Clearly understand stroke--FAQs about stroke

1. What is stroke?

2. Why does a stroke occur suddenly?

3. How to quickly identify a stroke?

4. What should I do if I suddenly have a stroke?

5. What else can we do while waiting for emergency treatment?

6. What tests should be done if cerebral infarction is suspected?

7. If a cerebral infarction occurs, what treatment will the doctor take?

8. What should I pay attention to after being discharged from the hospital?

9. What is the tertiary prevention of stroke?

1. What is stroke?

The brain, like the rest of the body, needs oxygen from the blood. When the blood supply to the brain is interrupted, brain cells are severely deprived of oxygen and damage occurs. The various clinical symptoms that follow are called stroke.

Ischemic stroke is mainly caused by fat accumulation in blood vessels. Fat accumulation easily forms blood clots and blocks blood vessels, just like a heart attack. This is why stroke is also called cerebral infarction.

Stroke is a general term for acute cerebrovascular disease, which is divided into "ischemic stroke" and "hemorrhagic stroke", which are commonly known as "cerebral infarction" and "cerebral hemorrhage".

Blood clots can form inside the brain or from other parts of the body. Blood clots outside the brain usually come from the neck, but can also come from the heart. Blood clots are more likely to form when there is an irregular heartbeat, also known as atrial fibrillation.

A stroke caused by a sudden rupture of a blood vessel is called a hemorrhagic stroke. Blood leaks from the ruptured blood vessel into or around the brain. The leaked blood can cause swelling of the brain tissue. Severe cases may require surgery.

If the clinical symptoms of stroke completely disappear within 24 hours, it is called a mini-stroke or transient ischemic attack (TIA).

Some TIA symptoms only last for a few minutes. Once a TIA is suspected, it should be treated immediately, just like a full-blown stroke, because TIA is a high-risk warning sign for a full-blown stroke.

2. Why does stroke occur?

The risk of stroke increases with age, and age is an irreversible risk factor for stroke.
Among the modifiable risk factors, high blood pressure, high blood lipids, unhealthy lifestyles such as smoking and drinking are all important pathogenic factors.

The increase in the incidence of chronic diseases and long-term improper lifestyle will push the age of stroke occurrence forward, significantly increasing the risk of stroke in middle-aged people.

Middle-aged people do not pay enough attention to the disease, and there is a misunderstanding among the public that stroke is an elderly disease.

The screening rates for stroke and even hypertension are low, and many patients do not know they have hypertension until they develop hemiplegia.

Middle-aged people have poor compliance with disease interventions, fail to take medications as required, and have irregular disease management, which increases the risk of stroke.

Furthermore, middle-aged people are under greater stress, and long working hours and mental stress can significantly increase the risk of stroke.

In addition, heavy drinking and mood swings in a short period of time are also short-term risk factors for stroke.

The cause of stroke is relatively clear. Early detection and early intervention of risk factors in middle-aged people can achieve good preventive and therapeutic effects.

3. How to quickly identify stroke?

Early signs of stroke should be taken seriously. Short-term weakness and slurred speech may be precursors to stroke and medical treatment must be sought early. If acute thrombolysis and other conditions can be treated promptly, better therapeutic effects can be achieved within the effective time window.
Sometimes stroke symptoms are hard to detect, but more often they are severe and can lead to disability. These symptoms are reversible if treated promptly. That is why it is important to see a doctor quickly if you suspect a stroke. A simple mnemonic is “Stroke 120”.

"Stroke 120" formula

“1” means “seeing 1 asymmetrical face”;

“2” means “check both arms for unilateral weakness”;

"0" means "listening (zero) to whether the speech is clear."

At the same time, remember the "BE FAST" formula for identifying early symptoms of stroke. The first five letters represent an early symptom, and the last letter is a reminder to call the emergency number and seek medical treatment immediately if you find any symptoms of stroke:

"B" - Balance refers to loss of balance or coordination, sudden difficulty walking;

"E" - Eyes refers to the eyes, sudden changes in vision, difficulty seeing;

"F" - Face refers to the face, which is asymmetrical and has crooked corners of the mouth;

"A" - Arms refers to sudden weakness or numbness in the arms, usually on one side of the body;

"S" - Speech refers to language, speaking unclearly and being unable to understand others' language;

"T" - Time refers to time. The above symptoms indicate a possible stroke. Please do not wait for the symptoms to disappear on their own. Call 120 immediately for medical assistance.

After a stroke occurs, approximately 1.9 million brain cells die every minute, and brain tissue and its motor, language, cognitive and emotional functions will also be gradually lost. If the "BE FAST" formula is used for early identification and the patient is sent to a (comprehensive) stroke center hospital with treatment capabilities by ambulance within 4.5 hours of onset and receives standardized vascular revascularization treatment, most patients can recover significantly or even completely, and their quality of life will be saved. Therefore, it is extremely important to detect the early symptoms of stroke in a timely manner. The earlier the detection and diagnosis, the better the treatment and rehabilitation effect.

4. What should I do if I suddenly have a stroke?

Whether the patient is suffering from cerebral hemorrhage or cerebral infarction, it is undoubtedly best to send him to the hospital as soon as possible.

The golden time for emergency treatment of cerebral infarction is 3 hours. It sounds like a long time, but the time for going to the hospital and taking X-rays is included, so there is not much time left for family members to consult and hesitate!

