Signs of a stroke

Article by Master, Doctor Mai Xuan Thien - Emergency Doctor - Emergency Department - Vinmec Times City International General Hospital

The golden time to treat and save a stroke person's life is < 4.5 hours after a stroke. Therefore, the signs of stroke need to be detected early, emergency treatment promptly, giving the opportunity to restore health, complete recovery and good quality of life for the patient.

A stroke is a condition of brain damage that occurs when the blood supply to the brain is interrupted or significantly reduced. The brain is starved of oxygen and nutrients, and brain cells begin to die within minutes. Therefore, a stroke is an urgent medical emergency that requires prompt diagnosis and treatment.
Stroke is the leading cause of disability and the 4th leading cause of death worldwide, leaving a heavy burden of disease and costs, especially in low-income or developing countries. like in Vietnam.
Over the past 20 years, the stroke rate in Vietnam has increased from 213.58/100,000 people in 1990 to 254.78/100,000 people in 2010. More than 200,000 people have new strokes each year and lead to 11,000 deaths nationwide. . The study on the burden of disease in 2013 showed that the death rate from stroke accounted for 32% and about 1.5 million people (equivalent to 1.6% of the population of Vietnam in 2013) were living with the consequences. of stroke.
One of the greatest opportunities to reduce stroke mortality and disability is to provide acute stroke care and comprehensive care for stroke patients according to the most up-to-date treatment guidelines. such as the use of thrombolytic drugs, cerebral revascularization techniques, as well as drugs for prevention and treatment of risk factors.
Watch now: Who needs stroke screening?

If you or you witness someone having a stroke, you need to pay attention to the time of onset. “Time is the brain” - within a few minutes without an adequate blood supply, brain cells will begin to die due to lack of oxygen, greatly affecting the body's ability to move and think, and can even lead to death. to death. However, early treatment of stroke gives very good results.
Signs of a stroke include:
Speech disorder or difficulty understanding language: People who have had a stroke may have confusion, slurred speech, or difficulty speaking. Numbness or paralysis of the face, arms or legs. A person who has had a stroke may suddenly develop numbness, weakness, or paralysis of the face, arm, or leg, often on one side. Facial paralysis manifests itself through signs such as eyes that do not close properly on one side, one cheek sagging down, the nucleus deviated, drinking water spills out, or when paralyzed, the patient may fall off objects when he is paralyzed. is holding (chopsticks, spoons, etc.) Vision disturbances in one or both eyes: People who have had a stroke may have blurred or double vision in one or both eyes. Headache: The patient may have a sudden onset of severe headache, which may be associated with nausea, vomiting, dizziness, or changes in consciousness (drowsiness, agitation...) Having a stroke can suddenly appear dizzy, with problems with coordination and balance.

You need to go to a medical facility immediately, preferably a hospital with a Stroke Unit or a Stroke Center, if any of the following signs or symptoms appear. Note that it is still important to go even if the signs of a stroke appear and then improve quickly on their own. Remember “FAST” for the fastest detection of stroke symptoms.
F. face: Ask the patient to smile. See if one side of the face is sagging? A. arms (Chi): Ask the patient to raise his arms. See if one side falls down? Or can one arm raise itself? S. speech: Ask the patient to repeat one or two simple sentences. Note can the patient repeat? Do you understand what I'm saying? Or is there anything abnormal in pronunciation (slurred, slurred, ..)? T. time: It is necessary to note and record the time of onset of symptoms, which is very important in deciding the treatment methods of the patient.

The first thing to do is Call medical assistance immediately. "Time is the brain". Therefore, do not wait, watch to see if the symptoms recover or not. Early treatment is extremely important for good treatment results, allowing patients to recover even without leaving any sequelae.
While waiting for support from medical staff, you need to keep calm and closely monitor the patient.
People who have had a stroke may lose their balance and fall or become unconscious. You need to take the following steps:
Be sure to call for help from medical staff, record the time of onset of stroke symptoms. In case the patient is awake, cooperating well, not vomiting, it is necessary to ensure their safety, put the patient in a comfortable position (Preferred position is Fowler or semi-Fowler position as shown below). , loosen clothes and reassure and encourage the patient to avoid fear and anxiety. Talk often so that the sick person is always awake, do not let the sick person sleep.

In case the patient vomits a lot, or has a disturbance of consciousness (Confusion, lethargy, ..) it is necessary to support the patient in a safe side-lying position (According to the picture below)

If the patient is unconscious or comatose, the breathing and pulse should be checked. If you are no longer breathing, you need to take immediate steps to CPR (This skill requires training and practice to ensure correct and effective implementation).

Talk, reassure and encourage the sick person. Cover the patient with a blanket to keep them warm. Tuyet must not give the patient anything to eat or drink, even drugs, especially antihypertensive drugs or anti-stroke drugs according to folk experience or oral tradition. Absolutely do not give first aid for a stroke according to your own experience, self-study on social networks such as shaving the wind, taking medicine to prevent stroke, or pricking blood with ten fingers ... If the patient has limb paralysis, it should be saved. Intention to avoid moving or pressing on the paralyzed limb. When the ambulance arrives, follow the instructions of the medical staff to be able to provide maximum support to the patient. Vinmec Times City International Hospital has 10 years of experience in treating acute cerebral stroke with thousands of cases. The emergency and intervention process for stroke patients is organized in a methodical manner with close coordination of many specialties: pre-hospital emergency, out-patient emergency, neurology, diagnostic imaging.
With the advantage of being located in the middle of the Times City urban area, over the years, Vinmec Hospital's emergency team has quickly approached and successfully treated, saving many lives of residents and people living in the unfortunate vicinity. stroke.
Early detection of stroke risk in young, normal people for optimal stroke prevention. In response to the request from that fact, the Hospitals in Vinmec Health System have provided the Basic Stroke Risk Factors Screening Package for the following subjects:
People ≥ 40 years old. If results are normal, re-test every 12 months. Particularly for in-depth surveys such as brain MRI, transesophageal echocardiography, Holter ECG, etc., the time of re-screening will be specifically advised by a stroke specialist after all test results are available. General health screening packages can be combined. People aged 20-39 years old. If the results are normal, re-screen every 3 years and adjust according to the age package. Can be combined with the regular health screening package People under 19 years old. If results are normal, re-screen every 5 years and adjust according to age package. Can be combined with a regular health screening package. Customers using the Basic Stroke Risk Factors Screening Package at Vinmec will be examined and treated with a team of highly qualified, experienced doctors with a full range of professional equipment for diagnosis. identification and treatment interventions according to international standards.