"BLOW" for stroke diagnosis

Strokes in Russia: a reminder for the healthy

Julia Bondar, Copper News

Almost half a million people suffer from stroke every year – the population of not the smallest city. Moreover, of those who have had a stroke, only 13-15% fully recover, and 84-87% of patients die or become disabled. But, unfortunately, even those who fully recover after a stroke can no longer feel safe: 50% of survivors have a second stroke within the next 5 years. According to the National Stroke Association (NABI), 31% of stroke patients need special care, 20% cannot walk on their own and only 8% can return to their former full life. In addition, stroke is no longer a disease exclusively of the elderly. According to Lyudmila Stakhovskaya, director of the N.I. Pirogov Research Institute of Cerebrovascular Pathology, over the past 5 years the average age of stroke patients has decreased from 73 to 68 years. At the same time, cases of stroke have significantly increased in very young people and even in children.

At the same time, the attitude to stroke in Russia remains frivolous – everyone believes that all these statistics relate to someone else. Meanwhile, the risk group for the most common indicator, arterial hypertension, in Russia includes from 77.1 to 97.3% of the population in different regions of Russia.

Risk factors most characteristic of stroke: 

• High blood pressure. In more than 50% of cases, this is a risk factor for the development of ischemic strokes, in 60% – intracerebral hemorrhages, in 30% – subarachnoid hemorrhages. In patients with confirmed arterial hypertension, the stroke rate is 3 times higher than in patients with normal blood pressure. Hypotensive therapy for 5 years leads to a 38% reduction in the incidence of stroke. A decrease in the level of diastolic blood pressure by 5, 7.5 and 10 mmHg leads to a decrease in the frequency of stroke by 35%, 46%, and 56%, respectively. So if you have high blood pressure, you need to contact specialists immediately.
• Atherosclerosis. 90-95% of cases of ischemic stroke are unambiguously associated with atherosclerosis of cerebral and precerebral vessels. Treatment of atherosclerosis is a complex event that includes, first of all, normalization of work and rest, a diet that excludes cholesterol–containing products and mandatory medication prescribed only by a doctor.
• Smoking, alcohol. Smoking increases the risk of stroke in men by 40%, in women – by 60%. Alcohol abuse increases the likelihood of a stroke by 4 times! 
• Diabetes mellitus. This disease doubles the risk of stroke. The combination of arterial hypertension and diabetes mellitus leads to an increase in the frequency of stroke by 4 – 7 times in comparison with the indicator for the population as a whole.
• Sedentary lifestyle, overweight or underweight are also risk factors for stroke. If any of these factors are present in your life, you should already consult a doctor for advice in order to develop a strategy for the transition to a healthy weight and lifestyle.
• Doctors also include depressive states, regular stress, sleep apnea, and blood pressure drops as a non-specific risk factor for stroke. You should also pay close attention to these factors in order to exclude their fatal impact on health.

Even if you have not found yourself or your loved ones at risk, you still need to be able to recognize the harbingers and the first signs of a stroke – it can happen very close to you.

The precursors of a stroke may be insignificant, and most often go unnoticed. These include: previously uncharacteristic drowsiness and apathy;

• causeless fatigue, not caused by heavy loads;
• alternating low and high body temperature;
• dizziness, temporary loss of orientation in space;
• painful sensations on a certain part of the head or in the whole head;
• significant jumps in blood pressure indicators.

If you occasionally or systematically observe one or more of the listed signs, this is a reason for serious alarm!

Signs of a stroke that has begun: 

• speech disorder;
• nausea, vomiting, not bringing relief;
• violation of the sense of smell, not previously characteristic;
• numbness of the extremities (usually on one side of the body), skin areas, numbness of the tongue or half of the face, muscle weakness;
• auditory disorders – sudden deafness, ringing and tinnitus;
• severe visual impairment (telescopic vision, vision loss in one or both eyes);
• hallucinations (visual, auditory, olfactory);
• inability to recognize previously known objects, faces, concepts.

Is it possible without medical education to quickly recognize the signs of the onset of a stroke in an outsider? Can. There is even a special mnemonic rule for this.:

U – smile. Ask the patient to smile. After a stroke, the smile will be crooked, asymmetrical;

D – movement. Limb movements after a stroke are difficult, one of the paired limbs will act slower or rise lower;

A – articulation. After a stroke, articulation is difficult, especially difficult to cope with a long and complex word. Ask a person to pronounce the word "articulation" if he has a stroke – he will not cope with the task;

R – solution: if there is at least one of the signs, urgently call an ambulance and tell the dispatcher about these signs to call a specialized team.

If medical care begins to be provided no later than three hours after the onset of a stroke, the chances of survival and even full recovery are significantly increased. After 3 hours from the onset of the disease, brain cells in the ischemic area begin to undergo irreversible changes. The maximum time ("therapeutic window") before the start of thrombolytic therapy for ischemic stroke is 4.5 hours. In the period up to 6 hours after the onset of stroke, individual cells still remain among the brain cells that died from ischemia, which are theoretically able to recover when blood supply is restored. After 6 o'clock, the prognosis becomes unfavorable.

What can be done before the arrival of the medical team:

• help the patient to take a horizontal position;
• lift his head and shoulders 20-30% above the body level – this will improve blood flow in the vertebral arteries;
• it is better to lay the victim on the right side, placing a bag in case of vomiting;
• unbutton your trousers, collar, loosen your belt or belt;
• open the window, provide fresh air;
• before the arrival of the SMP, measure the patient's pulse, blood pressure, prepare medical documents in advance;
• if breathing and pulse are gone, perform indirect heart massage and artificial respiration before the arrival of the SMP team.

Timely treatment of stroke can significantly limit the focus of necrosis of brain tissue. As a result, a person can avoid death and disability. 

Portal "Eternal youth" http://vechnayamolodost.ru  23.06.2017