Stroke – take signs seriously

It happens without warning: your face feels numb - you have trouble speaking - your vision is blurred - you feel dizzy - and after a few minutes it's all over.

This is a typical warning sign for a possible StrokeIf you notice such symptoms, you should call the emergency services immediately.

It does not necessarily have to be a stroke (yet). It could also be a short-term disruption of blood flow to the brain - a transient ischemic attack (TIA) - or a mild stroke.

A TIA - also known as a mini-stroke or "Schlägelchen" in the Rhineland - has similar symptoms to a "major" stroke. Fortunately, a mini-stroke does not cause permanent brain damage and the symptoms disappear. However, as a precursor to a major stroke, it must be treated urgently as an emergency.

mini-stroke (TIA)

A mini-stroke (TIA) is caused by the same things as a major stroke. The blood supply to the brain is interrupted, causing entire brain regions to die. In a TIA (transient ischemic attack), the blood supply is only blocked for a short time (transient) and the brain tissue is not permanently damaged.

The most common cause of a TIA is calcification of the arteries: cholesterol-containing fatty deposits (plaques) can form in the carotid artery, which supplies the brain with oxygen and nutrients. These plaques can break off as clots. If this clot gets into a vessel that supplies the brain with blood, a mini-stroke can be triggered.

The risk of a TIA increases with age. After a mini-stroke, the risk of a major stroke is increased for up to three years.

major stroke

About 80% of all strokes are caused by a blood flow disorder (ischemic) in the brain. The major stroke or cerebral infarction is the most common form of stroke.

The causes of a stroke are different. Chronic cardiovascular Diseases increase the risk of stroke. Hypertension, heart disease, Diabetes, obstructive Sleep apnea, atrial fibrillation, peripheral arterial occlusive disease (PAD) and narrowing of the carotid artery (carotid stenosis) are the most common risk factors. But high cholesterol levels, obesity, lack of exercise, smoking and alcohol abuse also increase the risk of stroke.

examination after a mini-stroke

A mini-stroke is a "harbinger" because patients often suffer a major stroke shortly afterwards. This is why a mini-stroke must always be treated as a medical emergency. The sooner treatment begins after a stroke, the fewer nerve cells are permanently damaged.

The Doctor first tests whether you can blink and frown and how firm your handshake is. Then he checks your vision and speech, your skin's sensitivity to touch and the strength of your arms and legs. Any problems you notice here are usually a sign of brain damage.

Blood tests can provide information about other trigger such as hypoglycemia or abnormally low sodium levels. The doctor uses a color Doppler ultrasound to check whether the carotid artery is narrowed. A electrocardiogram (ECG) measures the electrical activity of the heart and shows cardiac arrhythmias such as atrial fibrillation.

Im Hospital (ideally in a hospital with a so-called stroke unit), the brain is examined more closely using a computer tomography (CT) or magnetic resonance imaging (MRI). If a stroke has actually occurred, brain damage can be identified.

Other heart problems can be diagnosed with further tests, such as a chest X-ray or a herzultraschall (Echocardiography).

If symptoms persist, medication is prescribed to dissolve the clot. Alternatively, clots can be removed from the vessel using a special catheter.

Stroke therapy should be started within a few hours.
The blood clot (thrombus) that blocks the brain vessels can be dissolved within a time window of 4,5 hours with a drug called lysis therapy.

Preventing Stroke

Early stroke treatments can prevent permanent strokes. The goal is to improve circulation and treat whatever has blocked blood flow to the brain.

The following therapies can be used:

• Antiplatelet drugs prevent blood platelets from clumping together and new clots from forming. Low doses of acetylsalicylic acid (ASA) or clopidogrel (Plavix) are often used.
• Anticoagulants block the blood clotting process. In the past, it was mostly Marcumar, but today treatment is usually carried out with so-called NOAKs such as Xarelto. This therapy is prescribed for atrial fibrillation or blood clotting disorders.
• In the case of moderate to severely narrowed carotid arteries, blocking plaques can be surgically removed (carotid endarterectomy). Alternatively, a stent can be inserted into the narrowed artery.

To remember the most important signs and symptoms of a stroke, there is the FAST rule. Fast means "quick" - each letter has its own meaning:

Face (face) - corners of the mouth droop
Arms (arms) - weakness in the arms
Speech (speech)- speech disorders
Time (time) – initiate rapid emergency care

The personal risk of a stroke can be reduced by appropriate Way of life and through preventive examinations such as a heart and vascular check significantly reduce.