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Dr. Konstantinos Spegos, Neurologist, Director of the 2nd Neurological Clinic of HYGEIA and Head of the Department of Multiple Sclerosis & Demyelination Diseases of HYGEIA
THE sudden speech disorder and the joint are two typical symptoms of a stroke.
The distortion of the mouth and face also indicate a severe brain injury. Sudden muscle weakness in the arm or leg with difficulty standing and walking, numbness or loss of sensation in half of the body, sudden dizziness, nausea and unsteadiness, impaired vision and in some cases sudden and extremely severe headache are additional symptoms that may signal the establishment of an ischemic or hemorrhagic stroke.
What is the first step we take if we suspect a stroke?
The only correct response is immediate and without any delay transfer of the patient to the nearest appropriately staffed and equipped hospital, which ensures rapid diagnostic investigation and therapeutic intervention.
We don’t blindly give any medicine and we don’t waste time waiting to see the progression of symptoms, hoping for improvement. We do not wait for a doctor to visit the patient. We call the EMS and, if there is any delay, we take the patient to the hospital, so that precious time is not lost.
Any stroke should be treated as an emergency, as happens for example in cases of myocardial infarction.
Is there an effective treatment for strokes?
THE thrombolysis with the intravenous administration of Alteplase has been the most widespread treatment of acute ischemic stroke for two decades. It is estimated that more than 30% of patients can be treated this way with good prospects of recovery. Therapeutic options have clearly improved with the introduction of mechanical thrombectomy in stroke patients due to acute occlusion of large cerebral arteries. The method shows excellent efficiency and affects more than 10% of all patients. Yes, O combination of intravenous thrombolysis with subsequent thrombectomy seems to have even better results.
Patients with acute stroke should be hospitalized for at least a few days under conditions of increased care in appropriately staffed Units. In this way, complications are avoided or treated immediately, improving the clinical outcome of patients and shortening the overall length of their hospital stay.
What factor affects the effectiveness of treatment?
THE determinant for the outcome of each stroke case is o time that elapses from the onset of symptoms to the initiation of the appropriate therapeutic intervention. For intravenous thrombolysis, the safe time window is up to 4.5 hours. Indication for mechanical thrombectomy exists within 6 hours of the onset of stroke due to occlusion of a large cerebral artery. Under strict conditions and in a small number of patients, mechanical thrombectomy may be attempted up to 24 hours after the onset of symptoms. In general, however, the rule “the sooner the better” applies.
Can we prevent stroke?
As important as the correct and early recognition of the symptoms of a stroke and the fastest possible therapeutic intervention are, prevention is just as important and perhaps more important!
THE monitoring and regulation of blood pressure, control of sugar and cholesterol levels, smoking cessation, regular physical exercise and weight reduction are the most important steps in this direction. Detection of atrial fibrillation in the elderly and appropriate anticoagulation can also prevent serious strokes. THE Obstructive Sleep Apnea is an additional aggravating risk factor that should be controlled.
In any case, regular medical monitoring and consistent taking of the appropriate medication are absolutely necessary. Correct communication and cooperation between patient and doctor are the guarantee for the best possible prevention.