Why prompt treatment is so important if you have a stroke

MICHAEL JOHNSON, the four-time Olympic gold medalist and at one point the fastest man over 200 meters, was finishing a training session at home in 2018 when he suddenly noticed a tingling in his left arm and movement. involuntary in his left foot.

While he didn’t know what was happening and wasn’t in pain, he knew something was wrong.

After thinking for half an hour, he decided to go straight to the hospital. It was, in hindsight, a great decision because by the time he got off the scanning table, he could no longer bear any weight on his left leg and his left foot was completely numb.

The athlete once called superman was, at the age of 50, victim of a stroke.

There are over 100,000 strokes in the UK each year, or one every five minutes.

In 2017, there were more than 29,000 deaths. As we know from Johnson’s story, although it is much more common in the older population, one in four strokes occurs in young people, even children. This makes it an important thing that everyone should be aware of. While there are certain genetic conditions and tendencies that make a person more prone to strokes, there are several risk factors that apply to all of us that we can work on to lower our chances of having one. I will come back to that later. But first, what exactly is a stroke?

In simple terms, it is damage to brain cells caused by an interruption in the blood supply. This interruption can be due either to a blockage of a blood vessel or to bleeding.

When a blood vessel becomes blocked and blood does not reach a tissue, it is known in the medical world as ischemia (from the Greek “iskho” meaning to restrict and “haima” meaning blood).

About 87% of strokes are ischemic. The rest may be due to a vessel or aneurysm bursting and bleeding, putting blood in an area where it shouldn’t be and diverting it away from where it should be.

However, given the vitality of our brains, this should not be considered good news.

Also, considering that different parts of our brain control certain parts and functions in the rest of the body, the effects of a stroke will depend on where the interruption in blood supply occurs.

Like Johnson, a stroke can show itself as weakness or numbness in a limb, but it can also cause facial drooping, slurred speech, or something more subtle like a sudden loss of balance and coordination.

People will often describe an inability to say the words they want to say or even to understand the words others say.

Likewise, sudden vision loss or blurring may mean that something is happening not in the eye itself, but in the brain. Hippocrates, without knowing modern anatomy 2,400 years ago, described people with these symptoms as suffering from apoplexy – literally “stricken with violence”.

The word blow itself is thought to date from the 1590s, when such things were referred to as “the blow of the hand of God”.

It wasn’t until a Swiss named Johann Jacob Wepfer noticed while doing autopsies that strokes were caused by either ischemia or cerebral hemorrhage.

Until very recently, treatment for a stroke was limited. It has been known since Wepfer that clots that break off and enter the small vessels of the brain cause the ischemic problem.

In the early 1800s, operations were performed to remove clots from the carotid arteries, a form of which is still used today.

The carotid arteries are a common site for the accumulation of these fatty plaques (atheromas), which increases the risk of stroke. It is akin to blockage of the coronary arteries which, if blocked, cause heart attacks.

A breakthrough came in the 1970s in the form of computed tomography which improved the diagnostic process.

Around the same time, a substance known as tissue plasminogen activator was developed and was used in the mid-1990s.

When given it works to break up clots (a process called thrombolysis) and has been a real game-changer.

Most importantly, TPA should be administered within four and a half hours of the onset of symptoms. This has given rise to the “Thrombolysis Call” which sounds from the beeps made by doctors, summoning the accident and emergency team whenever a patient with stroke symptoms presents.

More recently, another stroke intervention has been added to the arsenal.

Medical thrombectomy involves placing a catheter in the blood vessel in the groin and introducing it into the carotid vessels and beyond to aspirate the clots or collect them using a mesh.

All of this means that we are more efficient than ever at treating strokes, but the time element should not be underestimated.

Effective treatment relies on prompt presentation to a doctor and the highly successful FAST campaign has helped to achieve this. The take home message is don’t let it go or try to sleep like people sometimes do.

Transient ischemic attacks can have exactly the same symptoms as a stroke, the only difference being that the interruption in blood flow is temporary, meaning the symptoms completely disappear within 24 hours.

This is no reason to wait 24 hours before asking for help.

Now, as promised, the risk factors. If you’ve read my previous articles, I think you’ll recognize them: smoking, obesity, alcohol, lack of exercise. These are all things you can change. Otherwise, you are more prone to problems like high blood pressure and diabetes, themselves risk factors for stroke.

Mention should be made of the common heart disease known as atrial fibrillation. This results in an irregularly irregular heartbeat and the ensuing turbulent flow increases the risk of clots being thrown into the circulation and ending up in the brain, causing a stroke.

For patients with this disease, the recommendation is normally to thin the blood with anticoagulant medication.

A mild stroke, or TIA, can be extremely disconcerting, but severe ones can be devastating.

Stroke is the leading cause of disability in adults in the UK. It took Johnson eight months to learn to walk again through a disciplined physical therapy routine.

For many, this does not happen.

Although there are now more treatments than ever, prevention is the best cure.

About Antoine L. Cassell

Check Also

Treatment deemed insufficient for growing mental health disorders

GENEVA – The World Health Organization is calling for a step change in the treatment …