Monday , April 19 2021

every minute of delay can cost lives



The symptoms need to be recognized

A stroke is an acute disorder of blood flow to the brain that occurs when the blood vessel that feeds the brain suddenly becomes clogged and causes symptoms of brain damage. Although stroke is often talked about, the head of the RVUL stroke center, doc. dr. Vilionskis says there could be more information: “Stroke is an acute illness and unfortunately we cannot predict when it will happen – there are no early warning signs.

A stroke that has already occurred has clear signs: a sudden speech disorder, weakness or numbness of one side of the body, impaired vision in one eye, disturbed balance. It should be noted that imbalance and dizziness (vertigo) are two different things and only imbalance is considered a typical sign of a stroke. If at least one of these symptoms occurs, help should be sought as soon as possible. “

Sometimes, a person who has had a stroke cannot assess their condition on their own, do not recognize the symptoms, or ignore them and try to act as if nothing has happened. Therefore, it is very important that the symptoms of this disease can be noticed by close relatives or even strangers who would call for help without waiting for anything.

When asked whether a person should do something while waiting for emergencies or not, the neurologist answers that there are no specific recommendations. The most important thing is to call an ambulance (GMP) immediately and report the signs of a stroke to the dispatcher very clearly.

If possible, doc. dr. A. Vilionskis advises that the medicines used by the patient be collected at home and the available medical documents so that future doctors will have as much information about the patient as possible in emergencies. It is especially important to know if the patient is taking anticoagulants (medicines that prevent blood clotting), to know their name and the time of last use. Also, keep up to date with recent bleeding and surgery.

“Time is the brain”

In the case of a stroke, time is of the essence. Doc. dr. A. Vilionskis urges them not to wait or expect the symptoms of a stroke to go away on their own: “We should not expect the symptoms to go away. The GMP should be called immediately. Late arrival of help will result in loss of access to specialist treatment available within 4.5 to 6 hours after the onset of symptoms.

These watches are the “golden age”. It is very important to understand that the sooner we start specialized treatment, the better the results will be. It is not in vain that time is supposed to be the brain. The sooner treatment begins, the more brain cells will be saved. “

The neurologist also notes that although modern stroke therapy can significantly reduce the long-term disability caused by a stroke, even timely specialized treatment cannot guarantee that the patient will fully recover and will not have the health consequences of the stroke.

Treatment and prevention

Under current procedures, patients with suspected stroke are urgently transported to the nearest stroke treatment center (IGC) or emergency hospital (TPL), where specialized stroke treatment is available. In the absence of specialized treatment, patients may be referred to other hospitals for further medical supervision. The goal is to deliver the person to a medical facility no later than one hour after the GMP call.

Doc. dr. A. Vilionskis says that in the emergency room of such a patient is immediately examined by a neurologist, performs the necessary examinations (for example, blood tests, computed tomography of the brain) and decides what specialized treatment to use.

“After confirmation of the diagnosis and in the absence of contraindications, the patient is immediately subjected to intravenous thrombolysis by direct intravenous administration of an antithrombotic drug or by mechanical thrombectomy when the thrombus is mechanically removed from a closed artery. Which method of treatment will be used depends on the patient’s condition, concomitant pathologies, obtained research results and other available information, “says doc. dr. A. Vilionskis.

The head of the RVUL Stroke Center points out that the disease is easier to treat, but to do everything to prevent it. According to him, identifying risk factors for stroke and eliminating them significantly reduces the chances of stroke: “These include monitoring blood pressure, early diagnosis and treatment of diabetes, detection and correction of high cholesterol, physical activity, quitting the habit, especially smoking. .

In atrial fibrillation, the use of anticoagulants significantly reduces the risk of stroke. It is important to know, however, that this did not guarantee that a stroke would never happen. “The doctor also warns that medical care is always necessary, as strokes do not only affect the elderly – every year the Stroke Center treats 3-4 patients under the age of 30.

Lithuania leads and lags behind

Doc. dr. A. Vilionskis says he will be in the RVUL Stroke Center in 2020. the drug is more than 1100 patients with acute stroke and this number remains similar to previous years. He points out that the stroke center during the pandemic and quarantine was the same and remains the same as in previous years: the difficult epidemiological situation in the country did not change the ways of treating stroke or the availability of treatment, and patients received all necessary help.

“Comparing the situation in Lithuania with other European countries, we can be happy that the treatment of stroke – thrombolysis and thrombectomy – is really large. We are in the top ten in terms of thrombolysis per million population in Europe and in the top three in terms of mechanical thrombectomy. “Besides, Lithuania is one of the few European countries where the mechanical thrombectomy procedure is fully reimbursed from the PSDF fund,” says the head of the stroke center.

Doc. dr. A. Vilionskis notes that the work of the RVUL Stroke Center in 2019. was evaluated internationally. According to the ANGELS initiative, supported by the European Stroke Organization (ESO), the Stroke Center received a gold award: “This award means that we are moving in the right direction, in step with stroke centers in other countries, using the latest treatments and tactics. It should give patients even more confidence in our institution and doctors. “At the same time, the neurologist hopes that in the future not only will treatment conditions improve, but more and more people will understand the importance of stroke prevention and the number of strokes in Lithuania will decrease.

The FAST message will help you identify a stroke and take action

F (face) – distortion of the face or asymmetry smiling. Smile and show your teeth. Note that one side of the face is distorted and has not lost sensitivity.

A (arms) – weakness or paralysis of the arm on one side. Raise both hands and note that one hand is weak, insensitive.

S (speech) – speech disorders or slurred speech. Say a few simple sentences out loud. Consider whether you can do this, whether you can speak or understand the language of those around you.

T (time) – time to call GMP. If you notice any of these symptoms, call GMP immediately.


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