Elderly people may suffer from cerebral hemorrhage when they go out in the cold wind in winter. How can we prevent this high incidence?

The temperature has dropped sharply recently. After getting up in the morning, my friend's father went out for a walk as usual. Unexpectedly, as soon as he went out, the cold winter wind blew and he suddenly had a severe headache. He then gradually developed severe nausea, vomiting, and unconsciousness. He was immediately rushed to the emergency department of a hospital by a 120 ambulance. After examination, it was confirmed that he had hypertensive cerebral hemorrhage. He is now in critical condition in the ICU.

1. What is stroke?

Cerebral stroke is commonly known as "stroke". It is a very common disease. Cerebral stroke is acute cerebrovascular disease, commonly known as stroke, which is a clinical emergency caused by cerebral infarction or cerebral hemorrhage due to blockage or rupture of cerebral blood vessels.

Stroke has the characteristics of "five highs": high morbidity, high disability, high mortality, high recurrence rate and high economic burden. Acute ischemic stroke accounts for about 80% of all strokes, and hemorrhagic stroke accounts for about 20%.

In September this year, the National Health Commission issued the "Guidelines for the Prevention and Treatment of Stroke in China (2021 Edition)", which pointed out that the incidence of stroke in my country has increased year by year and is becoming younger. At present, stroke has become the leading cause of death among Chinese residents and the disease with the highest disability rate among single diseases.

2. What are the reasons for the high incidence of stroke?

1. Poor blood pressure control.

There are more than 200 million people with hypertension in my country, and many stroke patients have long-term uncontrolled hypertension or have poorly controlled hypertension. Uncontrolled hypertension can easily lead to diseases such as stroke.

2. Eating and drinking excessively and not liking to exercise have led to an increase in the number of obese people, people with diabetes and coronary heart disease.

In modern society, people's diet is becoming more and more abundant, but their physical activities are becoming less and less. Many people play mahjong and sit at their desks every day.

People eat high-salt, high-fat, and high-sugar foods whenever they want, and smoking and drinking during social events are common. However, their health awareness is very weak and physical activity is reduced, leading to an increase in the number of obese people, people with diabetes and coronary heart disease.

3. Irregular lifestyle.

Many people stay up late to watch their phones or play mahjong. Although staying up late is fun, it can lead to metabolic disorders, weakened immune function, and excessive secretion of adrenaline, which can cause excessive fluctuations in blood pressure.

3. Which is more dangerous, cerebral hemorrhage or cerebral infarction?

The recovery of neurological deficits caused by hemorrhagic stroke (cerebral hemorrhage) is generally better than that caused by cerebral infarction. This is because the effect of hematoma on nerves is mainly compressive, and the nerve structure may not necessarily be severely damaged.

However, it is important to be aware that the severity of acute cerebral hemorrhage is closely related to the amount of bleeding and the location of bleeding. Generally speaking, the greater the amount of bleeding, the more serious the condition. If the patient's breathing rhythm changes significantly, becomes irregular or intermittent, or even stops; if the blood pressure changes dramatically, from rising at the beginning to falling significantly, it indicates that the respiratory and circulatory centers of the brainstem are failing, indicating that the patient is on the verge of death.

But as long as the critical period is passed and the hematoma is absorbed quickly, the neurodegeneration will not be so serious. However, ischemic stroke (cerebral infarction) directly causes ischemia and hypoxia of nerve tissue, which is much more serious.

4. During the recovery period of cerebral hemorrhage, what range should blood pressure be controlled within?

Cerebral hemorrhage is not like cerebral infarction. Generally, patients with acute cerebral ischemia can take medication well in about a week. Generally speaking, the blood pressure needs to be lowered to 160 mmHg initially, and then to 140~150 mmHg after the condition stabilizes for one month.

Cerebral hemorrhage does not require a very high perfusion pressure. Usually, it should be reduced to around 140 mmHg at the beginning, and can reach 130-140 mmHg after stabilization. In terms of blood pressure, patients will be safer within this range.

5. Remember the "120" formula for the signs of stroke

The 120 in this formula refers to three examinations. If one or more of these symptoms appear, family members should immediately call 120 for medical treatment.

"1" means looking at one face to see if there are any sudden symptoms of crooked mouth corners, drooling, or asymmetric facial paralysis;

"2" means checking both arms to see if there is limb numbness or unilateral weakness when raised in parallel;

"0" refers to hearing language, whether it is difficult to speak, slurred or unable to speak. If these symptoms suddenly appear, it may be a stroke.

6. How to prevent stroke? The following points should be noted in daily habits and behaviors:

1. Eat a low-salt, low-fat, low-sugar diet and eat more fresh vegetables and fruits;

2. Increase physical exercise moderately and overcome bad habits, such as quitting smoking and drinking, and avoiding sitting for long periods of time;

4. Prevent overwork and arrange work reasonably;

6. Maintain emotional stability and live a positive and optimistic life;

7. Pay attention to seasonal changes, protect yourself from cold and heat, and add or remove clothes appropriately;

8. Have regular health checks to prevent and treat problems early if discovered.