Stroke (CVA) is a problem that worries a lot of people, and, above all, that generates many doubts. The main ones related to the exact symptoms of the accident and the possibility of preventing it from happening.
Lázaro Fernandes de Miranda, Cardiology Coordinator at Hospital Santa Lúcia, Brasilia, and Counselor of the Brazilian Society of Cardiology, explains that stroke or stroke is an acute neurological disorder characterized by loss of cognitive and / or motor neurological function due to clogging or rupturing blood vessels in some part of the brain.
Ricardo Campos, neurologist at Hospital Anchieta, points out that stroke is nothing more than the abrupt and complete suppression of blood nutrition in an intact brain area until this event occurs.
Miranda explains that stroke may occur due to ischemia (90% of cases) and hemorrhage (10% of cases). ? The older the individual, the higher the risk of stroke, slightly predominating among women, especially those hypertensive, obese and diabetic. Heart diseases, especially rheumatic valvulopathies, chagasic cardiomyopathy and cardiac arrhythmias such as fibrillation and / or atrial flutter, are the main risk groups ?, he says.
Campos points out that, in a general pedagogical context, it can be said that stroke is divided into ischemic and hemorrhagic. ? Ischemic stroke can result from dozens of causal possibilities, which characterizes subtypes. So, too, can hemorrhagic stroke result from several etiological factors, which promotes a numerous classification of manifestations ?, he says.
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Classifying strokes into subtypes also takes into account the topography or brain area involved. For a more clinical approach, we subdivide stroke types by etiology, topography and symptomatic expression ?, explains the neurologist.
Briefly, it can be said that ischemic stroke happens when a clot blocks the artery that carries blood to the brain; the hemorrhagic, when there is rupture of an intracranial artery.
It is undeniable that a stroke is often a very bad experience, both for the patient and for the family or people who live with it. Thus, it is very important to be aware of the signals that the body gives, precisely to prevent stroke from having more serious consequences.
The main symptoms of stroke
Symptoms of stroke are basically difficulty in walking, speaking or mental confusion, as well as weakness or unilateral paralysis of the face, arm or leg.
It is important to be aware of these stroke symptoms, even to be able to stay calm if the accident unfortunately strikes someone close to you; Also, to know exactly from now on it is essential to seek medical help.
Also read: 11 Habits That Can Avoid a Stroke
1. Headache
Miranda explains that sudden headache (headache) may occur, with the blurring of visual fields, sometimes with dizziness and vomiting.
Remember that there are several types of headache, such as migraine. Stroke-related headache, in this sense, differs in that it is sudden and without apparent cause, and is usually associated with other symptoms, such as difficulty walking or seeing, sudden mental confusion, dizziness, vomiting, or difficulty speak.
2. Changes in speech
Miranda explains that difficulty with speech or stumbling tongue may occur.
Aphasia, which is the patient's inability to name objects and things, is common. In some cases, the person cannot even repeat a word spoken by a family member. The speech can even be confusing because the patient can only say a few words and is unable to say others.
There may also be dysarthria, which is characterized by difficulty in articulating words. The patient understands everything but cannot move the speech muscles to correctly articulate the words. Or it can even name things, but it does so in a "coiled way", often incomprehensible to the listener.
3. Deviation of the lip commissure to one side of the face
Deviation of the mouth against the paralyzed side is a common and noticeable sign in stroke. For example, the patient has a left-sided facial paralysis; then, the mouth deviates to the right side and the labial commissure is more prominent to the right.
But it is noteworthy that, in some cases, facial paralysis is very discreet and may go unnoticed by family members.In such cases, the patient may be asked to smile or whistle; therefore, if there is paralysis, it will be easily noticed.
4. Weakness or paralysis
Miranda explains that weakness can occur on one side of the body (arm and leg), sometimes preventing the person from walking. Thus, this weakness can range from very mild loss of strength to complete paralysis.
It is not common in stroke, however, for both legs or arms to be affected at the same time with the same intensity.
