Where can strokes happen

stroke

A stroke is a sudden disruption of blood flow to the brain. Doctors speak of an apoplexy, apoplexia cerebri or apoplexy. In colloquial language, one often speaks of a stroke.

Medical definition and epidemiology

Strokes are characterized by a massive malfunction of the brain that leads to an ongoing one Undersupply of oxygen and nutrients leads. Because of the lack of oxygen, brain tissue dies after just ten to fifteen minutes.

The human medical literature distinguishes between two basic forms of apoplexia cerebri:

  • The so-called ischemic stroke is the more common form, accounting for around 80 percent of cases. Here's the stroke on one acute hypoperfusion which is called ischemia.
  • In contrast, a hemorrhagic stroke occurs when the inadequate blood flow affects one Bleeding of the brain is based. Apoplexia cerebri, which can be traced back to such a direct cerebral hemorrhage, accounts for around 20 percent of global strokes.

In the Federal Republic of Germany, the frequency of new cases, the so-called incidence, is around 180 cases per 100,000 inhabitants. Thus a stroke represents after heart diseases and malignant tumors (cancer) the third leading cause of death in the Federal Republic of Germany. The neighboring countries Austria and Switzerland show a similar epidemiology.

Stroke patients are mostly over 70 years old. Occasionally, however, children and adults can also suffer from a stroke. Most stroke survivors are mentally or physically disabled. The type and extent of the disabilities depend on the individual case.

Symptoms: what happens if you have a stroke

A stroke represents a massive nuisance to the human body that leads to various neurological disorders and failures leads. The type and intensity of symptoms vary depending on the physical condition of the patient and the location where the stroke occurs. The most common signs of a stroke include acute paralysis, weakness, or numbness on one side of the body. This is what happens to some of those affected

  • drooping corners of the mouth or eyelids,
  • paralyzed arms or
  • asleep feet.

The failure phenomena always occur on the side of the body, for which the battered side of the brain is responsible. Failures on the left side of the body are an indication of a stroke on the right hemisphere and vice versa. Some people suffer from a stroke, paralysis of all four extremities (tetraparesis). They also include Visual disturbances the classic symptoms of a stroke. Affected patients

  • see double vision,
  • have a reduced field of view,
  • complain of a blurry image or
  • completely lose their eyesight.

Furthermore, the following signs are also considered to be typical symptoms:

  • general feeling of weakness
  • Impaired consciousness
  • Sensory disturbances
  • a headache
  • severe dizziness
  • Speech disorders

A stroke occurs suddenly, so suddenly on. Nonetheless, medical professionals have been able to show that a third of the patients will have a stroke as a result of a transient ischemic attack (TIA). This leads to a temporary occurrence of the typical symptoms of a stroke. Those affected suffer from paralysis, speech, sensation, consciousness or vision disorders for about 24 hours. In contrast to a real stroke, however, the symptoms disappear again.

Diagnosing a stroke

Every stroke is an emergency, one prompt treatment requirement. An emergency doctor should therefore be called immediately if there is a mere suspicion. This first checks the patient's vital functions. If the patient can be addressed, the attending physician asks about the symptoms that have occurred. In the hospital, neurologists are responsible for treating stroke patients.

The specialist examines the patient for ..

  • Coordination skills
  • Sensation of touch
  • Sight, touch and language skills

A really reliable diagnosis is only possible with help imaging procedures possible. As a rule, the treating physicians therefore immediately order a computed tomography of the head (so-called cranial CT). The images of the inside of the skull obtained by this procedure provide information as to whether an occlusion of the vessels or a cerebral hemorrhage caused the stroke. The cranial CT is usually supplemented by an image of the vessels (CT angiography) or a measurement of the blood flow (CT perfusion). Instead of a cranial CT, a nuclear spin or magnetic resonance tomography (MRT) can be arranged, since this procedure also provides information from the inside of the skull.

Occasionally, doctors also run a separate one X-ray examination of the vessels by. This so-called angiography is important to make existing malformations of the vessels or vessel leaks visible. In addition, a stroke requires a comprehensive one Examination of the functionality and performance of the heart. An electrocardiography (EKG) or a long-term EKG are therefore common diagnostic tools.

Furthermore, there are also various Blood tests important to confirm the suspicion of apoplexy or to clarify it in more detail. Are examined in particular

  • the blood count,
  • the blood clotting,
  • the blood sugar levels,
  • the electrolyte balance as well
  • the kidney values.

Treating a stroke

Treating a stroke requires special expertise. Therefore, ideally, it should be in a special department (a so-called Stroke Unit) respectively. Since a stroke leads to an insufficient supply of the brain, brain cells die particularly quickly. Treatment steps must be initiated as quickly as possible in order to keep the extent of the damage to a minimum.

As part of the acute medical treatment the vital functions of the patient are controlled and stabilized. In addition, the following parameters are also monitored:

  • breathing
  • Blood pressure
  • Blood sugar
  • Heart rate
  • Body temperature
  • Brain and kidney function
  • Water and electrolyte balance

Treatment of ischemic strokes

Ischemic strokes are caused by the so-called Lysis therapy (thrombolysis) treated. This is aimed at removing the vascular occlusion with clot-dissolving drugs (thrombolytics). This is intended to save as many nerve cells as possible. The drugs are usually given through an infusion.

In addition to the lysis therapy, there is also one mechanical elimination of the blood clot into consideration. As part of a thrombectomy, doctors push a thin catheter through an artery in the groin to the clot in the brain under X-ray control. The clot is then removed with fine instruments.

Today it is the medical standard to combine thrombectomy and lysis therapy.

Treatment of hemorrhagic strokes

Hemorrhagic strokes that can be traced back to a cerebral haemorrhage are not treated with either thrombectomy or lysis therapy. With minor cerebral hemorrhages, it is enough to avoid activities that lead to an increase in pressure in the head. Extensive cerebral hemorrhage, on the other hand, requires one surgery. This involves opening the patient's skull to remove the bruise and to close the bleeding area.

Rehabilitation measures after treatment

Strokes always make one long-term therapy required. The return to everyday life is always at the center of the neurological rehabilitation measures to be initiated. Those affected should find their way back to an independent life despite the consequences of the stroke.

Occupational therapy can counteract motor disorders. Physiotherapy can be helpful in learning how to deal with paralysis. Speech disorders are treated by a speech therapist. The consequences of a stroke lead to massive cuts in the everyday life of those affected. It may therefore be advisable to seek psychotherapeutic help.

Risk factors and prevention

A stroke can be prevented to a limited extent by Risk factors minimized become. However, this must be done early on. Risk factors include:

  • high fat diet
  • Sedentary lifestyle
  • stress
  • excessive consumption of addictive substances such as alcohol and cigarettes
  • excessive consumption of desserts

After an ischemic stroke or TIA, medical professionals prescribe their patients Antiplatelet drugsto prevent further seizures. These are often called blood thinner These drugs prevent platelets from clumping together and thus clogging a vessel. The active ingredients acetylsalicylic acid, clopidogrel and ticlopidine are currently approved for corresponding purposes.

Last changed on: 02/21/2020

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