Stroke, difference between ischemic and hemorrhagic, how to prevent it, symptoms, treatments –

Stroke, difference between ischemic and hemorrhagic, how to prevent it, symptoms, treatments –
Of Maria Giovanna Faiella

the first cause of death, the second of dementia, the third of disability. 80% of the events could be avoided by changing lifestyle habits and treating diseases such as high blood pressure, high cholesterol, diabetes, atrial fibrillation

Brain stroke strikes about 150,000 compatriots every year; the third cause of death after cardiovascular diseases and tumours; la prima di invalidit, the second leading cause of dementia
, according to data from ALICe Italia, the Association for the Fight against Cerebral Stroke. Cerebrovascular injury caused by interruption of blood flow to the brain due to blockage or rupture of an artery.

Difference between ischemic and hemorrhagic stroke

But which one difference between ischemia and cerebral hemorrhage? Ictus literally means “stroke”, i.e. the sudden appearance of a neurological deficit – said Professor Danilo Toni, director of the “Neurovascular Treatment” Unit at the Umberto I Polyclinic in Rome and president of the ALICe Technical-Scientific Committee Italy -. We speak of ischemia, which means lack of blood, when the (ischaemic) stroke is due to the closure of an artery, so that no blood reaches the brain; hemorrhagic stroke (or cerebral hemorrhage), on the other hand, is due to the rupture of an artery, therefore the blood extravasses into the brain, the brain tissue suffers because it does not receive blood and also because it is compressed by the blood that has accumulated outside the arteries.

What is a transient ischemic attack (Tia)

What is a transient ischemic attack (Tia – Transient ischemic attack)? TIA is when the blood supply to the brain is briefly cut off, so it is one form of ischemia ma so short in duration that it leaves no symptoms within minutes and most importantly, it does not provoke no damage not even visible with magnetic resonance – explains Professor Toni -. There difference between transient ischemic attack and ischemic stroketherefore, lies in the duration of the symptoms and in theabsence of the ischemic lesion in the TIA, wound which instead present in stroke. The TIA – emphasizes the neurologist – a very important stroke alarm bell so much so that a risk score has been prepared, “ABCD2 score”, in consideration of some parameters, namely: et; blood pressure; clinical features (motor, sensory or speech impairment); duration of symptoms and diabetes. From the combination of these variables a score is obtained: the higher, the greater the risk that a new ischemic event may occur in the following 48 hours.

Who risks more

What are the main risk factors that can lead to stroke? High blood pressure, smoking, diabetes
they are risk factors for both ischemic and hemorrhagic strokes – recalls Professor Toni -. High cholesterol and atrial fibrillation
are risk factors especially for ischemic stroke.

How to prevent stroke

Can stroke be prevented (and how)? According to the World Health Organization, 80 percent of events could be avoided, modifying one’s lifestyle and treating some pathologies that can cause stroke, such as high blood pressure, high cholesterol, diabetes, some cardiac function abnormalities, in particular atrial fibrillation. The risk factors that can be modified must be kept under control – underlines the neurologist -. Prevention starts with good habits in daily life, such as do not smoke, keep physically active, avoid incorrect nutrition which involves the tendency to be overweight up to obesity, do not consume alcohol or, at least, limit the amount to a minimum.
If there are any health problemsthen, it’s done use of necessary therapies. For example, the specialist points out: Those with high blood pressure should take antihypertensive drugs, those with diabetes will have to follow blood sugar control therapies, those with atrial fibrillation will treat it with anticoagulant drugs and with those that regulate the heart rate.

Most frequent symptoms

What are the tell-tale signs of a stroke? The most common symptoms are:
sudden loss of strength (or even sensitivity) to an arm or a leg or bothon the same side;
crooked mouth;
difficulty speaking because you cannot articulate words well (dysarthria) or cannot pronounce them at all, or understand what other people are saying;
not being able to coordinate movements nor balance;
vision loss;
severe and sudden headachenever tried.
In these cases the emergency number 118 (or 112 where active). The emergency vehicle will accompany the patient affected by stroke to the hospital, possibly equipped with a Neurovascular Unit (or Stroke Center or Stroke Unit) where he can receive the most appropriate therapies in a timely manner. Precocious administration of therapiesIndeed, the more effective the treatments are.

Therapies available

How is stroke treated? for theischemic stroke Fibrinolytic drugs have long been available that dissolve arterial obstructive material (thrombolysis), allowing to restore blood flow and limit damage to brain tissue. In some cases, drug therapy can be associated or replaced by endovascular treatments (mechanical thrombectomy), which are sometimes also possible when thrombolysis cannot be done. These are techniques that require high specialization and, for this reason, cannot be performed everywhere but only in hospitals equipped with second level Neurovascular Units (or Stroke Units). for thecerebral hemorrhage there are a number of indications to contain the extent of bleeding, while specific therapies are being developed.

Stroke unit (o Neurovascular o Stroke unit)

I currently am 220 stroke Units where it is possible to carry out thrombolysis compared to the 300 needed; in 65 of these centres mechanical thrombectomy can also be done – reports Professor Toni -. The shortages are recorded above all in the Southeven if you are trying to catch up.

Cognitive impairment after stroke (second leading cause of dementia)

What are the most frequent ailments after a stroke? They can be motor and non-motor types – clarifies the specialist -. The consequences at the motor level consist in the paralysis of one side of the body and, within 2-3 months, even one can develop spasticity of the paralyzed part. Then there are the cognitive disorders: stroke is the second leading cause of dementia after Alzheimer’s
Toni recalls. Frequently, then, the stroke patient undergoes depression, which is partly a depressive reaction to the impairment that occurs, partly due to the anatomical and physiological alteration of the areas of the brain responsible for controlling emotions. an important consequence because it affects the quality of life and, in turn, represents a risk condition for a worse prognosis, even for a recurrence of stroke.
All these disorders must be taken into consideration and treated adequately, with the appropriate therapies.

How long do you live after a stroke

How long do you live after a stroke? Professor Toni replies: It depends on the severity of the stroke

and how successfulin the acute phase, a limit the severity of the damage by promptly administering the specific therapiessuch as thrombolysis or mechanical thrombectomy.

March 28, 2023 (change March 28, 2023 | 06:46)


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