The weakness may also be accompanied by numbness, tingling or a sensation of slight "needle sticks".
Paralysis can easily be identified by the patient and family members, but when the loss of strength is slight, it becomes more complicated. But, a? Test? can be done: the patient's arms should be raised and held in line with the shoulders ("mummy position") for a few minutes. If one arm starts to fall, there is strong evidence of motor weakness. The same? Test? goes for the legs.
The patient may also be affected by lack of balance or vertigo.
5. Mental Confusion
Disorientation may occur and may progress to coma and even death, as Miranda points out.
The patient may, for example, lose track of time (day, month, year), not recognize where he or she is, and have a confused speech due to mental disorientation.
6. Seizure
In some cases a seizure may occur, which is caused by excessive electrical activity in the brain leading to involuntary muscle contractions with disordered movements, changes in mental state or other symptoms.
It is noteworthy, however, that seizure is not always a symptom of a stroke.
In summary, Ricardo Campos points out that the sudden suppression of cerebral artery flow causes loss of function as fast as the onset of the symptomatic event. That is, depending on the brain area involved, there may be sudden loss of consciousness. Is it possible for an unprecedented seizure to occur ?, he says.
But the most common expression is impairment of one or more of the following, usually involving one side of the body: muscle strength, sensitivity, balance, coordination, dexterity of movement, mental abilities, perception of the environment (sight, hearing, smell, taste and touch) ?, explains Campos.
The neurologist also emphasizes that the search for medical help must be immediate. • In case of ischemia, it is possible to use interventional neurological drugs and procedures that can reverse the cerebrovascular process, only for a few hours after the onset of symptoms. In case of bleeding, depending on the type of bleeding, minutes can make the difference between life and death, life autonomy and permanent disability ?, says.
Lázaro de Miranda points out that the patient should be immediately taken to the emergency room of a hospital with protocol for proper stroke care,? To undergo magnetic resonance imaging or skull tomography, to select the cases that will benefit from the therapy. thrombolytic, which has to be started within 4 hours of the onset of symptoms. It has to be fast, because time is brain saved or lost ?, he says.
Risk factors and prevention
Miranda points out that the main risk factor is advanced age, followed by hypertension, high cholesterol, diabetes mellitus, smoking, alcoholism, valvulopathies, cardiomyopathies and atrial fibrillation (cardiac arrhythmia).
Campos also points out as risk factors:
- Sedentary lifestyle;
- Obesity;
- Sleep apnea;
- Uncontrolled uric acid;
- Drug addiction;
- Climacteric period;
- Use of oral contraceptives.
In order to avoid stroke, some important guidelines are:
- Have a healthy life from childhood and adolescence, including good nutrition and physical activity;
- Miranda advises to control all risk factors as high blood pressure, bad high cholesterol, diabetes, cardiac arrhythmias appear;
- The cardiologist also points out that it is necessary to avoid the use of illicit drugs;
- In the indicated cases, it is necessary to make regular use and control of anticoagulants and antiarrhythmic drugs, as highlighted by Miranda;
- Campos highlights the importance of healthy habits also with regard to professional practices, personal relationships and margins for stress;
- Consulting a neurologist regularly can identify risk factors in addition to the most "known", as highlighted by Campos. "In this context, this can bring protection through corrections of what is verified in periodic exams of the specialty", he concludes.
Miranda also recalls that "who has had a stroke and was saved has a 4-6 times greater risk of having another stroke." Therefore, the importance of always being aware of health as a whole is reinforced!
It is true that no one expects to have a stroke or see someone nearby suffering, but it is essential to be aware of this possibility and the health as a whole, precisely to help prevent this accident from having more serious consequences. Therefore, at any sign of a stroke, do not hesitate to seek medical help as soon as possible. That will probably make a difference!
Stroke Signs, Symptoms Treatment | Dr. Reza Jahan - UCLA Health (April 2024)
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