Stroke is an acute cerebrovascular disease characterized by sudden neurological impairment caused by interruption of blood flow to the brain. According to statistics from the World Health Organization, stroke is one of the leading causes of death worldwide and a common cause of disability. Early recognition of symptoms and prompt treatment can significantly improve prognosis, making public awareness of this disease crucial.
Stroke is classified into ischemic stroke and hemorrhagic stroke. The former accounts for approximately 80% of all cases and results from blood vessel blockage, while the latter is caused by bleeding due to vessel rupture. Although their causes, symptoms, and treatment strategies differ, both require emergency medical intervention. This article systematically analyzes the causes, symptoms, diagnostic procedures, and preventive measures of stroke to help readers develop a comprehensive understanding of the disease.
The pathogenesis of stroke involves complex pathological changes. Ischemic stroke is often caused by atherosclerosis, where fatty deposits in the arteries form plaques that eventually lead to thrombosis or vessel occlusion. Chronic conditions such as hypertension, hyperlipidemia, and diabetes accelerate the process of arteriosclerosis, significantly increasing the risk of cerebral vessel narrowing. Hemorrhagic stroke is related to fragility of small intracranial vessels, commonly seen in patients with uncontrolled hypertension or congenital aneurysm rupture.
Typical stroke symptoms can be quickly identified using the "FAST" mnemonic: F (Facial drooping), A (Arm weakness), S (Speech difficulty), T (Time to call emergency services). During acute onset, patients may experience unilateral limb paralysis, visual disturbances, or sudden severe headache. Some cases may also present with less common symptoms such as memory loss, cognitive impairment, or spatial disorientation.
Damage to different brain regions results in different clinical manifestations:
It is noteworthy that approximately 15-20% of patients experience "mini-strokes" (transient neurological deficits) before a full-blown event. These symptoms usually resolve within 24 hours but serve as strong warning signs of an impending stroke.
The diagnostic process generally involves emergency assessment and subsequent examinations. Emergency personnel promptly evaluate neurological deficits using the "NIH Stroke Scale" and perform brain imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) to confirm the presence and location of hemorrhage or infarction. For suspected cardioembolic strokes, echocardiography can help identify underlying causes such as atrial fibrillation or endocarditis.
Blood tests include coagulation profiles, blood glucose, lipid analysis, and inflammatory markers. For patients suspected of arterial stenosis, carotid Doppler ultrasound or angiography (DSA) can provide precise assessment of vascular conditions. Differentiating between ischemic and hemorrhagic stroke is crucial, as treatment strategies differ significantly.
The optimal window for treating ischemic stroke is within 4.5 hours of symptom onset. Intravenous administration of tissue plasminogen activator (tPA) can dissolve clots but requires exclusion of bleeding risk. Mechanical thrombectomy is suitable for large vessel occlusions and involves removing the clot via catheter; this procedure should be performed within 24 hours of onset. For hemorrhagic stroke, treatment focuses on controlling blood pressure and reducing intracranial pressure. Some patients may require surgical evacuation of hematomas or aneurysm repair.
Post-acute rehabilitation includes physical therapy, speech therapy, and occupational therapy to help patients regain daily functioning. Long-term medication management aims to control risk factors, including antiplatelet agents (e.g., aspirin) or anticoagulants (e.g., warfarin) to prevent recurrence. Patients with atrial fibrillation should adhere to anticoagulation therapy and maintain control of blood glucose and lipid levels.
Primary prevention emphasizes managing risk factors: regular monitoring of blood pressure, blood glucose, and blood lipids; maintaining blood pressure below 140/90 mmHg; and lowering low-density lipoprotein cholesterol to below 100 mg/dL. Quitting smoking can reduce the risk by 30-50%. Dietary recommendations include adopting the DASH diet, reducing sodium intake, and increasing dietary fiber.
Secondary prevention targets individuals with a history of stroke, requiring ongoing use of antiplatelet drugs and strict control of risk factors. For patients with carotid artery stenosis over 70%, carotid endarterectomy or stenting can reduce recurrence risk. Regular cerebrovascular assessments, including magnetic resonance angiography and ultrasound, help detect potential lesions early.
If you experience symptoms such as unilateral limb weakness, speech difficulties, or sudden vision loss, call emergency services immediately. Even if symptoms resolve quickly (e.g., mini-stroke), seek urgent medical attention. Patients with hypertension, diabetes, or hyperlipidemia should undergo annual cerebrovascular risk assessments, and those over 50 are advised to have check-ups every six months.
If severe headache with neck stiffness, altered consciousness, or sudden seizures occur, consider it a medical emergency. Signs of brain hemorrhage include sudden blood pressure spikes and unequal pupil sizes, requiring immediate hospital transfer. Family members should activate emergency protocols if they observe "time is brain" warning signs.
Rehabilitation should begin as early as possible, typically within 24 to 48 hours after the condition stabilizes. Multidisciplinary rehabilitation programs including physical, occupational, and speech therapy can effectively improve limb function, cognition, and daily living activities. Early intervention promotes neuroplasticity and increases recovery chances.
What dietary components should be avoided to prevent stroke recurrence?Foods high in sodium, cholesterol, and sugar increase blood pressure and lipid levels, raising stroke risk. It is recommended to reduce processed foods, fried foods, and sugary beverages. Increasing intake of vegetables, whole grains, and omega-3-rich deep-sea fish, following the DASH diet principles, can help lower the risk of secondary events.
Can emotional stress directly trigger a stroke?Pure emotional stress is not a direct cause of stroke, but long-term stress can lead to elevated blood pressure and unhealthy habits (e.g., staying up late, overeating), indirectly increasing the risk of arteriosclerosis or thrombosis. Managing stress through exercise, meditation, and regular monitoring of blood pressure and lipids is advisable.
Do stroke patients need to continue taking antiplatelet medications after recovery?Yes, even if symptoms improve, physicians usually recommend long-term use of aspirin or other antiplatelet agents to reduce the risk of thrombosis. Patients should follow medical advice, take medications regularly, and avoid self-discontinuation. Regular follow-up is necessary to evaluate medication efficacy and dosage.
Can young people increase their stroke risk due to staying up late or prolonged sitting?Yes, recent studies show that individuals aged 30-40 are experiencing increased stroke incidence related to late nights, lack of exercise, obesity, and metabolic syndrome. Unhealthy lifestyles can accelerate arteriosclerosis. Young people should maintain regular routines, control weight, and undergo periodic health screenings.
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