WHAT IS STROKE ? CAN IT BE PREVENTED ?

What is stroke?

The clot that goes to the brain does not only come from the heart, but also the brain veins age as we age, and a process called arteriosclerosis occurs. This can create clots on the veins, and these clots go to the brain. Let’s think of the main vein coming out of the heart as a tree root. Let the end branches of the tree be small veins, and clots can come out of the root and cause blockages on the way. If the branches are blocked, the brain’s nutrition is disrupted, if the small vein is blocked, it causes less damage, and if the large vein is blocked, it causes more serious damage. These vein branches coming out of the heart narrow as they go deeper into the brain. The larger the clot, the earlier it blocks the vein and the more damage it causes. Stroke is a condition that occurs suddenly and results in loss of brain functions.

Stroke/paralysis in our country

Approximately 200,000 people have a stroke in our country every year. Every 40 seconds, one person has a stroke; and one person loses their life due to stroke in three minutes. Stroke was the third leading cause of death on the World Health Organization list until the last 20 years. However, especially in the last 20 years, thanks to rapid developments in diagnosis and treatment, it is a treatable disease and early action is vital for this treatment to be successful. In emergency cases, centers with experience in stroke should be determined for rapid and successful treatment and the emergency service should transport patients to these centers. Stroke treatment is a personalized treatment due to both the good evaluation of the process and the fact that the treatment methods to be used vary from patient to patient. In the fight against stroke, it is important not to have a single physician but a competent multidisciplinary team. There are diseases in medicine where we race against time, stroke is one of these diseases. We say that every passing time is the brain because the longer we delay reaching the health center as time goes by, we lose a part of our brain, stroke is such a disease. When we say stroke, it is considered distant from us but it can be very close to you. It can happen to anyone at any time. We are not disabled today but we can be tomorrow. Especially people in the risk group are important.

CAN STROKE BE PREVENTED?

Approximately 200,000 people have a stroke in our country every year. One person has a stroke every 40 seconds, and one person dies of a stroke every three minutes. Until the last 20 years, stroke was ranked 3rd among the causes of death on the World Health Organization list. However, especially in the last 20 years, it has become a treatable disease thanks to rapid developments in diagnosis and treatment. Therefore, acting early is vital for the treatment to be successful.
In emergency cases, centers experienced in stroke should be determined for fast and successful treatment and the emergency service should transport patients to these centers. Stroke treatment is a personalized treatment due to both the good evaluation of the process and the fact that the treatment methods to be used vary from patient to patient. In the fight against stroke, not a single physician but a multidisciplinary, competent team is of great importance…

There are diseases in medicine where we race against time. Stroke is one of these diseases… We say that every passing time is the brain because as time goes by, the more we delay reaching the health center, the more we lose a part of our brain, stroke is such a disease. It seems distant from us, but it can be very close to you. It can happen to anyone at any time. We are not disabled today, but we may be tomorrow. Especially people in the risk group are very important in this respect…

STROKE GIVES INFORMATION IN ADVANCE

Stroke often gives in advance that it will come. Preventive treatment of people at risk before a stroke develops should be the most important approach. Among the lifestyle changes in preventing stroke, nutrition is especially important. Avoiding foods containing saturated fatty acids and simple carbohydrates, taking care to eat fiber-rich foods, eating a diet rich in fruits and vegetables, and limiting salt are important. It has been shown that the Mediterranean diet is especially protective against stroke (a diet containing olive oil and vegetables).

On the other hand, increasing physical activity and doing aerobic exercises outdoors without straining are associated with a decrease in the risk of stroke. It is recommended that individuals regularly practice outdoor walking exercises for 45 minutes-1 hour 4 days a week or at least 30 minutes a day.

It is important to control risk factors such as hypertension, diabetes, high cholesterol, keep blood pressure below 140/90 mmHg, completely stop smoking and limit alcohol consumption, and reduce excess weight to appropriate limits with diets. Regular use of medications recommended by your doctor for these risk factors reduces the risk of stroke.

8 simple changes to reduce your risk of stroke:

Be active.
Keep your cholesterol under control.
Eat healthier.
Keep your blood pressure under control.
Lose weight.
Lower your blood sugar.
Quit smoking.
Reduce alcohol.

Even one of these is effective, but controlling all of them has been shown to significantly reduce the risk of stroke. So the more changes you make, the more your risk drops. For example, lowering your blood pressure to normal levels reduces your risk of stroke by 50 percent. Not smoking or quitting smoking reduces the risk by 40 percent.

EMERGENCY STROKE TREATMENT

Since it is generally not known whether stroke can be treated, it is very late to take patients to the hospital. There is a lack of information about the treatment of this disease. Unfortunately, there is a prejudice in society that ‘stroke cannot be treated’.

However, today, if a patient who has a stroke is taken to the hospital in the first hours and the sooner that patient is treated, the chance of treatment increases. It seems much easier for patients to return to their social life even if they have a stroke. Our society is not yet aware of this treatment, we need to increase awareness of this treatment.
Stroke treatment is a new approach in terms of intervention, it is necessary to save the brain tissue that is sensitive to lack of oxygen after the formation of the clot and to prevent the damage that will occur. Every minute that passes after a stroke means millions of cell deaths. Clot-dissolving treatments via veins must be applied to the patient in the first 4.5 hours of the stroke, and the method of removing the clot in the vein by performing cerebral angiography, i.e. mechanical clot removal, must be applied to the patient in the first 8 hours. When the treatment is applied within the first 3 hours, 1 out of 7 patients recover completely, when it is applied within the first 4.5 hours, 1 out of 11 patients recover completely.

SHOULD WE USE ASPIRIN IN CASE OF A SUDDEN STROKE?
The cause of a stroke may be a brain hemorrhage or a vascular occlusion. When we give a blood thinner, we may increase the bleeding. Therefore, we should not take a blood thinner drug on our own.

SHOULD WE MEASURE BLOOD PRESSURE IN STROKE AND GIVE BLOOD PRESSURE MEDICATION?

There is definitely no need to give a drug to lower blood pressure if such a patient has high blood pressure. The main problem here is that stroke mostly develops in those with high blood pressure, but if the blood pressure is high when we have a stroke, it should not be lowered because a vein is blocked and the vein carries blood to the brain. If we give medication for blood pressure, the blood pressure drops and the blood flowing to the brain decreases. In case of a sudden stroke, blood pressure medication should not be given.

SHOULD WE POUR COLOGNE ON THE PATIENT?

Giving the patient water, pouring cologne on them seem like things done to bring the patient back to his senses, but in fact, these waste doctors’ time. They steal time, but we need to act quickly, and time is limited for what we can do in the emergency room. We need to get the patient to the emergency room as soon as possible. When the patient has a stroke, their swallowing function may have been impaired. Therefore, we should not feed them or give them water to drink, otherwise it can get into the lungs and cause pneumonia, causing the disease to worsen rapidly.