May is Stroke Awareness Month, so we would like to share with you some knowledge about Stroke, how it can be identified, and what immediate steps need to be taken with the onset of warning signs. By the time you finish this article, on average, seven to 10 people will have suffered a stroke in the US alone (about one every 40 seconds). If one happens to you or someone around you, will you know what to do?
There are essentially two types of Stroke. The first occurs when the brain is deprived of oxygen, even if for a few minutes, needed to function due to a clot blocking blood flow in a vein or artery; this is an ischemic stroke (IS). The second type results from a burst vein leading to a part of the brain, or damage to the meninges, which is the membrane around the brain, causing it to become hemorrhaged; this being a hemorrhagic stroke (HS).
Ischemic stroke (IS)
Ischemic stroke is more frequent than the hemorrhagic type with straightforward, easily recognizable symptoms. The most common are:
• Paralysis or numbness of one side of the body, face, or limbs.
• Aphasia; the inability to verbally express oneself as well as understand others.
Testing (F.A.ST.: Face, Arm, Speech, Time):
One mnemonic you should learn to check if someone if having a stroke is FAST. Ask the person you believe may be having a stroke to:
- FACE: Ask them to smile. If one side of the face appears to droop it may be a sign of stroke,
- ARMS: Ask to lift both arms above their head. Strokes will cause weakness or numbness in the limbs making this difficult.
- SPEECH: Ask them to repeat a simple sentence, like: “We had a good day.” Is the speech is slurred, unintelligible or hard for them to get out?
- TIME: Call emergency services. If the person has difficulties completing any of the tasks listed above, call an ambulance (112 in Hungary).
If the person has difficulties completing any of the tasks listed above, call an ambulance (112 in Hungary). If the symptoms subside only to return it may be signs of a transient ischemic attack (TIA). Don’t wait, call an ambulance. There are a few other warnings to watch out for: a sudden severe headache with no cause; sudden trouble walking; dizziness; loss of balance or coordination; Trouble seeing out of either one or both of eyes.
• Lifestyle diseases. Diabetes, obesity, high blood pressure, cholesterol problems, sedentary lifestyle, smoking, unhealthy diet, and excessive alcohol consumption may all contribute to a greater stroke risk.
• Age. Although stroke may occur in all ages it is much higher in advanced ages.
• Gender. Stroke appears 25% more frequently among men than women. Unfortunately this leads many women to not recognizing symptoms of a stroke or unique signs for females.
• Other hereditary risk factors, like acute blood clotting diseases, or multiple family members with known cerebral aneurysms or subarachnoid bleeding issues. Often adults can be screened for some of these risk factors.
The goal of treatment is eliminating the clot from the vein so oxygen carried in the blood can return to the brain ASAP. There are two ways to do it. The first is thrombectomy, during which medical professionals try to remove the clot mechanically with the help of a catheter. Outside of the National Center of Neurosurgery there are few places in Hungary where this can be performed. The other procedure it is called thrombolysis, where attempts are made to dissolve the clot.
Unfortunately thrombolysis can only be performed on adults. While most have about four or five hours to find treatment after first experiencing symptoms, diabetics and those over 80 years have roughly three hours to begin. During this time patients needs to:
• Get to a hospital,
• be diagnosed,
• be given a cranial CT,
• have lab tests analyzed,
• have vital parameters taken,
• check potential contraindications,
• have infusions given.
The earlier the interventions begin the greater area of the brain that can be saved, decreasing the damage caused by bleeding. Stroke victims must get to the hospital as soon as possible to minimize damage to the brain. That’s why it is important to recognize symptoms and know what to do when they are observed.
Hemorrhagic stroke (H.S)
Hemorrhagic stroke is the condition where the brain, or the membrane surrounding the brain, suffer from direct hemorrhage caused by:
• extremely high blood pressure, or
• a perforation of a cerebral aneurysm (vascular protrusion), or
Risk factors (in addition to those listed at IS):
• High blood pressure.
• Aneurism – hereditary.
• Anticoagulant use among the elderly. As they tend to fall and become injured easily, there is a much greater risk of hemorrhage. A potential headache, confusion, slowness following a fall are signs to look out for as well.
In addition to those mentioned for IS, symptoms may include; severe headache; nausea and vomiting; a stiff feeling in the neck; an inability to tolerate light; and loss of consciousness.
Sometimes a hemorrhage can be removed but for some, the extensive or poorly situated ones, they are better left alone to become absorbed into the body.
Prevention of both types of stroke
Some lifestyle tips to help you reduce your risk of stroke.
- Maintain a healthy lifestyle by:
- keeping a Mediterranean diet,
- not smoking,
- moderating consumption of alcohol,
- exercising at least three times a week for a total of 60 minutes per week.
