There are two types of strokes: circulatory disorders involving an artery in the brain that has become blocked by a blood clot (embolism, thrombosis). Then there are cerebral hemorrhages that cause a hematoma in the brain due to a bursting of a blood vessel. The major risk factors for strokes are therefore related to the blood vessels. Is there any way to prevent strokes? Yes!
The main risk factors for stroke are:
- High blood pressure
- Elevated blood lipids and cholesterol
- Lack of exercise
- Poor diet (e.g. excess alcohol consumption)
Preventative measures can have a major impact on many of the factors listed above, even after a stroke has occurred. These factors are responsible for around 70-80% of strokes. Unfortunately, there is no way to control age. However, keeping these in mind and checking them regularly can dramatically reduce the risk of stroke.
Stroke warning symptoms
- Sudden faintness, paresis or sensory impairment on one side of the body (face, arm, leg)
- Sudden blindness (often in only one eye or in one direction)
- Impaired speech and difficulties understanding speech
- Intense vertigo accompanied by inability to walk
- Sudden, unusual and intense headaches
What will the doctor want to know?
The main focus will be on the patient’s current symptoms, their onset and their progression. The patient will be asked about any comorbidities and relevant pre-existing conditions. Are there any known cardiovascular diseases in the family? The parents’ cause of death may also be relevant.
Diagnostics in cases of stroke
Today, the vasculature of the brain is examined primarily by ultrasound. The examination aims to identify any changes in the vessel walls that may lead to the formation of blood clots. If needed, cranial MRI and other specialized imaging of the brain and vessels will be performed in the Department of Neuroradiology at Hirslanden Klinik. If treatment with medication is no longer effective, the patency of the vessels will be restored again using modern surgical techniques (thromboendarterectomy/stent implantation).
Common causes of stroke
Calcification (arteriosclerosis), inflammation, changes in the vessel walls (dissections, aneurysms, fistula) can diminish the blood supply to the brain and, in turn, oxygen and nutrients, which eventually leads to a stroke.
The most serious risk factor for strokes is high blood pressure, or arterial hypertension. Reducing high blood pressure is the most important way to prevent vascular calcification, or arteriosclerosis. Maintaining healthy blood pressure (consistently below 130/90 mm Hg) can prevent around half of all strokes.
In older patients, atrial fibrillation of the heart is another major cause of stroke. Blood clots can form in the atrium and be carried with the flow of blood into the vessels of the brain, causing a blockage. Signs of atrial fibrillation may include irregular heartbeat, heart palpitations and difficulty breathing.
Stroke treatment and prevention
A healthy lifestyle and diet (i.e. Mediterranean diet) reduces the risk of developing arterial hypertension, elevated blood lipid levels and diabetes. It is important that patients with these diseases undergo proper treatment and monitoring.
Starting at a certain age and for certain risk groups, regular medical examinations, including regular vascular examinations (e.g. ultrasound diagnostics), are recommended. Getting enough exercise and quitting smoking are paramount and greatly reduce the risk of stroke.
Strokes must be treated in a hospital. Time is of the essence when starting acute treatment! The blockage in the affected vessel will be cleared if possible (thrombolysis, thrombectomy). The faster blood profusion is restored to the region, the fewer nerve cells will die and the less permanent the damage will be.