Stroke is an acute cerebrovascular disease that causes severe damage to nerve cells due to interrupted blood flow in the brain. According to statistics from the World Health Organization, stroke is one of the leading causes of death globally and a common cause of disability. Early recognition of symptoms and treatment can significantly improve prognosis, making public awareness of this disease crucial.
Strokes are divided into two main types: ischemic stroke and hemorrhagic stroke. The former accounts for about 80% of all cases, while the latter is caused by bleeding due to a ruptured blood vessel. There are differences in etiology, symptoms, and treatment methods between the two, but both require emergency medical intervention. This article will systematically analyze the causes, symptoms, diagnostic processes, and preventive measures of stroke to help readers establish a comprehensive understanding of the disease.
The pathogenesis of stroke involves complex pathological changes. Ischemic stroke is often caused by atherosclerosis, where fat deposits in the blood form plaques, ultimately leading to thrombosis or vascular obstruction. Chronic diseases such as hypertension, hyperlipidemia, and diabetes accelerate the process of arterial hardening, significantly increasing the risk of narrowing of cerebral blood vessels. Hemorrhagic stroke, on the other hand, is related to the weakening of small blood vessels in the brain, commonly seen in patients with long-term uncontrolled hypertension or cases of ruptured congenital aneurysms.
The typical symptoms of stroke can be quickly identified using the "FAST" mnemonic: F (facial drooping), A (arm weakness), S (speech difficulties), T (time to call emergency services). During an acute episode, patients may experience unilateral limb paralysis, visual disturbances, or sudden severe headaches. Some cases may also present with less common symptoms such as amnesia, cognitive impairment, or spatial disorientation.
Different areas of the brain being affected can lead to different symptoms:
It is noteworthy that about 15-20% of patients may experience a "mini-stroke" (transient neurological deficit) before a full-blown stroke, with these symptoms typically resolving within 24 hours, yet they are a strong warning sign of an impending stroke.
The diagnostic process typically consists of two phases: emergency assessment and subsequent examinations. Emergency room staff will immediately conduct a "NIHSS stroke scale" assessment to evaluate the degree of neurological deficit and simultaneously arrange for a head CT or MRI to confirm the location of bleeding or infarction. For patients suspected of having cardiogenic embolism, echocardiography can help identify potential causes such as atrial fibrillation or endocarditis.
Blood tests include coagulation function tests, blood sugar and lipid analysis, and inflammatory marker assessment. For patients suspected of arterial stenosis, cerebral artery Doppler ultrasound or angiography (DSA) can accurately assess vascular conditions. It is essential to differentiate between ischemic and hemorrhagic strokes during the diagnostic process, as treatment methods differ significantly.
The golden treatment window for ischemic stroke is within 4.5 hours of onset, during which intravenous administration of tissue plasminogen activator (tPA) can dissolve blood clots, provided that bleeding risk is ruled out. Mechanical thrombectomy is applicable for patients with large vessel occlusion and can remove clots via catheter; this procedure must be performed within 24 hours of onset. Treatment for hemorrhagic stroke prioritizes controlling blood pressure and reducing intracranial pressure, with some patients requiring surgery to remove hematomas or repair aneurysms.
Rehabilitation treatment after the acute phase includes physical therapy, speech therapy, and occupational therapy to help patients regain their ability to perform daily activities. Long-term medication is necessary to control risk factors, such as using antiplatelet drugs (aspirin) or anticoagulants (warfarin) to prevent recurrence. Patients with atrial fibrillation need to use anticoagulants regularly while also managing blood sugar and lipid levels.
Primary prevention focuses on managing risk factors: regularly monitoring blood pressure, blood sugar, and lipid levels, keeping blood pressure below 140/90 mmHg, and ensuring low-density lipoprotein cholesterol levels are below 100 mg/dL. Quitting smoking can reduce the risk of stroke by 30-50%, and it is recommended to adopt the DASH diet, reducing sodium intake and increasing dietary fiber.
Secondary prevention targets individuals with a history of stroke, requiring continuous use of antiplatelet medications and strict control of risk factors. For patients with carotid artery stenosis greater than 70%, carotid endarterectomy or stenting can reduce the risk of recurrence. Regular cerebrovascular assessments, including magnetic resonance angiography and ultrasound examinations, help in the early detection of potential lesions.
When symptoms such as unilateral limb weakness, speech difficulties, or sudden blurred vision occur, emergency services should be called immediately. Even if symptoms temporarily disappear (such as in a mini-stroke), outpatient medical attention is still necessary. Patients with symptoms of the three highs (hypertension, hyperglycemia, hyperlipidemia) should undergo annual cerebrovascular risk assessments, and those over 50 years old are advised to have relevant examinations every six months.
If severe headaches accompanied by neck stiffness, confusion, or sudden seizures occur, they should be treated as medical emergencies. Patients with cerebral hemorrhage may exhibit critical signs such as sudden spikes in blood pressure or unequal pupil sizes, requiring immediate medical attention. Family members who notice warning signs indicating that "time is brain" should initiate emergency procedures without delay.
Rehabilitation treatment after a stroke should begin as early as possible, typically within 24 to 48 hours after the condition stabilizes. A multi-faceted rehabilitation program involving physical therapy, occupational therapy, and speech therapy can effectively improve limb function, cognitive abilities, and daily living skills. Early intervention can promote neuroplasticity and increase recovery chances.
What dietary components should be particularly avoided to prevent stroke recurrence?Foods high in sodium, cholesterol, and sugar can increase blood pressure and lipid levels, raising the risk of stroke. It is advisable to reduce the intake of processed foods, fried items, and sugary beverages. Increasing the consumption of vegetables, whole grains, and omega-3-rich deep-sea fish, while following the DASH Diet principles, can help lower the likelihood of a second stroke.
Can emotional stress directly trigger a stroke?Simple emotional stress is not a direct cause of stroke; however, prolonged stress may lead to elevated blood pressure and unhealthy lifestyle habits (such as staying up late and binge eating), indirectly increasing the risk of atherosclerosis or thrombosis. It is recommended to manage stress through exercise, meditation, and regular monitoring of blood pressure and lipid levels.
Do stroke patients need to continue taking antiplatelet medications after recovery?Yes, even if symptoms improve, doctors usually recommend long-term use of aspirin or other antiplatelet medications to reduce the risk of thrombosis. Patients should adhere to medical advice regarding medication schedules and should not discontinue medication without consulting their doctor, while also attending regular follow-ups to evaluate medication dosage and effectiveness.
Can young people increase their risk of stroke due to staying up late or prolonged sitting?Yes, modern research shows that the incidence of stroke is gradually increasing among individuals aged 30-40 due to factors such as staying up late, lack of exercise, obesity, or metabolic syndrome. Unhealthy lifestyles may accelerate atherosclerosis, so it is advised for young people to maintain regular schedules, control their weight, and undergo regular health check-ups.
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