Stroke: How to recognize it. Causes, symptoms, treatments, and prevention.

Cerebral stroke It is caused by the sudden closure, or even complete rupture, of a cerebral vessel, resulting in cell damage caused by a vital lack of oxygen and nutrients delivered by the blood. In this case, we speak of ischemia. When the cell damage is caused by compression caused by blood leaking from the vessel, it is called a cerebral hemorrhage.

Index of topics

Who strikes in Italy

For women, it is significantly more serious, as it affects the left hemisphere, in the back of the brain: in Italy, there are 200 cases of stroke each year. And one in five women is at risk of suffering a stroke in her lifetime, with risks increasing after age 65. Although 80 percent of stroke survivors survive, approximately 50 of them lose their independence. Two-thirds of strokes affect people over 65, and only 6 to 8 percent of new cases occur in men and women under 55.

Types of stroke

The brain damage caused by a stroke can vary, and for this reason two forms of stroke are classified.

Ischemic stroke in the case of obstruction of a cerebral artery. The obstruction, in turn, is caused by a thrombus or embolus.
Hemorrhagic stroke when one of the vessels ruptures and causes blood loss. In effect, it's a burst artery.

Symptoms

Unfortunately, there aren't many warning signs that alert us to the risk of stroke. However, five are crucial. Weakness or numbness in the face, a leg or arm, or one side of the body. This weakness is accompanied by intense tingling. Then there's the sudden inability to express oneself or understand who is speaking. Darkening or loss of vision in one eye. A feeling of dizziness and/or vertigo. A severe, unexplained headache. A throbbing headache, in a person who doesn't usually have these types of problems, combined with mental clouding, is a symptom that shouldn't be underestimated and requires immediate intervention to prevent the development of a hemorrhagic stroke.

Symptoms sometimes appear for a few minutes and then disappear. In these cases, the diagnosis is transient ischemic attacks (TIAs), which are unmistakable signs that can lead to a full-blown stroke. Hence, an urgent visit to a specialist is necessary.

Other symptoms of stroke that should absolutely not be underestimated are:

Difficulty speaking correctly
Difficulty seeing or blurred vision in one or both eyes
Numbness, numbness, or tingling: Usually one hand becomes weaker than the other
High headache without a known cause, different from usual
Face, even partially, paralyzed and mouth deviated
Lack of strength and sensation on one side of the body
Alteration of balance
Standing and walking problems
Confusional state

The time factor

Given the symptoms described, time is a crucial factor. In fact, stroke is defined as a "time-dependent" disease: for every second of delay in intervention, 32 neurons are burned, and for every minute, up to 1,9 million neurons are lost. Furthermore, the earlier the intervention, the better the results achieved with thrombolysis and mechanical thrombectomy.

Cause

The main causes of stroke are almost all attributable to lifestyle errors.

Cholesterol too high. For obvious reasons, which we've already discussed, high cholesterol is undoubtedly one of the most significant risk factors. Lowering cholesterol may even require a few natural remedies, as part of a healthy diet and physical activity. The correct cholesterol levels are well known; consult your doctor to achieve them and thus prevent the formation of arterial plaque.
Too much alcohol. Avoiding excessive alcohol consumption is a good form of stroke prevention for three reasons. Excess alcohol contributes to high blood pressure, promotes weight gain, and damages liver function. It also increases the risk of atrial fibrillation. Avoiding excessive alcohol consumption means avoiding strong alcoholic beverages, consuming them only in exceptional circumstances, and getting by with a couple of glasses of wine (preferably red) a day. That's a lot.
An enemy called stress.Combating stress is also a good preventative measure against strokes. Excessive stress can lead to heart attacks and strokes, and stressed people tend to avoid exercise or a healthy diet. Have you seen the news stories of drivers dying of heart attacks or strokes after a traffic collision? They're a snapshot of the risk of stress.
Care not respected. In some cases, and only with the advice of your doctor, it becomes essential to take certain medications to lower cholesterol or blood pressure, or both. These treatments should never be stopped unless your doctor prescribes them.
Ipertension, obesity, atrial fibrillation, smoking.
Abnormalities in the cerebral blood vesselsConditions such as arteriovenous malformations (AVMs) or brain aneurysms (abnormal dilations of an artery) can rupture, causing bleeding.
Coagulation disorders: Conditions that affect the blood's ability to clot properly, such as hemophilia or the use of blood thinners, can increase the risk of brain hemorrhages.
Head traumaA blow to the head or an accident that causes damage to the blood vessels in the brain can lead to a hemorrhagic stroke.

