In the world, 17 million people have a stroke a year and 6 million people die from stroke. The risk of stroke, which usually manifests as a sudden loss of strength in the face, arm, leg or one half of the body, decreases by 60 percent with lifestyle changes. Health Sciences University Antalya Training and Research Hospital (SBÜAEAH) Neurology Clinic Specialist Dr. Elif Sarıönder Gencer shared important information on the occasion of May 10, World Stroke Prevention Day.
Stroke or cerebrovascular accident is a combination of signs and symptoms that arise due to narrowing or complete obstruction of the brain vessels. Symptoms are usually in the form of sudden loss of strength in the face, arms, legs, or often in one half of the body. Apart from these, numbness in the same areas, fainting, confusion, difficulty speaking or understanding speech, severe headache of unknown cause, dizziness, inability to balance, loss of vision in one or both eyes, complete loss of consciousness can be seen. Stroke symptoms depend on which part of the brain the event affects and its severity. Even if the symptoms are not very severe, it is very important to think about stroke and to go to the center where treatment can be done quickly.
The risk of getting the disease increases with age. In addition to genetic and familial characteristics, problems such as hypertension, diabetes and heart diseases, high blood fats, and sleep disorders increase the risk of stroke.
Men are more likely than women to have a stroke
Risk factors in stroke are almost the same as cardiovascular disease risk factors. Risk factors that we cannot control; stating that it is age, family history and gender Health Sciences University Antalya Training and Research Hospital (SBÜAEAH) Neurology Clinic Specialist Dr. Elif Sarionder Gencer He said: “Men are slightly more likely to have a stroke than women. Another group; It is the presence of chronic diseases such as high blood pressure, high cholesterol, diabetes, and heart disease. This group can be controlled by arranging the necessary treatments. Finally, unhealthy lifestyle habits are important risk factors for stroke. We know that the risk of stroke can be significantly reduced with the right steps to be taken in physical activity, especially with nutrition, smoking and alcohol use. "
Strokes experienced by patients with atrial fibrillation are more severe
Exp. Dr. Elif Sarionder Gencer: “Stroke, which is a serious public health problem, has an important relationship with heart diseases. The clot that blocks the brain vessels in one out of every 5 stroke patients comes from the heart. Arrhythmia called atryial fibrillation is the most important cause of clot formation in the heart. Arrhythmia is seen with a frequency of 1-2 percent in the society. The incidence of this rate increases significantly as the age progresses. 100 out of every 5 patients with arrhythmia experience a stroke within a year. Strokes experienced by patients with atrial fibrillation are more severe and fatal, and their recurrence risk is also higher.
First of all, determining patients with atrial fibrillation is very important for prevention of stroke. The presence of arrhythmia and its effects on the heart must be examined in a person who has had a stroke. In patients with stroke, this rhythm disturbance can often be detected with a simple cardiac electrocardiography (ECG), but sometimes these rhythm disturbances can be seen intermittently. A normal ECG does not indicate that there is no arrhythmia. Therefore, even if the ECG is normal in patients with stroke, the heart rhythm of 24 hours and in some suspicious cases should be followed with a device called rhythm holter ”.
Stroke is still one of the threeok crippled bırakan illnessık
Stroke is still the most disabling disease in the world. The severity of the stroke symptoms depends on the location and size of the affected area. Exp. Dr. Elif Sarionder GencerHe added: “Weakness in arms and legs, impairment in speech and understanding skills at varying degrees can make the patient dependent on someone else for many activities in his daily life. When large vascular occlusions, which are responsible for 20-25 percent of strokes, are not treated, almost all patients may fall into severe disability. When limitation in physical activity, consciousness and nutritional disorders occur, the management of diseases such as hypertension, diabetes, high blood fats and cholesterol may become difficult. Pneumonia, urinary tract infection, bed wound, venous obstruction, bleeding that may occur due to the drugs used in the treatment of stroke, especially in patients with severe stroke, can cause serious problems that can be life-threatening in the first months. It is possible to minimize all the problems that may arise in the early and late periods after the onset of stroke, firstly by early intervention, and secondly, by using care and rehabilitation strategies specific to stroke at the highest level. "
Stroke requires prompt treatment
Exp. Dr. Elif Sarionder Gencer: “Stroke is a picture of cerebrovascular diseases that occurs suddenly and requires very rapid treatment. The most important factor in the treatment of stroke is rapid access to treatment, which we express as "time is the brain". For this reason, the patient who is thought to have had a stroke should be taken to a hospital where a neurologist works and a stroke unit, ideally a stroke center, by ambulance, if possible, and it should be ensured that they reach effective treatment as soon as possible. In strokes due to a blockage caused by the clot, the vein can be opened by using anticoagulant drugs in the first hours. The success rate is very high with clot-dissolving treatment given through a vein in the first 4,5 hours. In eligible patients, the occluded vein can be entered through the artery to mechanically remove the clot, or if there is a stenosis in the vein, the balloon at the end of the catheter can be inflated to expand the stenosis. If necessary, the vessel can be opened by applying a stent to the stenosis area in the artery.
