In medicine, there are “time-dependent” pathologies. The definition fits perfectly for stroke, which leads to the death of a more or less large portion of neurons. To save as much as possible and have less severe outcomes of the injury, it is essential to arrive early. As soon as symptoms such as sudden loss of strength in a limb or difficulty in speaking occur, it is necessary to go immediately to the emergency room for a diagnosis and the related necessary treatments.
The messages of ALICe often remember him. Italia Odv (Italian Association for the Fight against Cerebral Stroke) and the appeal was renewed, on the occasion of the Week dedicated to the brain, by the Italian Society of Neurology, through the words of Mauro Silvestrini, Director of the Neurological Clinic of the Department of Neuroscience of the University Hospital of the Marche.
Watch out for warning signs
“The sudden onset of loss of strength or sensation in an arm or leg, a twitching mouth, darkening or loss of vision in one eye or part of the field of vision, the inability to express oneself or to understand what we are told, they are all potential manifestations of a stroke – explains the expert. Even a violent headache, never presented before, can be a symptom of a stroke, more often of the haemorrhagic type. The latter, in the form of subarachnoid hemorrhage, can represent the consequence of the rupture of a congenital aneurysm, which often occurs at a young age “.
How to behave? It is important to call 118 immediately or go to the hospital, because the possibility of being treated is linked to the precocity of the administration of the therapies. The brain is the most delicate and fragile organ we have. Stroke interrupts blood flow in a more or less extended part of the brain and the brain cells, deprived of oxygen and other nutrients, begin to die at an impressive speed. “Even the simple consultation of the general practitioner at this stage is not only useless, but also harmful because the treatments can only be administered in an equipped hospital – reports Silvestrini. Knowing how to recognize suspicious symptoms, call 118 and get to the hospital in the shortest time possible, is the virtuous sequence that can save our brain “.
The treatments of today and tomorrow
On the treatment front, having pointed out the importance of the rapidity of aid, it must always be remembered that the earlier the intervention, the more effective the therapies, the fewer the complications of the treatment.
“For haemorrhages, there are a whole series of indications aimed at limiting the extent of bleeding, while real specific therapy approaches are being developed – recalls Silvestrini. For ischemia, on the other hand, fibrinolytic drugs have been available for some time which allow the dissolution of the obstructive material in the arterial level, favoring the rapid restoration of circulation in order to limit damage to the brain tissue “. In some cases, drug therapy can be combined with or replaced by “endovascular” treatments.
Through a catheter inserted in the femoral artery, it goes up to the brain and in the area where the obstruction is present some metal tubes (stents) are opened in order to reconstitute a passage for the blood flow – concludes the expert. These are techniques that require high specialization and which, for this reason, cannot be performed everywhere, but only and exclusively in hospitals equipped with Stroke Units, or neurovascular units dedicated to the management of patients with acute stroke. It should be further stressed that this type of acute phase interventions are not differentiated in relation to the patient’s age.
The same therapies are applied to the young and the elderly, without differences. There was initially a concern about the possible risks of side effects in elderly patients. Recent studies have confirmed that pharmacological fibrinolysis and endovascular interventions maintain their efficacy and safety even in subjects who develop a stroke after the age of 85 ”.