A stroke or cerebrovascular accident is an acute disease of the brain, in which mostly a sudden blockage or bleeding in the blood vessels of the brain cause a lack of oxygen supply. A stroke is an emergency that requires immediate urgent medical attention.
What is a stroke?
Infographic on the anatomy and causes of cardiovascular disease, such as stroke. Click image to enlarge. A stroke or cerebrovascular accident is a severe malfunction and sudden illness of the brain. In particular, the oxygen supply to the brain is interrupted. There are two main forms of stroke. On the one hand, the oxygen supply can be interrupted by a deficient blood supply to the brain (ischemia) and on the other hand, a direct bleeding in the brain (hemorrhagi) can also be responsible for a stroke. Due to the lack of oxygen, the brain cannot function normally and nerve cells die within as little as ten to fifteen minutes. Strokes occur more frequently in older people. In most cases, those affected are over 70 years old. Due to the consequences of the stroke, most patients are mentally or physically disabled after the stroke. The longer the time after a stroke until acute treatment, the greater the need for care of the affected person is usually afterwards.
Causes
The causes of stroke, as already noted, are defective cerebral blood flow (ischemia), most often caused by hardening of the arteries (arteriosclerosis) or by an embolism. Above all, the fatty deposits that accumulate in the blood vessels cause the vessels to become narrower, so that less and less blood can flow through them. Eventually, there comes a point where little or no blood reaches the brain and oxygen can no longer be transported from the lungs to the brain. Patients at risk are those with diabetes mellitus, high blood pressure and high cholesterol levels. Another cause of stroke is then direct bleeding in the brain (hemorrhage), in which an embolism or blood clot occurs. In this case, the blood clot (thrombus) in the blood vessels clots and the blood in turn cannot provide oxygen transport to the brain. The last cause is the so-called cerebral hemorrhage (hemorrhagic infarction), which occurs in 1/4 of all strokes. In this case, the cerebral hemorrhage is caused by a rupture or rupture of blood vessels in the brain. Again, patients with hypertension, diabetes mellitus, and high cholesterol levels are particularly affected.
Symptoms, complaints, and signs
The symptoms of a stroke are very versatile. For example, a sudden onset of unilateral paralysis or loss of strength for which there is no other cause may indicate a stroke. The paralysis typically occurs in the arm and/or leg. People with a stroke may further experience numbness in the arms or legs as well as the face. Likewise, the corner of the mouth drooping on one side is always a red flag. Various visual disturbances can also occur with a stroke. Patients see blurred, have a restricted field of vision or see double. In more severe cases, temporary blindness may even occur. If the speech center in the brain is affected by the lack of oxygen, patients speak slurredly. They always repeat the same words or syllables and/or make long pauses while speaking. A complete loss of speech is also possible. In addition to these speech disorders, expressive disorders may also occur. Those affected can no longer name certain objects or express themselves in an absolutely meaningless manner. In addition to these symptoms, sudden disturbances of balance and dizziness as well as loss of consciousness may indicate a stroke. Stroke-like and barely tolerable headaches are another symptom of stroke.
Disease progression
The course of a stroke depends largely on the severity and damage caused by bleeding in the brain and blood clots. If the stroke was detected and treated in time, serious complications can be avoided. Therefore, it is always advisable to call the emergency doctor in case of a suspected stroke in order to ensure fast medical help for patients at risk.Seen in this light, the course of the disease is therefore to be assessed individually by the extent of the stroke. The course can range from barely noticeable symptoms to absolute need for care and bed confinement. Above all, the speech disorders and paralysis have a lasting effect on the further life of the affected person. Most brain damage caused by stroke is still irreversibly damaged today and cannot be cured.
Complications
Severe complications, including death, can occur when a person suffers a stroke. In most cases, severe motor impairments and sensory organ dysfunction develop because of the stroke. Typical are visual problems, hearing loss and balance problems. If the excretory organs are affected, incontinence, urination disorders, bowel obstruction and other complications may occur. In most cases, intellectual performance is also reduced – complications ranging from forgetfulness to dementia are possible. As a result of bedriddenness, pneumonia, pressure sores, urinary tract infections, and spasticity, among others, may occur. In addition, joint stiffness, muscle atrophy and epilepsies may occur. Last, stroke can cause aphasia. In stroke therapy, the drugs used in particular can cause complications. Drugs used to thin the blood rarely cause allergic reactions. In isolated cases, for example, skin redness, itching and burning may occur. Painkillers and anti-inflammatory drugs are also not free of side effects and interactions. Typical are nausea and vomiting, skin reactions and, rarely, cardiovascular problems as well as kidney or liver damage. In the case of an acute stroke, infections or bleeding may occur during the operation. Wound healing problems and other complications may occur after surgery.
