Stroke (stroke): how to identify and treat

Stroke, also called stroke, and popularly known as stroke, is the sudden interruption of blood flow to some region of the brain, which causes symptoms such as paralysis of the body part, difficulty to speak, fainting, dizziness and headache, depending on the affected area.

This stroke can be of the ischemic type, which is more common and happens when there is loss of blood flow by a clot, for example, or of the hemorrhagic type, when a vessel ruptures and causes bleeding inside the brain or in the meninges, which are the films that surround the brain.

Both conditions must be treated urgently and can leave sequelae, such as difficulties in movement or communication. Thus, the ideal is to prevent the onset of stroke, which can be done with healthy lifestyle habits, balanced diet, physical activity and the correct treatment of diseases that can trigger this situation, such as high blood pressure, cholesterol or triglycerides. and diabetes, for example.

Main symptoms

Stroke symptoms appear suddenly, and sometimes, the person may even wake up with them. The main ones are:

• Weakness or difficulty in moving a limb, one side of the body or face; Loss of sensation in some region of the body; Difficulty speaking or eating; Blurred vision or partial loss of vision; Dizziness or imbalance; Loss of consciousness or fainting.

The appearance site, the amount and intensity of the symptoms can vary according to the region of the brain corresponding to the affected blood vessel and the amount of blood flow interrupted.

In the presence of any sign or symptom of a stroke, it is important to call SAMU 192 as soon as possible, so that first aid is carried out and treatment is started correctly in the emergency room.

How to treat

The treatment of a stroke must be done as soon as possible, because the faster the blood flow to the brain improves, the greater the chance of recovery from the clinical condition, as well as the less likely it is to have sequelae, such as paralysis of a region of the body, difficulties in walking, speaking or eating, alterations in memory or cognition, and fecal or urinary incontinence, for example.

Confirmation of the diagnosis and type of stroke are confirmed by a computed tomography scan of the skull or magnetic resonance imaging, to then start treatment.

1. Ischemic stroke

The treatment of ischemic stroke is done in order to try to re-establish the blood flow to the brain, in order to control the affected area and make recovery easier. The options are:

• Use of medicines: antihypertensive drugs, such as Captopril, are used to reduce blood pressure if it is high, anti-platelet aggregators, such as AAS and Clopidogrel, to decrease the formation of clots and thrombi in the brain, and cholesterol-lowering agents, such as Atorvastatin; Thrombolysis: it is done with a potent anticoagulant called rt-PA, capable of undoing the thrombus or clot in the vessel and allowing blood flow in the affected region and reducing the number of sequelae. This treatment must be done within the first 4 hours after the onset of symptoms; Cerebral catheterization: it is an alternative to the performance of thrombolysis, existing in some neurology centers, made with the insertion of a flexible tube that goes from the groin artery to the brain to try to remove the clot or to inject anticoagulant drugs on the spot; Clearance of the carotid artery: it is done in cases where the obstruction of the blood flow happens in the carotid artery, an important vessel that carries a large amount of blood to the brain, and this procedure serves both to diminish the effects and to prevent a new cerebral effusion; Cerebral decompression surgery: it is only indicated in some cases of a very large stroke or that caused the large swelling in the brain, being necessary to do a procedure that opens the skull for a period, until the swelling decreases causing less damage to the person's brain.

The sooner stroke treatment is started, the easier the person will recover and the greater the chance of having less sequelae.

2. Hemorrhagic stroke

The treatment of hemorrhagic stroke is intended to try to decrease bleeding and reduce the affected area. Thus, an antihypertensive agent is generally used if blood pressure is too high, as in cases such as pressure of 220 x 120 mmHg, to decrease the bleeding size without compromising blood flow to the rest of the brain.

Most of the time, the hemorrhage is absorbed by the body's own cells, but in larger bleeds, brain decompression surgery may also be necessary to reduce swelling.

It is also very important to treat the cause of bleeding, which can be an aneurysm, a malformation of blood vessels or a blow to the head, for example, so, after stabilizing the person's clinical condition, it is possible to investigate the characteristic of the cerebral vessels, through exams such as angiography, and schedule a surgical correction procedure.

See more details on how the treatment, recovery and rehabilitation of each type of stroke was done.

What causes stroke

Ischemic stroke, which is the most common type of brain stroke, happens when there is an impediment of blood flow in the brain, which can be due to accumulations of fatty plaques inside the vessel, by the impaction of a clot or even by a decrease blood flow due to changes in the body's circulation.

This type of stroke is very common in people who have diseases such as obesity, high blood pressure, diabetes, cholesterol and increased triglycerides and who are not receiving the correct treatment, and also in people who have cardiac arrhythmias.

Hemorrhagic stroke, on the other hand, happens when a blood vessel ruptures and causes bleeding inside the brain or in the meninges, films that surround the brain. Bleeding from this type of stroke can happen in situations such as very high blood pressure, an aneurysm rupture, brain trauma due to an accident, use of anticoagulant drugs, use of illicit drugs, brain tumor or diseases that alter blood clotting, due to changes autoimmune, liver or blood, for example.

What to do to avoid

Ischemic stroke can be prevented by controlling risk factors such as weight reduction, a diet rich in vegetables and low in salt, fat and sugars, physical activity, quitting smoking, in addition to the correct treatment of diseases that can trigger this situation, such as pressure, cholesterol, triglycerides and glycemia, for example, following the doctor's instructions. See our tips for preventing cardiovascular diseases like heart attack and stroke.

Hemorrhagic stroke can also be prevented with these attitudes, however, it is important to investigate other possible causes, such as the presence of an aneurysm or malformations of brain vessels, which can be causes of frequent headaches and dizziness, blood clotting diseases and, in addition, if anticoagulant drugs are used, it is important to follow up with the doctor with blood tests and returns to reassess the doses.