Introduction
Ischemic stroke is one of the main causes of disability and death worldwide. It is characterized by the sudden interruption of blood supply to an area of the brain, due to the blockage of a cerebral vessel. Early recognition and treatment of the episode are critical to minimize the consequences and restore the patient's functionality.
Pathogenicity
Ischemic stroke is usually caused by the blockage of a cerebral artery branch by a clot or embolus. This occlusion reduces or interrupts the blood supply to the brain area dependent on the specific vessel, leading to neuronal death and loss of function in the affected area of the brain. The most common causes are atherosclerosis, atrial fibrillation, and heart disease.
Risk factors
The main risk factors for having an ischemic stroke include:
Hypertension: It is the most important modifiable risk factor.
Smoking: Significantly increases the risk of thrombosis and vascular disease.
Diabetes: Contributes to the development of atherosclerosis.
Hypercholesterolemia: High cholesterol contributes to the formation of atherosclerotic plaques.
Atrial fibrillation: Can cause blood clots to travel to the brain.
Obesity and sedentary lifestyle: Associated with other risk factors such as hypertension and diabetes.
Clinical Picture
The clinical picture of ischemic stroke varies depending on the area of the brain affected. The main symptoms include:
Sudden weakness or paralysis: Often affects one half of the body (face, limbs)
Difficulty speaking or understanding speech: This may include dysphasia or aphasia.
Vision loss: Usually occurs in one eye or half of the field of vision.
Dizziness and loss of balance: Often accompanied by difficulty walking.
At Neurolife we use the acronym APLA (in Greek every letter corresponds to Extremity, Face, Reason, Immediate) so that anyone can easily distinguish the symptoms that may appear in a stroke and immediately call for help.
Diagnosis
Diagnosing ischemic stroke requires rapid and accurate assessment. Initially, a good clinical examination will raise the suspicion of ischemic stroke, which will then be confirmed with imaging tests. The main diagnostic methods include:
Computed Tomography (CT): Helps to differentiate ischemic from hemorrhagic episode.
Magnetic resonance imaging (MRI): Provides a detailed picture of brain tissues and can detect smaller lesions.
Angiography: Special techniques such as CT angiography or MR angiography can image the vessels and locate the blockage.
Treatment
Treatment of ischemic stroke is immediate and includes both pharmacological and interventional approaches:
Thrombolytic therapy: Administration of intravenous alteplase (tPA) within a certain time window of the onset of symptoms can dissolve the clot and restore perfusion.
Mechanical thrombectomy: Used to remove the clot in larger vessels and is effective up to 24 hours after symptoms start.
Antithrombotic therapy: The use of antiplatelet (such as aspirin) or anticoagulant drugs to prevent new clots.
Therefore, given the time limitation that exists in order to provide the appropriate treatment, the timely transfer of the patient to a hospital is of great importance.
Prognosis and Rehabilitation
The prognosis after an ischemic stroke depends on the extent of the damage and the speed of treatment. Early intervention can significantly reduce the likelihood of disability and improve quality of life. Restoration includes:
Physiotherapy: To restore mobility and balance.
Speech therapy: To restore language and communication skills
Prevention
Prevention of ischemic stroke focuses on managing risk factors:
Regulating blood pressure: Through medication and lifestyle changes.
Stop smoking: With the help of counseling and pharmaceutical support.
Controlling Diabetes and Cholesterol: Through Diet, Exercise, and Medication.
Regular exercise: Promotes cardiovascular health and reduces the risk of stroke.
Conclusion
Ischemic stroke is a serious medical condition that requires immediate and coordinated action to avoid serious consequences. Understanding risk factors, early recognition of symptoms, and rapid medical intervention are critical to improving patient prognosis and quality of life. Therefore, in any suspicion of an ischemic stroke, we immediately call an ambulance to enable the patient to receive the appropriate treatment.
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