Stroke (Cerebral Vascular Accident) is a problem that worries many people, and above all, it generates many doubts. The main ones related to the exact symptoms of the accident and the possibility of preventing it from happening.
Lázaro Fernandes de Miranda, coordinator of Cardiology at Hospital Santa Lúcia, in Brasília, and advisor to the Brazilian Society of Cardiology, explains that CVA or Cerebral Stroke is an acute neurological disorder, characterized by loss of cognitive and/or motor neurological function, resulting from blockage or rupture of blood vessels in some part of the brain.
Ricardo Campos, a neurologist at Hospital Anchieta, highlights that stroke is nothing more than the abrupt and complete suppression of blood nutrition in an intact brain area until the occurrence of this event.
Miranda explains that stroke can occur due to ischemia (90% of cases) and hemorrhage (10% of cases). “The older the individual, the greater the risk of stroke, with a slight predominance among women, especially those with hypertension, obesity and diabetes. Heart diseases, particularly rheumatic valvular heart disease, Chagas cardiomyopathy and cardiac arrhythmias such as atrial fibrillation and/or atrial flutter, are the main risk groups,” she says.
Campos highlights that, in a general pedagogical context, it can be said that stroke is divided into ischemic and hemorrhagic. “Ischemic stroke can result from dozens of causal possibilities, which makes up the characterization of subtypes. In the same way, hemorrhagic stroke can result from different etiological factors, which promotes a numerous classification of manifestations”, he says.
“Classifying strokes into subtypes also takes into account the topography or the brain area involved. For a more clinical approach, we subdivided the types of stroke by etiology, topography and symptomatic expression”, explains the neurologist.
In summary, it can be said that ischemic stroke happens when a clot blocks the artery that carries blood to the brain; hemorrhagic, when there is rupture of an intracranial artery.
It is undeniable that a stroke is usually a very bad experience, both for the patient and for the family or people who live with him. Thus, it is very important to be aware of the signals that the body gives, precisely to prevent a stroke from having more serious consequences.
The main symptoms of stroke
The symptoms of a stroke are basically difficulty walking, speaking or mental confusion, as well as weakness or one-sided paralysis of the face, arm or leg.
It is important to be aware of these stroke symptoms, even to be able to keep calm, in case the accident, unfortunately, affects someone close; and, also, to know exactly from the moment it is essential to seek medical help.
Miranda explains that there may be a sudden headache (headache), with blurred visual fields, sometimes with dizziness and vomiting.
It is worth remembering that there are different types of headache, such as migraine. Stroke-related headache, in this sense, is distinguished by being sudden and without an apparent cause, and by being usually associated with other symptoms, such as, for example, difficulty walking or seeing, sudden mental confusion, dizziness, vomiting or difficulty in breathing. speak.
2. Changes in speech
Miranda explains that speech difficulties or stumbling tongues may occur.
Aphasia, which is the patient’s inability to name objects and things, is common. In some cases, the person cannot even repeat a word said by a family member. The speech can even be confused, as the patient can only say a few words, being unable to say others.
Dysarthria, which is characterized by difficulty in articulating words, may also occur. The patient understands everything, but is unable to move the speech muscles in order to correctly articulate the words. Or he even manages to name things, but he does it in a “rolled way”, often incomprehensible to the listener.
3. Deviation of the labial commissure to one side of the face
The deviation of the mouth away from the paralyzed side is a common and noticeable sign of stroke. For example, the patient has a left-sided facial paralysis; then, the mouth deviates to the right side and the labial commissure becomes more prominent on the right.
However, it is worth noting that, in some cases, facial paralysis is very discreet and may go unnoticed by family members. In these cases, the patient can be asked to smile or whistle; for, thus, if there is paralysis, it will be easily noticed.
4. Weakness or paralysis
Miranda explains that weakness on one side of the body (arm and leg) can occur, sometimes preventing a person from walking. Thus, this weakness can range from a very mild loss of strength to complete paralysis.
