Hospital Care: Preventing Strokes From Getting Worse

A stroke is a life-threatening medical emergency that requires immediate attention to prevent permanent damage or death. It occurs when there is an interruption in blood flow to the brain, resulting in the death of brain cells due to oxygen deprivation. The longer the delay in receiving treatment, the greater the risk of permanent brain damage or death. Therefore, seeking prompt medical attention is crucial to improving the chances of recovery and minimising the severity of the stroke.

Strokes are a life-threatening emergency requiring immediate medical attention to prevent permanent damage or death

Strokes are a life-threatening medical emergency that requires immediate medical attention. A stroke occurs when there is an issue with blood flow to the brain, often due to blocked arteries or bleeding in the brain. This interruption in blood supply causes brain cells to be deprived of oxygen, resulting in their eventual death if left untreated. Therefore, timely medical intervention is crucial to prevent permanent brain damage or even death.

The faster a person having a stroke receives medical attention, the better their chances of recovery without disabilities. Recognizing the warning signs of a stroke is essential, and the BE FAST acronym is a helpful tool for this:

• Balance: Watch for a sudden loss of balance.
• Eyes: Look for sudden loss of vision or double vision in one or both eyes.
• Face: Ask the person to smile and observe for a droop on one or both sides of the face, indicating muscle weakness or paralysis.
• Arms: Check for muscle weakness on one side by asking the person to raise their arms; one arm may sag or drop.
• Speech: Strokes often cause difficulty in speaking, slurred speech, or trouble choosing the right words.
• Time: Time is critical; don't delay in seeking medical help.

Strokes are a leading cause of disability and the second-highest cause of death worldwide. They can have severe and permanent consequences, including serious disabilities, the inability to live independently, and even death. Even with good treatment and care, a severe stroke can result in significant health complications and a challenging road to recovery.

Additionally, the risk of a second stroke is much higher after an initial stroke, and this increases the likelihood of further health deterioration. Therefore, it is imperative to seek immediate medical attention for strokes to optimize the chances of recovery and prevent permanent damage or loss of life.

The longer the delay in receiving treatment, the greater the risk of permanent brain damage or death

A stroke is a life-threatening medical emergency that requires immediate attention. The longer the delay in receiving treatment, the greater the risk of permanent brain damage or death.

Strokes occur when there is an interruption in the blood supply to the brain, resulting in the death of brain cells due to oxygen deprivation. The faster a person receives medical attention, the better their chances of recovery without disabilities. With rapid medical intervention, many people can survive an initial stroke. However, the longer the delay, the higher the likelihood of permanent neurological damage or even death.

Time is of the essence in stroke treatment. The quicker the blood flow is restored, the more effectively the severity of the stroke can be mitigated. Every second counts, and immediate medical attention is critical to prevent permanent damage or death. The first few hours after a stroke are crucial for treatment, and certain treatments are only effective within a specific timeframe. For example, thrombolytic drugs, which dissolve blood clots, are effective within the first three to four and a half hours after a stroke. Beyond this window, they increase the risk of dangerous bleeding complications.

Additionally, the risk of a second stroke is much higher after the first, and the impact of a subsequent stroke can be more severe, especially if the initial stroke has already caused damage to the brain. Therefore, it is imperative to seek medical attention promptly to reduce the risk of another stroke and the potential for further brain damage or life-threatening complications.

In summary, delaying treatment for a stroke can have severe consequences, including an increased risk of permanent brain damage or death. Seeking immediate medical attention is crucial to improving the chances of recovery and reducing the potential for long-term disabilities or life-threatening complications.

Stroke treatment options are expanding due to advances in technology and medicine

A stroke is a life-threatening medical emergency that requires immediate attention to prevent permanent damage or death. Treatment options for stroke are expanding due to advances in technology and medicine. Here are some ways in which stroke treatment is evolving:

