In Colombia, stroke is the leading cause of disability and one of the main causes of non-traumatic mortality.
A cerebrovascular attack or stroke happens when the blood supply to an area of the brain is reduced or blocked. If this happens, it cannot receive oxygen and nutrients, which can cause cells to die and cause permanent damage.
In relation to treatment, the most important thing is that it must be timely, it is important that people recognize the symptoms, and in the face of any suspicion act immediately, taking the patient as soon as possible to an emergency service. In ACV “time is brain”.
Symptoms to detect stroke
C: face cake
Or: eyevisual impairment
A: quick decreased strength in some part of the body
A: rare in speaking
E: call the line of emergency or take him to an emergency room
What happens to a patient who comes in with stroke athe service emergency?
The faster the symptoms are detected, the better the outcome in terms of prognosis and treatment.
Treatments for the attack ischemic cerebrovascular
This stroke is generated by the formation of clots in already narrowed arteries (thrombotic cerebrovascular accident), or by the detachment of clots from other blood vessels or from the heart that reach the brain (cerebral embolism or embolic cerebrovascular accident), the most common way to treat it consists of uncovering the artery, which can be done in two ways:
Within the first 4.5 hours after the onset of symptoms:
A non-contrast brain scan or CT scan is needed to see the inside of the brain and rule out the event as a stroke. If there is no bleeding, thrombolytic treatment is started. Fibrinolysis by the thrombolytic has the potential to dissolve the clot, which creates a high probability of effecting the obstruction.
On the other hand, when the clot is very large and obstructs one of the arteries at the base of the brain, medicine is not enough, endovascular treatment is required, which involves inserting a catheter that travels to the brain artery from the site of the obstruction, to remove or aspirate the clot with specialized devices and unclog the artery.
Treatments for hemorrhagic cerebrovascular accident
Although they are less frequent than ischemic ones (20% of strokes), they have a more delicate prognosis and can cause more pain. They happen when a blood vessel in the brain breaks generating a spill, and are the consequence of not controlling blood pressure, arteriovenous malformations, or anticoagulant medications; so dealing with them is a bit more complex:
Options for timely treatment of a hemorrhagic stroke focus on controlling high blood pressure and slowing the expansion of the hematoma.
Some of these treatments can be followed depending on the severity:
In the first hour, the patient’s blood pressure must be controlled with medication to reduce the expansion of the hematoma.
If the area of bleeding is extensive, surgery may be done to remove the blood and relieve pressure on the brain.
If the stroke is caused by a ruptured intracranial aneurysm, treatment may be endovascular or surgical to repair the damaged artery.
What happens after the stroke patient is stabilized?
After being stabilized, the patient enters a period of observation in the ICU since after the attack his health condition may be unstable and requires motorization and immediate treatments.
After this acute phase of stroke, the patient remains under observation where two processes begin:
A neurovascular scan is carried out, which is nothing more than research to determine the causes of the stroke, which allows the prevention of another attack.
The second step is key to the patient’s reintegration into their normal life and is comprehensive rehabilitation consisting of physical, language, occupational, cognitive and social therapies.
ACV route at the Shaio Clinic
The ACV Code is an emergency code implemented in the Clinic to act in a timely and precise manner when a patient with suspicious symptoms arrives, activating all the human and technological resources available in the institution.
This is the result of joint work between specialties, forming a team with the aim of treating these patients.
Preventing stroke is possible
People with high blood pressure, obesity, diabetes, smoking and atrial fibrillation (arrhythmia) are at increased risk of stroke. In fact, strokes resulting from atrial fibrillation have the worst prognosis.
For this reason, it is necessary to take measures for primary prevention, that is to say, before the fact happens, and also for secondary prevention when a first event has already occurred. This is why it is necessary to promote healthy habits such as physical activity, not smoking, maintaining a healthy diet, avoiding excess alcohol and one of the most important, properly controlling blood pressure.
The Shaio Clinic is an advanced center and internationally certified by the WSO, and one of the first in the country in the treatment of stroke. We have an ACV team (Stroke Team) highly specialized, with great experience in the management of this disease.
This article had the advice of Dr. Javier Torres Zafra, neurologist and thematic leader of the Centre of Excellency Advanced with ACV from the Shaio Clinic.
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