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Stroke Treatment and Prevention of Recurrence

After a stroke, necrotic brain cells compress other parts of the brain, potentially leading to a fatal crisis if the brainstem, which connects the brain to the spinal cord, is compressed. Stroke treatment and surgery depend on the type of stroke, and appropriate treatment combined with active rehabilitation and lifestyle adjustments can prevent another stroke.

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Clarifying the Type of Stroke for Targeted Treatment

Post-stroke treatment involves clarifying the condition through computer scans, angiography, magnetic resonance imaging, and more. Treatment depends on whether the stroke is hemorrhagic or ischemic, and also on the severity of the condition. Minor cases may not require surgery, but very severe strokes are also not suitable for surgical intervention. For example, patients who enter a deep coma due to delayed treatment and severe neurological damage, as indicated by a Glasgow Coma Scale score below 8 or even as low as 3 or 5, may survive the surgery but could be left in a vegetative state or severely disabled.

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In treatment, ischemic strokes need rapid vascular clearance to prevent cell death. Conservative treatment may involve the intravenous administration of thrombolytic agents within 3 to 4.5 hours. If endovascular surgery is used, it must be performed within 6 to 8 hours. For minor hemorrhagic strokes, conservative treatment includes medications to reduce brain pressure and control blood pressure, or administering fluids to balance electrolytes. Patients with paralysis or coma from hemorrhagic stroke may undergo minimally invasive microscopic surgery to reduce intracranial pressure or use stereotactic techniques to remove blood clots. Both medication and surgery aim to reduce the severity of disabilities resulting from strokes, and some patients may fully recover without any residual effects. Clinical observations indicate that if ischemic strokes are treated promptly, survival and recovery rates are generally higher than for hemorrhagic strokes.

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For treatment and prevention of recurrent strokes, patients should take cholesterol-lowering or blood pressure medications as appropriate. Patients at risk of clotting and who can tolerate anticoagulants are often prescribed these drugs for conditions like atrial fibrillation or cardiogenic embolism. For ischemic strokes not caused by cardiogenic embolism, antiplatelet medications like aspirin may be used as preventative drugs. Additionally, it's vital to quit smoking and alcohol, and control blood pressure, diabetes, and cholesterol levels.

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Post-Stroke Speech and Swallowing Disorders

One of the major concerns of stroke is the range of mild to severe sequelae, particularly speech and swallowing disorders. If the stroke occurs in the left hemisphere of the brain, it can affect the right side of the body and the primary language control centers located there, leading to communication difficulties. Damage to the brain's language centers can cause aphasia or dysarthria. Aphasia often presents as being able to describe an object's use but not being able to name it, sometimes confusing words like calling a fork a knife. Dysarthria, resulting from neuromuscular damage, affects the coordination of the speech organs, leading to imprecise articulation and slurred speech. Strokes can also cause reading and writing disabilities, articulatory disorders, and apraxia (difficulty controlling the lips, tongue, and cheeks during speech). Cognitive communication impairments due to affected memory, concentration, problem-solving, learning, and thinking skills may also occur.

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Swallowing difficulties arise when patients have trouble coordinating and controlling the muscles of the mouth, leading to dysphagia or respiratory difficulties when food is inhaled into the airways instead of being swallowed properly, potentially leading to pneumonia and suffocation. Speech therapists and specialists provide specialized barium swallow X-ray studies (VFSS) or endoscopic swallowing studies (FEES) for a comprehensive assessment of swallowing function, after which individualized treatment plans are developed, such as muscle training or adjusting food consistency to gradually improve swallowing ability.

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To prevent stroke, maintain a regular routine, keep a calm mindset, eat a balanced diet with more vegetables than meat, engage in appropriate exercise to maintain ideal body weight, quit smoking and drinking, and undergo regular medical check-ups. People with chronic conditions such as hypertension, sleep apnea, or atrial fibrillation should seek early medical advice, and those recovering from a stroke should follow medical advice for check-ups and medication. This approach helps to prevent stroke and avoid a second occurrence.

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Is Stroke More Likely in Winter?

The number of stroke patients increases in winter, but it is not the absolute temperature but rather the rapid changes in temperature that pose a risk. Sudden shifts from cold to warm or rapidly from warm to cold challenge the body's ability to adapt, especially as the body's adaptive capacity diminishes with age or pre-existing cardiovascular diseases. If blood pressure is poorly controlled, the body may not adjust to sudden temperature changes, significantly increasing the risk of stroke. Additionally, cholesterol build-up in the neck arteries can lead to stroke if neck manipulation or abrupt movements dislodge cholesterol deposits.

Is "Blood Letting" an Effective Emergency Treatment for Stroke?

There are rumors that pricking a finger to release blood can serve as an emergency treatment for ischemic strokes, where the sudden pain might temporarily increase blood pressure and dislodge a blockage. However, for hemorrhagic strokes, where blood pressure could spike due to the pain of pricking, this could worsen the bleeding. Therefore, the safest course of action upon signs of stroke is to seek immediate medical attention and not attempt self-treatment or take medication that could delay proper medical intervention, potentially leading to more severe neurological damage.

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