• Portable MRI Machines: Dr. Kevin Sheth, Division Chief of Neurocritical Care and Emergency Neurology, has collaborated with a team of doctors and engineers to develop a portable MRI machine. This machine can be easily wheeled to a patient's bedside, providing early medical interventions that can mean the difference between a full recovery and significant disability or death.
• Advanced Neuro-Monitoring Technology: Vascular neurologist Nils Petersen and his team are using advanced neuro-monitoring technology to study how to manage a patient's blood pressure in the acute phase after a stroke. Their research shows that optimal stroke treatment depends on personalized blood pressure parameters, which can be complicated to calculate.
• Harnessing the Immune System: Dr. Lauren Sansing, Academic Chief of the Division of Stroke and Vascular Neurology, is working to understand how the immune system responds to stroke and how this knowledge can be used to develop targeted therapeutics to minimize early injury and enhance recovery.
• Endovascular Therapy: Endovascular intervention with mechanical thrombectomy has been shown to improve functional outcomes in select patients with severe stroke and large artery occlusion in the anterior cerebral circulation. This treatment option can reduce death and disability.
• R-tPA Treatment Window Expansion: Recombinant tissue plasminogen activator (r-tPA) is a treatment for acute ischemic stroke, but its limited time window for administration has excluded many patients. Recent advances have extended the treatment window, increasing the number of patients who can benefit from this therapy.
• Telestroke and Mobile Stroke Units: Telestroke and mobile stroke units have improved access to stroke care, particularly in rural areas. These innovations have reduced delays in treatment and improved functional outcomes.
• Information Technology and Mobile Health: Mobile health applications and information technology are being utilized to enhance stroke management, including rapid detection, triage, prehospital assessment, in-hospital communication, and rehabilitation. For example, the "iPronator" application helps to objectively assess arm weakness using a built-in accelerometer on mobile devices.

The risk of a second stroke is much higher after the first, and can be more severe

A stroke is a life-threatening condition that occurs when there is an interruption in the blood supply to the brain, resulting in brain cell death due to oxygen deprivation. The risk of experiencing a second stroke is significantly elevated after the first occurrence, and this subsequent stroke can have more severe consequences.

The likelihood of having a second stroke is much higher following an initial stroke. This heightened risk underscores the importance of proactive prevention strategies to mitigate the chances of recurrence. The risk of recurrence is highest in the early stages after the first stroke but remains elevated for several years. Therefore, implementing secondary prevention efforts as soon as possible is crucial to optimising long-term benefits.

The impact of a second stroke can be more severe, particularly if the individual already has brain damage from the initial stroke. A subsequent stroke can exacerbate existing neurological deficits and further compromise the individual's health. The medical team plays a pivotal role in reducing the risk of a second stroke by actively managing risk factors such as blood clotting, high blood pressure, and heart problems.

The risk of a second stroke underscores the importance of seeking immediate medical attention for the initial stroke. With prompt treatment, many individuals can survive the initial stroke and reduce the likelihood of recurrence. However, even with optimal care, a severe stroke may result in serious disabilities or impede an individual's ability to live independently.

To summarise, the risk of a second stroke is significantly elevated after the first, and this subsequent event can have more severe health implications. Proactive prevention strategies, early identification of risk factors, and timely medical intervention are crucial to mitigating the chances of recurrence and minimising potential health consequences.

Good treatment and care can help people make the best possible recovery

A stroke is a life-threatening medical emergency that requires immediate attention. The faster a person receives treatment, the better their chances of recovery without disability. Good treatment and care can help people make the best possible recovery.

The Rehabilitation Team

The rehabilitation team for a stroke patient includes physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, and nurses. They meet daily to discuss the patient's condition, and therapy is delivered as often as every hour during the first day or two.

The Rehabilitation Process

The rehabilitation process focuses on helping the patient regain their ability to perform basic activities of daily living (ADL), such as bathing or preparing food. Rehabilitation psychologists and neuropsychologists play a crucial role in screening for cognitive, emotional, and behavioural challenges. They create a plan to improve cognitive function and develop resilience in the face of potential permanent lifestyle changes.

Types of Therapy

Physical Therapy

Physical therapy helps improve or regain the ability to use hands, arms, feet, and legs. It also addresses balance issues and muscle weakness.

Occupational Therapy

Occupational therapy helps retrain the brain to perform daily activities. It is particularly beneficial for improving precise hand movements and muscle control.

Speech Therapy

Speech therapy assists in regaining language and speaking abilities and improving the ability to control muscles involved in breathing, eating, drinking, and swallowing.

Cognitive Therapy

Cognitive therapy is recommended for individuals experiencing memory problems or difficulties with tasks requiring focus and concentration.

Recovery Timeline

The recovery timeline after a stroke varies for each individual. The first three to four months after a stroke are crucial for recovery, with most patients making significant progress during this period. However, improvements are still possible beyond this timeframe, albeit at a much slower pace.

Frequently asked questions