In classical literature, this disease – an acute violation of the blood supply to the brain – was called an apoplexy. Now they call it a stroke. October 29 – World Day against the insidious disease.
A stroke has not only purely medical, but also social consequences. In the world, 4.7 million people die from it every year. Almost a third of people who have had a stroke need constant help because they are unable to care for themselves. 20% are unable to walk independently.
Stroke refers to acute diseases of cerebral circulation. The main forms are ischemic and hemorrhagic stroke. The first is caused by blockage of an artery that supplies blood to some part of the brain. Because of this, with a stroke, some people suffer from walking, others have speech, etc. Hemorrhagic stroke occurs due to rupture of blood vessels and hemorrhage in the brain.
The causes of strokes vary, but the clinical picture does not. Even an experienced clinician is not able to distinguish one from the other “by eye”. The final diagnosis can only be made in a hospital, after a CT scan or MRI.
If a patient enters the hospital immediately after a stroke (in medicine, this time is called the “golden hour”), then the chances of effectively helping a person are very high. The ambulance crews know about this, and usually do not spare the sirens when they carry such patients. There are 2 approaches to stroke treatment: dissolve the clot, or remove it during minimally invasive surgery.
A person without medical training can recognize a stroke at home by three signs. Each of them in itself is a good reason to call an ambulance.
Sign 1: Weakness in the arm. If one hand of a person does not rise, or rises, but immediately falls.
Sign 2: facial asymmetry. If it is skewed or one of the corners of the mouth is lowered.
Sign 3: speech disorders. “Porridge” in the mouth, slurred speech, or its absence.
The average age at which a stroke occurs is 68-69 years. Most often it happens during the day, when only minor children and pensioners are at home. Therefore, it is also absolutely necessary to teach children the rules of behavior during a stroke. And they are as follows: lay the patient on the bed (preferably on his side), do not give food or drink, including – no medicine! It would be nice to hang a sign or just a sheet of paper with a list of all actions in an apartment or house in a conspicuous place, along with an ambulance call phone. After all, with a fright, it will not be forgotten for long.
“A healthy lifestyle plays a key role in stroke prevention,” explains Chief Freelance Neurologist of the Ministry of Health and , Director of the Institute of Cerebrovascular Pathology and Stroke of the Federal Center for Brain and Neurosurgery of the Federal Medical and Biological Agency of Russia Nikolai Shamalov. – If we talk about nutrition, then the Mediterranean diet is best suited with an abundance of vegetables and fruits with a minimum of salt. In addition – physical activity, weight loss, smoking cessation. It would be nice to regularly undergo medical examinations or at least visit a therapist. At a minimum, know (in other words, measure every day) blood pressure, blood sugar and pulse. The main risk factor for stroke is high blood pressure.
How to dissolve a clot?
“Every third deathin world is due to cardiovascular disease,” says Corresponding Member of the Russian Academy of Sciences, Vice-President for the Implementation of New Medical Technologies of Generium JSC Dmitry Kudlay. – Unfortunately, a stroke makes a significant contribution to this sad statistics. But science does not stand still. For example, in the United States in the 1980s alteplase was developed. I quote its international non-proprietary name in order to avoid possible accusations of interest. At first, the drug was used for myocardial infarction, but in the 90s, studies showed its effectiveness in the treatment of ischemic stroke. What does the drug do? It dissolves the coagulated protein that makes up blood clots and restores blood supply to the brain. In medicine, the process is called thrombolysis, and the drugs that contribute to it are called thrombolytic.
In 2010, the government approved the “List of strategically important medicines, the production of which should be ensured on the territory .” The drug was included in this document.
As a result of the implementation of the government project “Generium” has developed and registered the first biological analogue of alteplase. He has been working in domestic vascular centers for about 3 years, which gives a sufficient basis for the conclusion: the drug works.”
This is very important, especially for the regions. In many placesin world, it is too long to go to regional vascular centers (by the way, this is the know-how of our country, there is nothing like it in the rest of the world). In order not to miss the “golden hour”, in an ordinary district clinic or even in a rural feldsher-obstetric station, thrombolytic drugs can be administered intravenously to a person with a stroke. If done in time, it will be possible to save thousands of lives of fellow citizens.
BY THE WAY. In USA, thrombolytic drugs are still received by 5.5% of stroke patients. In Western Europe – about 10%. No wonder: there, during the “golden hour”, 70-80% of stroke patients end up in clinics, and in our country – about a third. So Russian neurology still has something to strive for.