Blog | Stroke and its consequences
One of the most frequent neurological pathologies that has the greatest impact on the population is stroke or cerebrovascular disease. To get an idea of how common it is, it is said that in Spain a stroke occurs every 6 minutes.
Stroke is an acute neurological disorder due to a circulatory problem in the brain that starts suddenly, so it is very important to act quickly to take the person to a doctor. Stroke is one of the main causes of death and disability, so its detection and early treatment are essential.
Adequate control and treatment of vascular risk factors, such as high blood pressure, diabetes, excess cholesterol or obesity, as well as smoking cessation could prevent 9 out of 10 strokes. Although there are other risk factors that cannot be modified, such as advanced age or family history, it is necessary and advisable to lead a healthy life to prevent it.
How does a stroke occur?
When the brain does not receive adequate blood flow, it suffers extremely, so every minute counts, because in that time thousands of neurons are dying. "Time is brain", so to speak: hence the importance of acting quickly and alerting the emergency services when the first signs of a stroke are detected.
There are two types of stroke, depending on the mechanism that produces the circulatory problem at the brain level:
- Ischemic stroke: occurs when a clot obstructs an artery in the brain. This clot may have been formed locally in the artery wall, by an atheroma plaque ("cholesterol"), or come from the heart (heart disease such as atrial fibrillation). By clogging the artery, it prevents enough blood from reaching the brain, so the neurons cannot function properly and end up dying (due to lack of oxygen and nutrients). It is the most common type.
- Hemorrhagic stroke: it occurs when a blood vessel in the brain breaks, generating bleeding within it, with damage to neurons and dire consequences.
Signs of stroke and its sequelae
Now, the big question: how can we detect stroke?
The most common symptoms are a sudden loss of strength in a limb, a sudden deviation of the corner of the mouth, an inability to speak or understand, a sudden loss of vision in one or both eyes, or a sudden loss of balance or stability.
If we detect these symptoms in someone close, what we must do is immediately notify the emergency services, explaining the perceived symptoms and their start time, as well as staying with the person who suffers from it. The sequelae that can remain after a stroke depend on the type of stroke that has been suffered and the affected brain area. Stroke disability encompasses motor, cognitive and behavioural problems that limit activities of daily living.
In order to reduce the impact of the brain damage produced and facilitate the return to daily activity, it is very important to carry out early physiotherapy. Initially, passive physical therapy is most important to avoid deformities, contractures, or abnormal postures. Later, when the patient's situation stabilizes, it is important to start an active rehabilitation, with exercises and sensory stimulation techniques to activate mobility and gait, coordination and manual dexterity. In case speech is affected, speech therapy can help to recover part of the deficit.
As far as possible, once the patient has been discharged from the hospital or corresponding centre, it is advisable to continue doing the exercises indicated at home.
Stroke and dementia
Finally, it should be noted that patients with dementia also have an increased risk of suffering a stroke due to their age and because they often have vascular risk factors. That is why we must be alert to the possible alarm symptoms of a stroke in order to act early and, above all, promote a healthy lifestyle, without forgetting physical exercise or, if necessary, resort to physiotherapy to help stimulate mobility and gait and prevent the impact that these risk factors may have on the vascular health of your brain.
Dr. ESTER ESTEBAN
Neurologist Fundació ACE
Associate professor at the Faculty of Medicine and Physiotherapy of the Universitat Internacional de Catalunya.