- Stabilize high blood pressure and diabetes.
- Maintain regular medical checkups, especially for those with high risk factors.
There is a lot you can do to help prevent and help recognize the onset of a stroke especially by following the guidelines above. It is advisable for everybody above 40 to partake in regular annual medical checkups. Speaking with a medical professional may help identify risk factors and prepare you if you are at a great risk of stroke. Don’t hesitate, make an appointment today if you have not had your annual checkup yet.
This article first appeared in our May, 2015 Newsletter.
Mei ni Mwezi wa Ujuzi wa Stroke, kwa hivyo tungependa kushiriki na wewe maarifa kadhaa juu ya Stroke, jinsi inavyoweza kutambuliwa, na ni hatua gani za haraka zinahitaji kuchukuliwa na mwanzo wa ishara za onyo. Wakati unapoimaliza makala hii, kwa wastani, watu saba hadi kumi watakuwa wamepatwa na kiharusi nchini Marekani pekee (karibu mtu mmoja kila sekunde 40). Ikiwa jambo kama hilo litakupata wewe au mtu mwingine, utajua nini cha kufanya? Kimsingi kuna aina mbili za kiharusi. Ugonjwa wa kwanza hutokea wakati ubongo unapokosa oksijeni, hata kwa dakika chache, inayohitajika kufanya kazi kwa sababu ya kuganda kwa damu kuzuia mtiririko wa damu katika mshipa au mshipa; hii ni kiharusi cha ischemic (IS). Aina ya pili ni kutokana na kuvunjika kwa mshipa wa damu unaoongoza kwenye sehemu fulani ya ubongo, au uharibifu wa utando wa ubongo, ambao ni utando unaozunguka ubongo, na kusababisha damu kutiririka; hii ni kiharusi cha kutiririka kwa damu (HS). Ischemic stroke (IS) ni ugonjwa wa kawaida wa damu ambayo huathiri watu wengi na ina dalili rahisi za kugundua. Matatizo ya kawaida ni: • Kupooza au kutoweza kusikia upande mmoja wa mwili, uso, au viungo. • Aphasia; kutoweza kujieleza kwa maneno na pia kuelewa wengine. Majaribio (F.A.ST. "Kama vile ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji"" au ""mwenyeji""" Mwambie mtu unayeamini anaweza kuwa na kiharusi: - Uso: Mwambie tabasamu. Ikiwa upande mmoja wa uso unaonekana kuanguka, inaweza kuwa ishara ya kiharusi, - VYAMBA: Omba kuinua mikono yote miwili juu ya kichwa chao. Mshtuko wa akili utasababisha udhaifu au kutokuwa na hisia katika viungo na kufanya hilo liwe gumu. - SHAHIDI: Waulize warudie sentensi rahisi, kama: <unk>Tulikuwa na siku nzuri.<unk> Je, hotuba ni blurred, incomprehensible au vigumu kwa ajili yao kupata nje? - Weka simu kwa huduma za dharura. Ikiwa una matatizo ya kukamilisha kazi yoyote iliyoorodheshwa hapo juu, piga simu ya ambulansi (Hongaria 112). Ikiwa una matatizo ya kukamilisha kazi yoyote iliyoorodheshwa hapo juu, piga simu ya ambulansi (Hongaria 112). Ikiwa dalili zinapungua tu kurudi, inaweza kuwa ishara ya shambulio la ischemic la muda mfupi (TIA). Usisubiri, piga simu ya wagonjwa. Kuna baadhi ya dalili za kuumiza kichwa bila sababu; matatizo ya kutembea; kizunguzungu; kupoteza usawaziko; matatizo ya kuona kwa jicho moja au zote mbili. • Magonjwa ya mtindo wa maisha. Ugonjwa wa kisukari, unene wa mwili, shinikizo la damu la juu, matatizo ya kolesteroli, mtindo wa maisha usio na shughuli nyingi, kuvuta sigara, kula vyakula visivyo na afya, na kunywa kileo kupita kiasi, yote yanaweza kuongeza hatari ya kiharusi. • Umri. Ingawa kiharusi chaweza kutokea katika umri wote ni cha juu zaidi katika umri wa hali ya juu. • Jinsia. Ugonjwa wa kiharusi hufanyika mara 25 zaidi kwa wanaume kuliko wanawake. Kwa bahati mbaya, hii inaongoza wanawake wengi kutotambua dalili za kiharusi au ishara za kipekee kwa wanawake. • Vipengele vingine vya hatari ya