Stroke patients in Korea 19% ↑ in 5 years… Symptoms of doubt and how to deal with it?

The number of stroke patients in Korea has increased by 19% over the past five years, and a stroke warning is on. Stroke is the second most common cause of death after cancer.

‘Stroke’, a collective term for brain infarction where blood vessels are blocked and cerebral haemorrhage where blood vessels burst, and its causes, symptoms, treatment, and link with dementia, were investigated through a question and answer session. answer from Professor Won-Sang Cho of Neurosurgery. at Seoul National University Hospital.

◇What are the main symptoms of a stroke?

-When you have a stroke, you often think of a scene in a play where you fall down by grabbing the back of your neck. However, the symptoms of an actual stroke are different. The most common sign is a momentary obstruction of vision, as if a light had been turned off. Half the field of view is narrowed as if a curtain had been drawn. In addition, parts of the body may become paralyzed or sensory functions may be reduced.

Speech dysfunction is one of the symptoms of a stroke. After a stroke, speech can become slurred or aphasia can develop, and it can be difficult to understand other people’s words even if they speak well. In severe cases, you may lose consciousness and collapse.

◇Are there any new cases of stroke emerging?

-The main common causes of cerebral infarction and cerebral hemorrhage are hypertension, diabetes, hyperlipidemia, smoking, family history, and obesity. In recent years, taking the wrong medication has also been a cause of stroke. This is the case if you are taking antiplatelet and anticoagulant medicines, which are blood thinners.

In particular, some of the elderly personally buy and take antiplatelet drugs, such as aspirin, for the purpose of preventing cerebral infarction. Medically, taking aspirin is not recommended because there are more ‘disadvantages’ such as cerebral haemorrhage and gastrointestinal bleeding than ‘benefits’ such as preventing cerebral infarction. Make sure you consult your doctor before taking it.

◇Can memory loss occur after a stroke?

– Stroke and dementia are linked. This is because damaged brain blood vessels can damage brain tissue and cause memory impairment. This is called ‘vascular dementia’ to distinguish it from general degenerative dementia such as Alzheimer’s. It is typically accompanied by other neurological symptoms such as paralysis and disturbances in the visual field.

Hydrocephalus, caused by a pool of water in the head due to a stroke, can also cause symptoms of dementia. Fortunately, hydrocephalus is a disease that can be cured with relatively easy surgery. Dementia caused by hydrocephalus has been identified as the only ‘treatable dementia’.

Professor Cho Won of Seoul National University Hospital Neurosurgery ⓒSeoul National University Hospital sang

◇How is a stroke treated?

-Cerebral haemorrhage with ruptured blood vessels and cerebral infarction with blocked blood vessels are treated differently. In the case of cerebral hemorrhage, if the amount of bleeding is large enough to affect the intracranial pressure, surgery is performed and a small amount of bleeding is allowed to be absorbed. Continued bleeding is also important. If the blood vessels do not stop bleeding, hemostasis should be performed.

On the other hand, in cerebral infarction, the degenerative state of the brain is important. When blood vessels are blocked, the brain swells, and brain swelling is more severe than skin swelling. If the brain is so degenerated that it cannot return to its original shape, it is impossible to puncture the blocked blood vessels, so only drug treatment is possible.

The skull can be opened to a safe place so that the swollen brain does not press on the blood vessels, and sometimes hypothermia is performed to prevent swelling of the brain by lowering the body temperature to lower the intracranial pressure.

◇Do you have any countermeasures to preserve the golden hour of a stroke?

-If you see someone nearby who has fainted, it is important to call 911 and go to the emergency room as soon as possible. Because treatment is so advanced, medication can be used if you arrive at the emergency room within 4 hours and 30 minutes of symptom onset. In a cerebral infarction caused by a blockage of blood vessels, if you get to the emergency room within 24 hours, the blocked blood vessels can be cleared.

◇A word for people with cerebrovascular disease

-Sometimes people ask a lot of questions about cerebrovascular disease prevention, but there is nothing special about cerebrovascular disease prevention. The most important thing is to control risk factors. It is important to exercise appropriately, abstain from alcohol and smoking, as well as manage underlying diseases such as high blood pressure, hyperlipidemia, and diabetes on a daily basis. Management of other parts can be left to the medical staff after consultation.

Those who have already suffered a stroke need ongoing management to prevent it from happening again. Even if there are sequelae, most of them can recover close to normal if they are well rehabilitated.

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