It is not common in stroke, however, for both legs or arms to be affected at the same time, with the same intensity.
Weakness may also be accompanied by numbness, tingling or a light “needle stinging” sensation.
The paralysis can be easily identified by the patient and his family, but when the loss of strength is slight, it becomes more complicated. But, a “test” can be done: the patient’s arms must be raised and kept in line with the shoulders (“mummy position”) for a few minutes. If one of the arms starts to fall, there is a strong indication of motor weakness. The same “test” goes for the legs.
The patient may also be affected by lack of balance or vertigo.
5. Mental confusion
Disorientation may occur, and may progress to coma and even death, as pointed out by Miranda.
The patient may, for example, lose track of time (day, month, year), not recognize where he is, and have confused speech due to mental disorientation.
In some cases, a seizure can occur, which is caused by excess electrical activity in the brain causing involuntary muscle contractions with disordered movements, changes in mental status or other symptoms.
It is worth noting, however, that the seizure is not always a symptom of a stroke.
In summary, Ricardo Campos highlights that the sudden suppression of cerebral arterial flow determines the loss of function as fast as the onset of the symptomatic event. “That is, depending on the brain area involved, there may be sudden loss of consciousness. Unprecedented seizures are possible,” he says.
“But the most common expression is impairment of one or several of the following, usually involving one side of the body: muscular strength, sensitivity, balance, coordination, movement dexterity, mental abilities, environmental perception (sight, hearing, smell, taste and touch)”, explains Campos.
The neurologist also highlights that the search for medical help should be immediate. “In case of ischemia, it is possible to use drugs and interventional neurological procedures that can reverse the cerebrovascular process, only for a few hours after the onset of symptoms. In case of hemorrhage, depending on the type of hemorrhage, minutes can make the difference between life and death, autonomy of life and permanent disability”, he says.
Lázaro de Miranda points out that the patient should be taken immediately to the emergency room of a hospital with a protocol for adequate stroke care, “to undergo magnetic resonance imaging or cranial tomography, to select the cases that will benefit from the therapy.” thrombolytic therapy, which must be started within 4 hours of the onset of symptoms. It has to be fast as time is brain saved or lost,” he says.
Risk factors and prevention
Miranda highlights that the main risk factor is advanced age, followed by arterial hypertension, high cholesterol, diabetes mellitus, smoking, alcoholism, valvular heart disease, cardiomyopathies and atrial fibrillation (cardiac arrhythmia).
Campos also highlights as risk factors:
- Sedentary lifestyle;
- Sleep apnea;
- Uncontrolled uric acid;
- drug addiction;
- Climacteric period;
- Use of oral contraceptives.
In this sense, to avoid a stroke, some important guidelines are:
- Have a healthy life since childhood and adolescence, including good nutrition and physical activity;
- Miranda advises to control all risk factors as high blood pressure, bad high cholesterol, diabetes, cardiac arrhythmias appear;
- The cardiologist also highlights that it is necessary to avoid the use of illicit drugs;
- In the indicated cases, it is necessary to make regular use and control of anticoagulants and antiarrhythmics, as pointed out by Miranda;
- Campos highlights the importance of healthy habits also with regard to professional practices, personal relationships and margins for stress;
- Seeing a neurologist regularly can identify risk factors beyond the most “known”, as Campos points out. “In this context, this can provide protection through corrections of what was verified in periodic examinations of the specialty”, he concludes.
Miranda also recalls that “those who have already had a stroke and were saved are 4 to 6 times more likely to have another stroke”. Therefore, the importance of always being attentive to health as a whole is reinforced!
It is a fact that no one expects to suffer a stroke or see someone close to them suffering, but it is essential to be aware of this possibility and health as a whole, precisely to help prevent this accident from having more serious consequences. That way, at any sign of a stroke, don’t hesitate to seek medical help as soon as possible. This will likely make a difference!
The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.
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