urithi, kama vile magonjwa makali ya kuganda kwa damu, au washiriki wengi wa familia na aneurysms ya ubongo inayojulikana au masuala ya kutokwa na damu ya subarachnoid. Mara nyingi watu wazima wanaweza kuchunguzwa kwa ajili ya baadhi ya mambo hayo ya hatari. Lengo la matibabu ni kuondoa kuganda kutoka kwenye mshipa ili oksijeni inayobebwa katika damu iweze kurudi kwenye ubongo haraka iwezekanavyo. Kuna njia mbili za kufanya hivyo. Njia ya kwanza ni thrombectomy, ambayo wataalamu wa kitiba hujaribu kuondoa damu kwa njia ya mashine kwa kutumia catheter. Nje ya Kituo cha Kitaifa cha Upasuaji wa neva kuna maeneo machache nchini Hungaria ambapo hii inaweza kufanywa. Utaratibu mwingine unaitwa thrombolysis, ambapo majaribio hufanywa ili kufuta damu. Kwa kusikitisha thrombolysis inaweza tu kufanyika juu ya watu wazima. Ingawa watu wengi wana masaa manne au matano ya kupata matibabu baada ya kuonekana dalili za ugonjwa huo, wagonjwa wa kisukari na wale wenye umri wa miaka zaidi ya 80 wana masaa matatu tu ya kuanza. Katika kipindi hiki, wagonjwa wanapaswa: • Kufikia hospitali, • Kupatikana, • Kupatiwa CT ya fuvu la kichwa, • Kupimwa kwa vipimo vya maabara, • Kupimwa kwa vipimo muhimu, • Kuchunguza uwezekano wa contraindications, • Kupatiwa infusion. Kadiri upasuaji unavyoanza mapema, ndivyo eneo kubwa la ubongo linavyoweza kuokolewa, na hivyo kupunguza uharibifu unaosababishwa na kutokwa na damu. Waathiriwa wa kiharusi wanapaswa kupelekwa hospitalini haraka iwezekanavyo ili kupunguza uharibifu wa ubongo. Hiyo ndiyo sababu ni muhimu kutambua dalili na kujua nini cha kufanya wakati wao ni kuchunguzwa. Ugonjwa wa mshipa wa damu (Hemorrhagic stroke) ni hali ambapo ubongo, au utando unaozunguka ubongo, unateseka kutokana na damu ya moja kwa moja inayosababishwa na: shinikizo la damu la juu sana, au perforation ya aneurysm ya ubongo (kuinuka kwa mishipa), au sababu za hatari (zaidi ya zile zilizoorodheshwa katika IS). • Aneurism <unk> urithi. • Matumizi ya dawa za kuzuia kuganda kwa damu miongoni mwa wazee. Kwa kuwa wao huanguka na kujeruhiwa kwa urahisi, kuna hatari kubwa zaidi ya kutokwa na damu. Ugonjwa wa kichwa unaoweza kutokea, kuchanganyikiwa, na kupunguza mwendo baada ya kuanguka ni ishara ambazo unapaswa kuzitazama pia. Kwa kuongezea zile zilizotajwa kwa IS, dalili zinaweza kujumuisha; maumivu makali ya kichwa; kichefuchefu na kutapika; hisia ya kugonga shingo; kutoweza kuvumilia mwanga; na kupoteza fahamu. Wakati mwingine damu inaweza kuondolewa, lakini kwa baadhi ya watu, ambayo ni kubwa au ni mbaya, ni bora kuachwa peke yake ili kuingizwa ndani ya mwili. Kuepuka aina zote mbili za kiharusi Baadhi ya vidokezo vya mtindo wa maisha vinavyokusaidia kupunguza hatari ya kiharusi. - Kuendeleza mtindo wa maisha wa afya kwa: - kudumisha mlo wa Mediterania, - kutokuwa na uvutaji sigara, - kupunguza matumizi ya pombe, - kufanya mazoezi angalau mara tatu kwa wiki kwa jumla ya dakika 60 kwa wiki. - Kudumisha shinikizo la juu la damu na kisukari. - Fanya uchunguzi wa kawaida wa kitiba, hasa kwa wale walio na mambo ya hatari. Kuna mengi unaweza kufanya ili kusaidia kuzuia na kusaidia kutambua mwanzo wa kiharusi hasa kwa kufuata miongozo hapo juu. Kwa wale wenye umri wa miaka 40 na zaidi, ni muhimu kufanya uchunguzi wa matibabu kila mwaka. Kuzungumza na daktari wa kawaida kunaweza kukusaidia kutambua sababu za hatari na kukuandaa ikiwa una hatari kubwa ya kupatwa na kiharusi. Usisite, fanya miadi leo ikiwa bado hujafanya uchunguzi wako wa kila mwaka. Makala hii ilichapishwa kwa mara ya kwanza katika jarida la May 2015 Newsletter.