prevention, detection and recovery of life-changing neurological diseases

A ictus It is more than a health problem: it is a turning point in a person’s biography, an event that marks a before and after in the lives of those who suffer from it. This neurological disease, caused by disruption of blood flow to a certain part of the brain, is a medical emergency and is the first cause of disability in adults and mortality among women (second highest among men).

In Spain, the incidence is about 200 cases per 100,000 inhabitants per year; and the profile of the victims is as follows: man about 70 years old which accumulates vascular risk factors, although for various reasons it also affects increasingly younger people.

Speed ​​and accuracy of response are essential: adequate treatment in the acute and subacute phase, added to early and multidisciplinary rehabilitation This can make a significant difference in the patient’s life.

What is a stroke?

Stroke is a disease affecting the brain that occurs when there is a lack of blood flow to a certain area of ​​the brain, leading to suffering and death. neurons in a matter of minutes. There are two main types: ischemic stroke and hemorrhagic stroke.

As explained by Dr. José Carlos Fernández Ferro, Head of the Neurology Service King Juan Carlos University Hospital Integrated into the Madrid-based public health network SERMAS, the first occurs when a thrombus (blood clot) blocks an artery in the brain, cutting off blood flow to the area. This is the most common type, accounting for 85% of cases. On the other hand, a hemorrhagic stroke occurs when a blood vessel ruptures and blood enters the brain tissue. Both types present with similar symptoms and can cause serious consequences if not treated promptly. The distinction necessarily involves a CT scan of the brain; before performing it, we cannot know whether we are facing an ischemic or hemorrhagic stroke.

Risk factors and prevention

Stroke doesn’t just affect older people; In fact, the incidence of this disease is increasing among young people. Dr. Natalia Barbero,

a neurologist at a Madrid hospital explains that stroke is the leading cause of disability in adulthood and the leading cause of death among women in Spain.

Risk factors such as high blood pressure, diabetes, cholesterol, smoking, alcohol, obesity and a sedentary lifestyle are directly linked to stroke. All of them are modifiable, so a healthy lifestyle can significantly reduce the likelihood of a stroke. “The stroke with the best prognosis is the one you’ve never had.”“, says Dr. Fernandez Ferro. In addition, it mentions that some of these factors pose a particular risk, for example in the case of obesity (as it is commonly associated with hypertension, hypercholesterolemia and obstructive sleep apnea). Prevention through a healthy lifestyle is key.

Warning Symptoms: Recognizing a Stroke

To act quickly, you need to know how to recognize the symptoms of a stroke. Dr. Fernandez Ferro describes four main signs that should alert anyone:

1. Language problems: Difficulty speaking, understanding, or slurred speech (pronunciation difficulties).
2. Deviation of mouth angle: asymmetry of the face due to deviation of the angle of the lips in one direction or another.
3. Loss of strength or sensation on one side of the body.: It may affect an arm, a leg, or both arms on the same side.
4. Sudden and severe headache: It usually appears suddenly and for no apparent reason.

To our knowledge, at least one of these four is present in the majority of stroke patients. Phrase “time is the brain” sums up the importance of seeking immediate help. The faster you act, the less brain damage there will be and, therefore, the better the prognosis.

Immediate Action Protocols: Stroke Code

When community emergency services identify a patient with a suspected stroke, the so-called “Stroke Code” is activated, a rapid care protocol designed to minimize brain damage and optimize the patient’s recovery options. This code allows neurologists, neuroradiologists and interventional neuroradiologists, among other specialists, to act quickly and in a coordinated manner to find the best treatment option for each individual case. According to Dr. Fernandez Ferro, the first measure is to “perform a CT scan to distinguish between ischemic and hemorrhagic stroke,” and then make a decision depending on the evolution time, the condition of the brain tissue, the age and the initial situation of the patient. As stated in Dr. BarberoThe goal is always to restore cerebral blood flow as quickly as possible to avoid or minimize brain damage.

Stroke treatment

There are two main approaches to treating ischemic stroke. One of them is intravenous fibrinolysispharmacological treatment, which must be carried out in the first four and a half hours after the onset of symptoms. This procedure aims to dissolve the clot blocking the artery and restore blood flow.

In cases with larger blood clots, additionally use mechanical thrombectomya method whose purpose is to mechanically remove a blood clot using special devices. Thrombectomy is an interventional technique performed using advanced technological devices that are inserted through the artery and lead to the clot. There, they proceed to “aspirate, or extract, the clot using a stent retriever, a type of spring that catches the clot and removes it,” the doctor explains. Dr. Claudio RodriguezHead of the Department of Interventional Neuroradiology of the Jiménez Díaz Foundation. This technique has completely changed the prognosis of ischemic stroke since its introduction in 2015, demonstrating excellent results in many patients. It has also contributed to a better understanding of what ischemic brain injury entails; which, in turn, allows for renewed research into neuroprotective treatments that complement the benefits of thrombectomy and will become a reality in the coming years.

Care and recovery in the stroke unit

After stabilization of the patient’s condition, hospitalization in the stroke department is necessary to receive comprehensive care. These hospital units are staffed by multidisciplinary teams who specialize in closely monitoring patients. Carmen PajueloHead of the Stroke Unit at the Jiménez Díaz Foundation University Hospital, stresses the importance of training nurses to immediately detect changes in a patient’s condition. “It is very important to have trained nursing staff who are able to identify at any time any changes that may occur in the patient, because a neurological patient is a complex patient whose vital signs must be closely monitored, so we must monitor them and do neurological surveillance. . By carefully monitoring signs and symptoms and measuring them using a scale,” he explains.

The importance of stroke units lies in the fact that their benefits equally apply to patients with ischemic and hemorrhagic strokes, in mild and severe cases, of any age. In the specific case of hemorrhagic stroke, treatment in a stroke unit is currently the only treatment modality demonstrated to improve prognosis.

Coming Home: The Challenge of Life After Stroke

Overcoming the acute phase of a stroke is only the first step. Full recovery may take time, although the optimal time is in the first 3 or 6 months. This depends, among other things, on the severity of the event, the consequences and the individual characteristics of each patient over a period of months or even years, depending on the severity of the event, consequences and age. Rehabilitation at this stage plays a decisive role. Dr. Raquel CutillasDeputy Director of the Rehabilitation Service, explains that starting rehabilitation from the first moment is very important “to promote stimulation, because this will be a way to stimulate all the neural networks and all the neuroplasticity of the brain that is generated in the patient at that moment.” ” “From now on the brain has to relearn all the lost functions, which will allow it to achieve

through rehabilitation,” he notes.

Returning home can be one of the biggest challenges for patients. Reintegration into the family and social environment requires adjustments and sometimes psychological assistance to cope with the emotional impact of the stroke. For this reason, centers such as the Rey Juan Carlos University Hospital have launched stroke school, where patients and families receive information and support to manage this new phase of life. As described Dr. Fernandez Ferro, This program resolves doubts and fears in a safe environment, better preparing patients for everyday life.

Healthy lifestyle in the long term

Prevention of a new stroke involves maintaining a healthy lifestyle and constant medical monitoring. Dr. Barbero insists on the need to regular examinations and adherence to recommended pharmacological treatment. to reduce risks.

Stroke is a disease that affects thousands of people every year, but its consequences can be minimized with early detection and appropriate treatment. As Dr. Fernandez Ferro sums it up well: “The best shot is the one you never had.” The key to success is prevention, rapid response to symptoms and full recovery.