All About Stroke

Written by: Dr. Jaime Masjuan Vallejo
Edited by: Anna Raventós Rodríguez

In Spain there are between 120,000 and 130,000 strokes every year, one every six minutes. It is the first cause of death in women (because they have a higher life expectancy), the first of dependence in the adult and the second cause of dementia, after Alzheimer. They are complicated data, so it is important to explain that it is a very common disease, which can be prevented if we correct the risk factors, and if it occurs, it has treatment.


It is one of the lesser known diseases. A decade ago there was no effective treatment, and when someone had a stroke or was left with major sequelae or died.


We speak of a problem that outnumbers heart attacks. In addition, there is a big difference between heart attack and stroke, and is that when a person suffers a heart attack, he leaves the hospital walking and, generally, after a few months he can return to work. In the case of stroke, there may be intellectual or motor sequelae or limitations that may prevent working, walking or talking.


More than 60% of the patients treated do not have any type of dependence after six months of having the stroke. In the case of sequelae, the most frequent is the inability to walk, have problems of sight or speech, loss of control of sphincters ... 20% are left with minor sequels that with rehabilitation recover and others are left with sequelae Forever, dependent for everything.


It is difficult to return to working life with some physical sequel: a sleeping hand, lack of coordination or mental quickness, not able to write ... Thus, without further, a person becomes unprofitable for the company with 50 years and with a Family in charge. You see dramas like that almost daily.


About 10% of patients die in the hospital, and 20% over the first year, although mortality rates have declined by more than 10% in the last decade.



Causes of stroke

ictus It is a disease of the brain that appears when there is an alteration in the blood circulation in this organ. There are two types: cerebral infarcts - 80% of cases - that occur when a brain area runs out of blood supply from an artery blockage, and cerebral haemorrhages or strokes - a 20% - occur When an artery ruptures and causes cerebral bleeding, causing a hematoma.


When an artery is blocked it does not reach blood, but it can last from four to five hours, because the irrigation arrives temporarily by other. It depends on the part that is left without blood circulation, will be affected capacities or other. On the left side of the brain is the language area, and on the right the space-time orientation.


More than 60% of strokes occur after age 65. However, in recent years there has been a significant increase in stroke in young people (between 35 and 55 years), and currently represent 15% of them. In most cases they are due to bad habits (tobacco or drug use, lack of exercise or inappropriate food) or to the presence of risk factors of unknown or poorly controlled strokes such as hypertension, diabetes or hypercholesterolemia.


Symptoms of stroke

A stroke suddenly happens, without any warning. The person who suffers it notices how it does not control the movement of a hand, loses visual field, does not understand what they say or can not speak well, loses strength in the middle of the body ... The main difference between stroke and myocardial infarction is that In the second it hurts the chest, but in the stroke there is usually no headache.


Most strokes occur without warning, although there are so-called "transient strokes", in which the symptoms occur for a few minutes and then disappear. This is a sign, and you should go to the nearest Ictus Unit to be treated by a Neurologist .


Treatment of stroke

Once it is detected that it is a stroke, it is necessary to call the Outpatient Emergency Services (112 or 061) and explain as clearly as possible the symptoms suggestive of stroke. In this way, the ictus code can be activated, which will activate the entire emergency operating system. When the patient arrives at the hospital with Ictus Unit, a cranial CAT is done to see the treatment that he needs.


In the first 4.5 hours from the onset of symptoms, an injection of a drug that dissolves the thrombus (intravenous thrombolysis). In the case of severe stroke with occlusion of a large caliber artery, we can perform an intervention in which a catheter is inserted through an artery in the groin, reaching the center of the brain to dissolve or extract the thrombus with a clamp , Without having to sleep the patient and without surgeries (mechanical thrombectomy). In some cases of cerebral hemorrhage, the neurosurgeon can intervene the patient.


The patient should be admitted to the Stroke Unit the first few days, with a nurse trained in stroke care. Every four hours a neurological examination is made, taking vital signs ... And at 24 hours, a new CT scan, to check the effect of the treatment and evaluate the damages. Then, rehabilitation is begun and measures of preventive treatment or change of according to what habits are adopted so that it does not happen again.


Once the stroke is over, it is necessary to maintain control over a lifetime. The risk of having a second stroke is especially high during the first year, especially the first three months. By age 10, more than half of patients will have a stroke again if they do not receive adequate treatment and control their risk factors.


Can a stroke be prevented?

Four habits can be recommended to try to prevent the onset of a first stroke:


  • No Smoking.
  • Exercise daily, for example, walk half an hour.
  • Monitor cholesterol, sugar, and stress levels at least once a year. If any of these factors is altered we should try to control it by changing our way of life or with medication. "Having a risk factor is bad, but if you have two or three the risk is multiplied."
  • Follow a Mediterranean diet and take olive oil every day.


*Translated with Google translator. We apologize for any imperfection

By Dr. Jaime Masjuan Vallejo

Recognized specialist in neurology, Dr. Masjuan Vallejo is Chief of Neurology at the Ramon y Cajal Hospital in Madrid. He is an expert in stroke, cerebrovascular disease, stroke, cerebral hemorrhage and myasthenia gravis. He is also expert in the use of new anticoagulants of direct action and has conducted studies doppler for stroke prevention. He is a researcher in numerous studies in the field of cerebrovascular diseases, and has published more than a hundred times over stroke. In turn, it is former coordinator of the Study Group for Cerebrovascular Diseases of the Spanish Society of Neurology and advisory member of Ictus Commission of the Ministry of Health of the Community of Madrid.

*Translated with Google translator. We apologize for any imperfection

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