Even if treated correctly in the early period, it may take up to 3 months for symptoms or stroke to improve in stroke patients. "Any disruption (pneumonia and urinary tract infections, irregular blood sugar, nutritional deficiencies, consciousness and sleep problems, bed sores) that may arise in a situation requiring long-term treatment, care and rehabilitation delays the healing process and reduces the amount of recovery,” he said.
Many people who suffer from stroke as a result of their rehabilitation plan gain the ability to take care of themselves. Exp. Dr. Elif Sarionder Gencer He continued as follows: “Since 3-4 percent of patients who have a stroke are at high risk of experiencing a second stroke later, they should stick to their treatment and in addition to lifestyle changes such as a balanced diet, physical activity, restricting alcohol intake and not smoking to avoid such a situation again. As a result, chronic diseases such as high blood pressure, high cholesterol, diabetes or heart disease should be controlled and treated. Especially in patients with stroke due to atrial fibrillation, the drugs recommended by the physician should be used at an appropriate dose and frequency, and skipping doses should be avoided for any reason.
Stroke risk decreases by 60 percent with lifestyle change
Expert Dr. Elif Sarionder Gencer: “In terms of public health, as in the approach to epidemic diseases in today's conditions, it also requires strong forward-looking strategies to protect healthy and at-risk society as well as patients with cerebrovascular disease. It has been proven that enlightening stroke patients about lifestyle changes that will reduce risk factors and that all organs of the society prepare and maintain the appropriate environment in this regard are as effective as drug therapies. To prevent cerebrovascular diseases:
- Tobacco and alcohol use should be avoided
- At least 30 minutes of physical activity a day
- Fat, sugar and salt should be reduced in the diet
- 5 meals a day of vegetables and fruits should be consumed
- In addition, blood pressure, blood lipids, blood sugar and weight should be learned in consultation with the doctor, and the doctor's recommendations should be followed.
Studies show that; If only lifestyle changes are made, the risk of stroke is reduced by 60 percent. "If 100 people are going to have a stroke, we will save 60 people," he said.
Blood thinners should be used carefully under the direction of the physician.
In patients with stroke, after determining the source of the clot coming to the brain, blood thinners are used to prevent a secondary clot from forming. The use of drugs called blood thinners oral anticoagulants used in patients with rhythm disorders should be planned specifically for the person. Exp. Dr. Elif Sarionder Gencer He added: “The risk of a new clot formation must be determined in these patients. The risk of these drugs to cause bleeding in the brain or body must also be taken into account. The risk of bleeding due to blood thinners in patients at risk of stroke and the possibility of new vascular occlusion that may occur with inadequate drug use are the two important conditions that worry the patients the most. As soon as the protection of blood thinners is removed without consulting a doctor to reduce bleeding before some surgical procedures or dental treatment, the number of patients who have had a stroke is not underestimated. Combinations of blood thinners used unconsciously or their high doses can also cause serious bleeding and pose a danger to the patient. As a result, blood thinners should be administered to every patient at risk of stroke as recommended by their physician, and the controls required for drug dose adjustment should not be neglected.
These recommendations reduce risk factors for both COVID-19 and stroke.
Expert Dr. Elif Sarionder Gencer: “The reports reported during the COVID-19 epidemic, which has been in a serious health problem all over the world in recent months and is considered a pandemic, reveal that the disease affects not only the respiratory tract but also the neurological systems. Neurological findings have been reported in approximately one third of the patients. The most common symptoms reported in the current situation are smell and taste disturbance, but the most important factors that increase the need for intensive care and determine the outcome of the patient in intensive care are the risk factors of cerebrovascular disease that the patient has. In addition, COVID-19 infection can cause stroke by affecting both the direct neurological structures of the virus, blood coagulation properties and vascular structure. The presence of age, hypertension, diabetes, obesity, and heart diseases can not only increase stroke rates in these cases, but also determine whether patients can fight infection more successfully. Smoking also increases the risk factor of stroke and makes recovery difficult in case of COVID-19 infection, just like existing chronic diseases. "
During the pandemic process, we must first stay healthy. We should be able to manage our risk factors well, eliminate risk factors, have them treated, adopt and maintain a lifestyle that protects from risk factors. Exp. Dr. Elif Sarionder Gencer“This is a pandemic after all and the possibility of COVID-19 transmission is extremely high; However, we are not losing everyone who is infected with COVID-19, or not everyone is suffering from the disease severely. You can get a virus, but we can get around it very lightly. It has been understood in recent months that even if people are old, if their hypertension is under control, if their weight is under control, if their weight is under control, if they do moderate activity (walking) for 30 minutes a day or exercise 5 days a week, if they consume 5 meals a day of vegetables and fruits, If he has adopted a diet, is receiving treatment for cardiac arrhythmia and is regularly checked, if his diabetes is in a controlled manner and follows his diet, if he has quit smoking and alcohol, then he may be much stronger against COVID-19. Then, even if COVID-19 is transmitted, we will be more successful in this fight. These recommendations reduce risk factors against both COVID-19 and stroke, ”he said.