteriosclerosis, hardening of the arteries). For details on the pathogenesis of atherosclerosis, see below the disease of the same name. The cause … Stroke (Apoplexy): Causes
The following are the most important diseases or complications that may be contributed to by an apoplexy (stroke): Respiratory system (J00-J99) Aspiration pneumonia – pneumonia (pneumonia) resulting from aspiration (inhalation) of saliva, vomit, or food due to dysphagia (difficulty swallowing). Endocrine, nutritional and metabolic diseases (E00-E90). Malnutrition (Malnutrition) Volume deficiency Factors influencing health status and … Stroke (Apoplexy): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: Assessment of consciousness using the Glasgow Coma Scale (GCS). General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes Neck vein congestion? Central cyanosis? (bluish discoloration of skin and central mucous membranes, e.g., tongue). Abdomen … Stroke (Apoplexy): Examination
Acute diagnostics before therapeutic intervention: Coagulation parameters – INR, Quick (prothrombin time, PT), aPTT, thrombin time. INR correlates with vitamin K antagonist serum concentration. Quick (more precise than aPPT) correlates with serum concentration of direct Factor Xa inhibitors (apixaban, edoxaban, rivaroxaban); meanwhile, a Factor Xa activity assay is also available Thrombin time correlates with dabigatran … Stroke (Apoplexy): Test and Diagnosis
Medical device diagnostics should be performed on a patient with suspected apoplexy within half an hour of arrival at the hospital so that treatment can be started within one hour. The following medical-device diagnostic procedures should be used immediately: Computed tomography (CT) – cross-sectional imaging (radiographs from different directions with computer-based analysis) [hypodense area; ischemic … Stroke (Apoplexy): Diagnostic Tests
Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used for prevention: Vitamins B12, B6 and folic acid. Potassium Omega-3 fatty acids docosahexaenoic acid and eicosapentaenoic acid Secondary plant compounds – isoflavones genistein, daidzein and glycitein, flavanones hesperitin and naringenin, alpha-carotene, beta-carotene and lycopene. In the context of micronutrient medicine … Stroke (Apoplexy): Micronutrient Therapy
