[굿클리닉]Establishing a coordinated stroke diagnosis system…blood pressure. Oxygen saturation. 24 hour ECG monitoring

[이데일리 이순용 기자] A stroke is a disease caused by a blockage or obstruction of blood vessels in the brain, and most strokes are caused by slow blood vessel disease due to risk factors such as high blood pressure, diabetes, hyperlipidemia, smoking, excessive drinking, and lack of exercise. a long time

Strokes affect around 15 million people worldwide each year, of which around 6 million die. The number of domestic patients is also constantly increasing. According to disease statistics of public interest, the number of patients diagnosed with stroke increased by more than 25,000 in 3 years from 595,000 in 2018 to 620,000 in 2021.

Stroke is the third leading cause of death in Korea and the most important cause of physical disability in people over 60 years of age. Stroke, a disease that leaves frightening neurological sequelae such as hemiplegia, aphasia, visual field disorder, and dementia, has long been known as a difficult disease to treat.

◇ More cases after age 55

It is known that people with high blood pressure are 4 to 5 times more likely to have a stroke than people without high blood pressure. Arteriosclerosis, which is formed by the accumulation of fat components and inflammatory cells on the walls of blood vessels caused by high blood pressure, diabetes, hyperlipidemia, and smoking, narrows the blood vessels, causes problems with blood circulation, and causes thrombosis to block the blood. blood flow, leading to damage to the brain, causes In addition, in the case of arrhythmia or heart valve abnormalities, blood clots form in the heart, and then the blood clots break and block blood vessels in the brain.

Professor Soon-Eok Kwon of Asan Medical Center’s Department of Neurology (President of the Korean Stroke Association), who is in charge of the Stroke Center at Asan Medical Center, said, “Strokes occur mainly in the elderly, but when the human body has its allocation, arteriosclerosis, the main cause of stroke, already in the 30s and 40s. began to be discovered. Although stroke symptoms appear to have occurred suddenly, they are actually the result of an exacerbation of the underlying disease years or decades ago. If you have a stroke at the age of 55, it means that the cause could be arteriosclerosis that has developed since your 30s.”

◇ It is necessary to know the symptoms of a stroke

A stroke can have fatal consequences if it is delayed. Therefore, it is crucial to identify stroke patients in advance and get treatment early.

If you suddenly feel a severe headache during everyday life, if you keep falling with dizziness, if you suddenly have trouble seeing part of your field of vision, if you have numbness in one arm or leg, if you cannot speak and your pronunciation is slurred, you should suspect a stroke. If you suspect the symptoms of a stroke, ask for help around you or call 119 immediately and tell them you have had a stroke, then move quickly to the hospital in accordance with the actions of the paramedics and receive treatment without going past the golden age.

◇ Strokes are prone to recurrence, and prevention is important

One in three stroke survivors will live with a disability for the rest of their lives. Patients who have had a stroke once are very likely to have it again. Arteriosclerotic cerebral infarction, the leading cause of stroke, is closely associated with high blood pressure, diabetes, hyperlipidaemia, smoking and drinking.

In order to prevent a stroke from happening again, it is also important to take medication well so that the blood vessels of the brain do not get worse and blood clots do not form in damaged blood vessels. However, taking medication alone is not enough. Professor Soon-Eok Kwon said, “The most fatal thing is alcohol and cigarettes. For brain health, especially, you should never smoke. There was a story that a small amount of alcohol could prevent dementia, but it is better not to drink because the effect can be different for each person and blood flow can be sufficiently improved in other ways.”

◇ The last hope for refractory patients who are difficult to treat

The Stroke Center of Asan Medical Center has established a collaborative consultation system with various related departments, including neurology, neurosurgery, radiology, vascular surgery, rehabilitation medicine, and emergency medicine, for the effective treatment of stroke patients. It was decided that active interaction between the stroke treatment team was necessary in order to apply the continuously developing stroke treatment technique to patients more safely.

The Stroke Center of Asan Medical Center in Seoul performs various cerebrovascular procedures for incurable patients who are difficult to treat at all local hospitals. Specifically, a stroke intensive care unit in the neurology ward is equipped with a 24-hour monitoring system for blood pressure, oxygen saturation, and electrocardiogram Professional nurses and doctors are stationed there to monitor and treat stroke patients professionally.

In addition, we operate an intensive care unit for intensive monitoring and treatment of severe stroke patients, such as patients requiring emergency surgery due to cerebral infarction or cerebral haemorrhage, patients requiring ventilator treatment, and patients who have undergone interventional radiation or surgical treatment.

To provide prompt and most effective treatment for stroke patients visiting the emergency room, the emergency room has a dedicated bed for acute stroke patients only so they can focus on treating stroke patients regardless of congestion in the emergency room.

Stroke tries to reopen blocked blood vessels using thrombolytic drugs as soon as symptoms occur, but in severe cases, treatment is performed with procedures or surgery. Coil embolization is performed to treat aneurysms at risk.

Seoul Asan Medical Center began the first brain aneurysm surgery in 1989, performed the first aneurysm neck ligation in Korea in 1991, and in 1996, Professor Kwon Do-hoon of Neurosurgery performed embolization using a GDC coil for the first time in Korea. , attempts have been made to treat brain aneurysms.

Stroke is treated by intravenous injection of a thrombolytic agent within a short time after symptom onset (usually within 3 hours) and intravenous administration of a thrombolytic agent (usually within 6 hours). On the other hand, for severely narrowed blood vessels, balloon angioplasty and stent placement are performed, and for aneurysms with a risk of bleeding, coil embolization is performed to block dangerous areas. Carotid endarterectomy to widen the narrowed carotid artery, cerebrovascular anastomosis to improve blood flow by connecting blood vessels to the blocked area, brain decompression surgery to lower intracranial pressure in the case of severe brain edema as a complication of stroke, hematoma to remove a large brain haemorrhage Surgery may be performed to remove the aneurysm, or to tie off the brain aneurysm to remove the aneurysm.

Soon-Eok Kwon, head of the Stroke Center at Asan Medical Center, said, “After a stroke, the most important thing is to ensure that rehabilitation treatment is carried out quickly at the right time. Gaining maximum functional independence and promoting return to family and society through comprehensive treatment including social work and vocational rehabilitation as well as rehabilitation treatment such as gait training, movement of daily living training, cognitive rehabilitation, speech therapy, and swallowing rehabilitation Our aim is to improve quality of life by improving quality of life,” says the goal of stroke patient treatment.

Professor Soon-Eok Kwon, director of the Stroke Center at Asan Medical Center in Seoul, explains the treatment method to a patient who has visited the hospital with a stroke. Provided by Seoul Asan Medical Center

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.