Stroke
Cerebrovascular Accident (Stroke) is an expression of a cerebrovascular disease. Globally, around 15 million individuals are affected by stroke, resulting in 5 million fatalities and an additional 5 million individuals living with permanent disabilities.
According to estimates, there are approximately 15,000 stroke incidents in Israel annually. A stroke is ranked as the third most frequent cause of mortality in Israel.
Types of Cerebrovascular Accidents (Strokes)
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Approximately 85%of stroke incidents are ischemic strokes, caused by an obstruction of brain blood vessels.
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Approximately 15%of stroke incidents are haemorrhagic strokes, which are due to a rupture of a blood vessel that causes haemorrhage (bleeding) into the brain’s tissue.
An incident of a transient ischemic attack
This type of stroke is characterized by symptoms that typically subside within a few minutes or hours. If you experience new symptoms, it is recommended to seek medical evaluation in the emergency room, as it could indicate a transient ischemic attack. Occasionally, the medical evaluation may necessitate hospital admission for a few days.
Ensuring strict adherence to prescribed medication therapy following a stroke and embracing a healthy lifestyle (physical activity, nutrition, and smoking cessation) may help prevent some of the recurrent stroke incidents.
Risk factors for cerebrovascular accident (stroke)
The main risk factors for a stroke are hypertension, diabetes, elevated levels of fat in the blood, ischemic heart disease, atrial fibrillation, obesity, transient ischemic attacks, and additional factors.
During a stroke, the flow of blood to the brain is either obstructed or there is bleeding, leading to a lack of oxygen in the affected area due to reduced and impaired blood circulation. As time passes, the number of brain cells that are permanently damaged increases. Therefore, the phrase "time=brain" is commonly used, emphasizing the critical importance of timely diagnosis and treatment in order to salvage as much brain tissue as possible.
Preventing a stroke
Adopting a healthy lifestyle as early in life as possible and maintaining it with perseverance can potentially contribute to the prevention of strokes. For instance:
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Maintaining physical fitness
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Nutritional changes
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Quitting smoking
Symptoms that may indicate a stroke
If you experience new sensations or symptoms such as weakness in the torso, specific organ weakness or paralysis, a new paresthesia (prickling sensation) in body organs, new and sharp headaches, or new vision disturbances, it is crucial to seek immediate medical examination for a quick diagnosis and treatment. If you suspect a stroke, it is crucial to go to the nearest hospital emergency room without delay. If you experience an unfamiliar symptom, it is advisable to seek medical evaluation to determine its nature.
Critical symptoms indicating a stroke
If you experience new occurrences such as speech impairment, even temporary, a new sensation of confusion, a weakness in the torso or in one limb, you may undergo a stroke. If you identify someone else who has similar symptoms, it is essential to stop whatever you are doing, and accompany them to a medical assessment, preferably in an emergency room.
Treating a stroke
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Initial stroke treatment
Quick evacuation to a medical facility is essential for a quick diagnosis and treatment of a stroke. If you have a distress button and you experience one of the symptoms indicating an impending stroke, activate the button to summon an ambulance, which will evacuate you to an emergency room.
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Treating a haemorrhagic stroke
Once a diagnosis is obtained from a neurologist, further assessments will determine the necessity of procedures such as Cerebral Angiography for blood drainage, bleeding control, or ongoing monitoring to track the progression or resolution of bleeding using repeated brain scans. It is worth noting that in some cases, drainage of the bleeding may not be necessary or feasible.
Usually, hospitalization will be required until the condition stabilizes, followed by hospital rehabilitation or home care.
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Treating an ischemic stroke
The neurologist will assess the need for thrombolytic therapy at the hospital, which involves administering IV-line medications to dissolve blood clots, or additionally, they will consider performing a Cerebral Angiography to address the obstruction.
Patients who endure neurological damage causing a functional impairment such as arm weakness or an increased muscle tonus of a limb, requiring a splint, will usually be transferred to hospitalized rehabilitation.
If the symptoms are mild, home care may be possible.
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Medication therapy after a stroke
Medication therapy is usually administered according to the type of stroke. For instance, after a haemorrhagic stroke, blood thinners are considered. In the case of an ischemic stroke, additional medications will be considered for managing blood pressure and for reducing cholesterol levels.
Recovery after a stroke
Regaining full function as it was prior to the stroke or experiencing functional disability caused by the stroke depends on the severity of brain damage during the stroke and the speed and effectiveness of the therapy administered.
Stroke complications
In some cases, during the treatment of a stroke, attempts to unblock an artery or control bleeding may not be successful. Occasionally, additional interventions, whether invasive or involving medication, may be pursued if the patient's condition permits, in order to obtain improved blood flow or to stop bleeding.
What does life look like after a stroke
Based on the degree of impairment in bodily functions and regardless of the treatment and rehabilitation outcomes, the patient may experience lifelong neurological impairments. These impairments may be minor and treatable, while others can be more severe, necessitating assistive devices for mobility and other purposes.
According to the patient's condition following hospitalization, a decision will be made regarding their appropriate follow-up therapy in the community or potential placement in a nursing institution.
Social rights after a stroke
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Speech therapy
People who suffered a stroke are eligible for therapy with a speech therapist. The service is included in the health basket services.
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Rehabilitation therapy
If the stroke caused a substantial functional disability, your family doctor, nurses, or a social worker at the clinic will refer you to receive the necessary supportive services, such as occupational therapy, physiotherapy, and nursing help, if required. These services are included in the health basket.
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Health basket
People who have undergone a stroke are advised to contact their HMO to inquire about the services included in the health basket, for instance, regular check-ups and complementary medicine treatments.