Who treats strokes?

The doctor who manages strokes, from diagnosis to treatment and prevention, is the neurologist. He or she may request the involvement of other specialists to support the treatment. A typical example is the physiotherapist, who intervenes when the patient needs to regain movement and speech.

Tests to be done

The tests to be done to reduce the risk of stroke are:

Pressure controlThere are no specific tests to prevent strokes. But one check, which is very simple, is blood pressure. In particular, high blood pressure must be brought back to normal levels and is the most dangerous with respect to stroke risk, but even too low blood pressure is certainly not reassuring. The optimal values are 130 millimeters of mercury for the highest blood pressure and 80 for the lowest blood pressure. In case of significant and constant deviations, consult your doctor (do not take home blood pressure medications) and he will give you the right advice. A second very simple test, which you can have at your local pharmacy, is for atrial fibrillation: several studies have shown that 20 percent of ischemic strokes are due to this cardiac arrhythmia, which, unfortunately, is almost always asymptomatic. Finally, glycemia: you can check it once a year, as if the value is too high it could indicate a warning sign of diabetes risk.
Type 2 diabetes. This type of diabetes is linked to hyperglycemia, which occurs as a result of the body's resistance to insulin. Type 2 diabetes is linked to an unhealthy diet, excessive body weight, and lack of physical activity: all factors that, when combined with the specific disease, exponentially increase the risk of stroke.
Weight under control. You don't have to become obese to increase your risk of cardiovascular disease. Simply being overweight for a prolonged period is more than enough. Risks increase as your body mass index increases, which should be less than 94 centimeters for men and 80 centimeters for women.

Treatments and cures

In the event of a stroke, or signs of one, there's not a second to waste. An ambulance must be called to reach an emergency room as quickly as possible and the stroke victim must be taken to the nearest hospital, preferably one equipped with neurovascular units. In Italy, there are 225 such units capable of performing thrombolysis, a procedure to remove blood clots or emboli that block arteries or veins. Stroke centers are organized to minimize the time between the patient's arrival and the start of treatment. They also ensure 24-hour monitoring of the stroke victim's neurological status, allowing doctors to intervene promptly should further crises occur.

As for the first treatment, it involves the administration, within the first 4-5 hours after the stroke, of the thrombolytic drug which is used to dissolve the clot.

Prevention

But more than treatment, which depends on the severity of the disease and the patient's age, stroke prevention requires precautions—that is, self-defense we can take to avoid wasting our health, both on our own and with natural remedies. Despite many dangers, 30 percent of strokes could be avoided simply with good prevention, including lifestyle, diet, and a few medical measures. The most important preventive measures against stroke are:

Physical exerciseIt's not necessary to go to the gym every day, but what matters is regular exercise, which reduces cardiovascular disease mortality by 20 percent. And regular activity means 30 minutes a day, without any particular effort. This includes walking or climbing stairs.
Healthy nutritionThere's no perfect diet, but there are certainly healthier foods we can eat: among these are fruits, vegetables, white meat, and fish. It's neither tiring nor difficult to eat them regularly and ensure, for example, that our cholesterol levels are within acceptable limits. On the other hand, it's preferable to consume less than 5 grams of salt per day.
Zero cigarettes. There are no middle ground on this health waste front. Either you smoke, or you quit with the necessary determination. Knowing that any doctor will have all the evidence to confirm what science has irrevocably demonstrated: smoking promotes thrombosis and thrombotic phenomena. And therefore we can consider it one of the most negative factors in the risk of stroke.
Checks and tests. Checkups should be scheduled as recommended by a neurologist or other specialists, such as a cardiologist. And, if the doctors so recommend, specific tests such as color Doppler ultrasound of the neck vessels, transcranial Doppler ultrasound, and echocardiogram may be necessary.

rehabilitation

Once the life-threatening situation has been overcome and the stroke has been detected in time, the rehabilitation phase begins, lasting one to three months. Some people may continue afterward, especially to fully recover their speech. Rehabilitation generally involves motor skills, but also speech therapy and exercises that can help with swallowing correctly and easily.

How to recognize a stroke