When should you see a doctor?
In today’s world, the risk of stroke continues to increase. Many people get a stroke at a young age. The most important question is when to see the doctor. First of all, it should be noted that the slightest sign of a stroke is already important and should not be ignored. If signs indicating this disease occur more often and limit the affected person in everyday life, a doctor should definitely be consulted. But it is not always necessary to see a specialist. Often, symptoms that indicate a stroke can also have completely different causes. The first thing to do is to visit the family doctor so that other diagnoses can be ruled out. If he is also of the opinion that a specialist examination is advisable, then he issues a referral. The neurologist is the right person to contact if there are signs of a stroke. He ensures that certain examinations are arranged in order to make the correct diagnosis. So if symptoms that could indicate a stroke occur more often, a specialist should be consulted immediately.
Treatment and therapy
Treatment or therapy for stroke should be initiated as soon as possible. The longer the brain is without oxygen, the more nerve cells die and the brain cannot be healed. If a stroke occurs, it should be reported immediately to an emergency physician. The treatment of a stroke therefore always aims to minimize the damage caused by the lack of oxygen. Nevertheless, the therapy depends on the cause of the stroke. This is first determined by the emergency physician and then in the hospital. If a blood clot is the cause, medication will be given immediately to dissolve this blood blockage. In addition, the doctor will try to rule out a cerebral hemorrhage. Today, this can be done with the help of computed tomography (CT). In most cases of brain hemorrhage, neurosurgical intervention must be performed as soon as possible to stop the bleeding. In addition, possible hematomas should be removed. In addition, all vital functions are monitored so that sudden death can be prevented. The subsequent long-term therapy for stroke mainly includes the treatment of motor disorders, such as speech disorders and paralysis. Above all, rehabilitation is then the main focus of treatment in order to give the affected person back a dignified life, as far as possible.
Prevention
Stroke can be prevented. However, this must be done as early as possible and throughout life.This includes, above all, low-fat food, plenty of exercise and sport, little stress, no smoking and excessive drinking of alcohol. Too much sweet food should also be avoided. Likewise, frequent checkups with a doctor can provide possible warnings in time.
Follow-up care
Good aftercare following a stroke plays a crucial role in regaining physical and mental abilities. The measures that are necessary and appropriate depend on the severity of the stroke and the impairment it caused. Acute treatment in hospital should be followed immediately by rehabilitation in a specialist clinic: This can reduce the consequences of the stroke, and at the same time the patient learns to cope with everyday life with unavoidable permanent restrictions. Physiotherapy is very important, during which mobility and perception of the impaired side of the body and thus motor skills are improved. During occupational therapy, everyday activities such as dressing, eating or household tasks are practiced. The patient is also trained in the use of assistive devices, with the help of which he can better manage his daily life. The aim of speech therapy is to reduce speech, language and swallowing disorders and thereby restore the patient’s ability to communicate and eat independently as much as possible. Neuropsychological rehabilitation is recommended for memory disorders, attention deficits and to stabilize the patient emotionally. After the rehabilitation measure, blood pressure and blood values should be checked regularly by the general practitioner and, if necessary, adjusted with medication; in many cases, the further implementation of outpatient physiotherapy, occupational therapy and speech therapy is advisable. Effective follow-up care also includes eliminating risk factors such as smoking or obesity.
Here’s what you can do yourself
A stroke is a medical crisis that requires immediate emergency medical attention. Affected individuals should seek medical help at the first signs. Self-help measures are indicated only during convalescence. A stroke is often accompanied by damage to the brain, which severely restricts the ability of the affected person to speak. In this case, patients should learn to speak again as early as possible with the help of a speech therapist. Perseverance and patience are required here. Without the patient’s committed cooperation, there is hardly any improvement. Often, motor skills are also impaired after a stroke. In this case, physical and occupational therapy measures help patients to improve their motor skills again and to be able to perform everyday tasks themselves. Often, patients also suffer greatly psychologically as a result of the physical impairment. This is especially true if the patient has to give up his or her previous job as a result of the stroke. Patients usually cope better with this psychological trauma if they talk to other people affected by the stroke. There are now numerous self-help groups for this purpose, both locally and on the Internet. In larger cities, there are even so-called stroke guides who help those affected to cope with the greatly changed life situation.
