Neurologist: “This is the method by which anyone can recognize a stroke”
A person who has suffered a stroke must be transported as soon as possible to a specialized hospital, but a problem is that not all hospitals do thrombolysis (clot dissolution), says Armand Frăsineanu, a neurologist at the Clinical Hospital Colentina in Bucharest, at the conference organized by the Centre for Innovation in Medicine with the occasion of the World Day of the Brain 2017.
At the same time, the doctor emphasized the importance of a national stroke program.
“Rapid presentation at a hospital specializing in the treatment of stroke after the onset of symptoms and treatment instituted early maximizes the chance of therapeutic success and post-stroke recovery.
Treatment methods for stroke have continually improved over the past 15 years, from the introduction of intravenous thrombolysis to more sophisticated means, such as endovascular thrombectomy. (…) Our problem today remains the timely movement to a specialized hospital. Not all hospitals with neurology do thrombolysis (clot dissolution).
We do not have a national program for stroke. Everything is chaotic, the ambulance leads the patient regardless of the time window or the clinical picture, to hospitals that either do not have neurology, or have neurology but do not do thrombolysis. So, unfortunately here we are deficient and I think we have a big problem with these emergency services,” Armand Frăsineanu said.
The physician has highlighted the importance of ways to educate the population because the patients are still hesitant to address emergency services and they go to the hospital; it is preferable to address emergency services directly, and they should do the sorting. The doctor also claimed that patients should be accountable for prescribed treatments and controls.
“Vascular stroke, in addition to mortality, is also a cause of disability, with possible deficits that mean lowering the quality of life for the patient, for their family, for the social system. (…) It is easier to prevent. Speaking of a new type of anticoagulants and perceiving them as a brand new modern medication. What are their advantages – first, greater efficacy, but the most important, decrease in adverse events and side effects? A big advantage is that we have much less bleeding, and here we are talking about brain, digestive, intraocular bleeding in this class of new type of anticoagulants,” Armand Frăsineanu showed.
He also spoke about the recognition of the vascular accident by the FAST (Face, Arms, Speech, Time) method.
Among the signs to be traced in recognizing a stroke are – facial asymmetry, inability to lift both arms, speech problems. In the event of such symptoms, the emergency number should be called and that person moved as soon as possible to the nearest hospital.
“About 30% of patients have mute vascular accidents. There are areas in the brain that, although they bear a small heart stroke, do not have a special clinical expression. (…) With regard to prevention, we are discussing the identification of modifiable factors. We have unchangeable risk factors such as age, we all evolve towards a risk factor, male sex – a 40-year-old man has the same risk as a 70-year-old woman, genetic disease. (…) Very important is the time factor. 85% of vascular accidents are ischemic. In other words, a blood clot left somewhere and stopped in a larger or smaller vessel. If we are talking about atrial fibrillation, it usually starts from the heart and is a big clot,” continued Armand Frăsineanu.