Simple questions about stroke diagnosis

Three questions also allow laypeople a quick stroke diagnosis

10/01/2012

In a stroke, fast action is particularly important to prevent permanent damage to the brain and the worst-case scenario in those affected. Often, however, the symptoms are not associated with a stroke and unnecessary time is lost before the stroke patients receive medical attention. Three simple questions can allow laymen to assess the situation. If these confirm the suspicion of a stroke, an emergency doctor should be consulted as soon as possible.

Every year around 270,000 people in Germany suffer a stroke, according to experts from the Center for Stroke Research at the Berlin Charité. According to information from the Federal Statistical Office in Germany, almost 70,000 patients die each year as a result of a stroke. Also be one „Stroke is the leading cause of acquired disability in adulthood“, reports the Foundation Council Chairman of the German Stroke Help, Karl Max Einhäupl. The stroke usually affects the elderly, according to Einhäupl, who is also Chairman of the Charité Universitätsmedizin Berlin. According to the expert, around 80 percent of those affected are over 60 years old.

Rapid help reduces the risk of permanent damage in strokes
Cause of a stroke are usually sudden hypoperfusion of individual brain areas (clogged blood vessels) or cerebral hemorrhage (burst blood vessels). Due to the undersupply of the brain cells with oxygen, nutrients and other substances, these are no longer functional and threaten to die. The longer the shortage exists, the greater the risk of lasting damage to the brain or, in the worst case, even a fatal course. On the other hand, fast acting could save the endangered brain cells and thus significantly improve the prospects for the patients, the experts report. „The chance that a person recovers from it without permanent mental or physical consequences increases significantly with the speed at which help approaches“, explained the neurologist Karl Max Einhäupl. Therefore, it is important that as many people as possible know the typical symptoms of a stroke and know how to react.

Three questions as stroke rapid test
The three-question test for rapid stroke diagnosis can be used not only by paramedics but also by laymen to gain an assessment of the situation. First, it checks to see if the patients can form their mouths into a steady smile. Then it is to test whether both arms can be held evenly with the palms. And finally, patients have to repeat a simple sentence. If all tests are not successful, according to the experts „95 percent have a stroke before and the affected person must go to the hospital immediately.“ But even abnormalities in just one of the issues, should be the occasion to alert the ambulance.

In case of stroke symptoms, immediately dial the emergency call
Symptoms of stroke include blurred vision, speech problems, severe dizziness, partial body sensations of numbness, paralysis and severe headache. The Secretary General of the German Stroke Society, Otto Busse, said: „If you suddenly notice any of them, either yourself or others, dial 112.“ Here is the principle, „rather the rescue service too much once too little“ call. There are many more options than dialing the emergency number anyway. It is only important that those affected reach a clinic as quickly as possible. At hospital admission, the cause of the stroke is determined first on the basis of computed tomography (CT) or magnetic resonance tomography (magnetic resonance imaging, MRI). According to buses, this is „in 85 percent of all cases a lack of blood flow through the brain by a vascular occlusion.“ In only 15 percent of the cases is it a cerebral hemorrhage.

Treatment options for strokes
Cerebral hemorrhages and reduced blood flow are basically different approaches. While blood clots, which are the cause of vascular blockage, are usually dissolved in the clinic with the help of an infusion of anticoagulant medication, cerebral hemorrhages generally require coagulation-promoting drugs. However, according to the Secretary General of the German Stroke Society, the resolution of possible blood clots must „at the latest four and a half hours after the onset of the first symptoms, otherwise the procedure is too dangerous and hardly effective.“ In the treatment of cerebral hemorrhages, according to the experts also rush is required. „This too must be done as soon as possible“, emphasized buses. It would be advantageous if the clinic includes a so-called stroke unit, which specializes in the treatment of strokes. However, only 229 clinics in Germany currently have a corresponding unit.

Stroke units at the clinics specializing in strokes
The first day after the stroke, according to the experts, practically the rehabilitation begins. The clinics with a stroke unit are also relatively well positioned in this respect. Patients around the clock would be looked after by a team of neurologists, cardiologists, neurosurgeons, vascular surgeons and radiologists. These also discuss with the patients possible approaches to rehabilitation. „The stroke unit has the character of an intensive monitoring station“, explained the specialist in neurology, Peggy Ehrlich, from Vivantes Auguste-Viktoria-Klinikum at the end of September in a lecture at the stroke center of the Berlin Charité. Here important vital functions such as heart activity, blood pressure, respiration, blood sugar and body temperature were closely monitored, with the goal „the best possible setting of these parameters“ to achieve and thus protect the brain from further damage. (Fp)

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Picture: Martin Büdenbender