If you suspect a stroke, call 120 immediately! Do not waste time discussing with others (including relatives and friends who work in the hospital). It is useless to ask anyone before a clear diagnosis! After arriving at the hospital, you must also trust the judgment made by the doctor in front of you!

It is not recommended to use private cars to transport patients to the hospital. If there is a traffic jam or the patient's condition suddenly worsens, the family members in the private car will not be able to handle it. It is also difficult for family members to distinguish which hospitals have green channels for stroke.

Don't delay! Don't delay! Don't delay! It won't work if you delay a little.

Even if the symptoms are very mild, you may just feel that your speech is a little unclear, or you just have less strength to hold the cup. Some symptoms may be relieved within a few minutes. This is medically known as a "transient ischemic attack."

You must not relax your vigilance at this time. If the abnormal cause is not eliminated, the symptoms are likely to recur in a short period of time, and the next symptom may be significantly worse. Therefore, you should go to the hospital for examination as soon as possible.

5. What else can we do while waiting for emergency treatment?

While waiting for the ambulance, do not give the patient medicine, food, or water, and do not use your fingertips to draw blood.

Let the patient lie flat, turn his head to one side (to avoid suffocation due to vomiting), remove foreign objects in the mouth and nose to ensure the patient's breathing is unobstructed, and wait for the ambulance.

6. What tests should be done if cerebral infarction is suspected?

Head CT: to determine whether it is hemorrhagic infarction or ischemic infarction;

Head MRI: determine the specific location and size of cerebral infarction;

Ultrasound examination: Check the status of arteriosclerosis and atherosclerotic plaques;

Electrocardiogram: Check for risk factors such as arrhythmia;

CT angiography or cerebral angiography: whether there is occlusion or stenosis of the blood vessels in the head and neck;

Relevant laboratory tests: timely detection of risk factors.

7. If a cerebral infarction occurs, what treatment will the doctor take?

① Intravenous thrombolytic therapy: If the disease can be detected in the first few hours, drugs are usually given to dissolve the blood clot, which is referred to as "thrombolysis".
In the acute phase of cerebral infarction, potent thrombolytic drugs are used for treatment. Alteplase thrombolysis can be used within 4.5 hours of onset, and urokinase thrombolysis can be used within 4.5 to 6 hours of onset.

② Neurovascular interventional surgical treatment (mechanical thrombectomy, etc.); using minimally invasive surgery, a thrombectomy stent or aspiration catheter is sent into the cerebral blood vessels to "pull" or "draw" out the thrombus, or a stent or balloon is used to "reshape" the blood vessels.

③Drug treatment: anti-thrombotic, lipid-regulating, blood circulation promoting, collateral circulation improving, nerve nutrition;

④Control blood pressure, blood sugar, blood lipids, homocysteine ​​and other indicators, and carry out health education;

⑤Early rehabilitation exercises.

8. What should I pay attention to after being discharged from the hospital?

Discharge does not mean recovery. Even if a stroke patient is discharged from the hospital, treatment is far from over, and follow-up treatment is often aimed at preventing stroke recurrence and the occurrence of post-stroke dementia.

①Prevent stroke recurrence. The recurrence rate of stroke is very high!!!

Therefore, you cannot stop taking the medicine, and you should continue to take it to control risk factors such as the three highs to prevent a second stroke!

②Prevent post-stroke dementia. Nearly 80% of patients after a stroke will experience cognitive impairment. Memory loss, poor attention, lack of vocabulary, etc. 30% of them may develop dementia, and in the end they may not even recognize their family members! Family members should pay more attention to the patient's mental state after discharge, and seek medical treatment in time if any abnormality is found, and receive treatment and training under the guidance of a doctor.

③ "Stroke rehabilitation" is very important. Stroke can cause disability, but over time, the brain can slowly adapt and adjust, and eventually partially or even completely recover the lost functions. Therefore, "stroke rehabilitation" is very important. Rehabilitation is a difficult process, and patients and their families must have confidence. Doctors, nurses, and therapists will also wholeheartedly help patients overcome difficulties.

④ Above all else, prevention is the most important thing.

9. What is the tertiary prevention of stroke?

Stroke prevention can be divided into primary prevention, secondary prevention and tertiary prevention.

Primary prevention: It is mainly to prevent stroke in people who have not suffered from stroke and take precautions before it happens.

Secondary prevention: refers to preventing strokes from recurring in people who have already suffered one, thus achieving the goal of “mending the fold before the horse has bolted”.

Level 3 prevention: It means that patients who are suffering from stroke can get better treatment and recovery, so that they can escape from danger.

Clinical practice has proven that stroke is preventable and controllable! We must strictly guard against the four main culprits: hypertension, diabetes, dyslipidemia, and atrial fibrillation.

Finally, I emphasize again: Be sure to remember the following two stroke principles

① Rapid identification and prompt medical treatment: Time is brain. Timely and appropriate treatment can control the progression of the disease as much as possible, minimize the degree of brain damage, and lay a good foundation for later stroke rehabilitation.

② Early, continuous and correct rehabilitation: The brain is plastic. Early, continuous and correct rehabilitation training will help to better restore some or even all of the patient’s lost functions.