Stroke (cerebral apoplexy)

Overview

Cerebral apoplexy (stroke) is the sudden interruption of blood supply to a specific area of the brain. Depending on the area of the brain that is affected, a stroke can lead, for example, to paralysis, speech problems or visual impairment. It is an absolute medical emergency if these symptoms appear suddenly.

Symptoms

Main symptoms

• Paralysis on one side of the body, arm or leg paralysis, often accompanied by sensory disturbances
• Facial paralysis
• Speech problems (the patient can no longer pronounce words correctly or can’t speak at all, the ability to understand words can also be lost)
• Vision impairment, blindness

Other symptoms

• Dizziness
• Nausea, vomiting
• Headache, disorientation
• Unsteady gait

Course

Many of the symptoms can improve after a while with therapy. Full recovery, however, is only possible for mild strokes. Some symptoms (paralysis, speech problems, etc.) often persist. If the damage is very serious, a stroke can also lead to death.

Causes and treatment

Causes

• Obstruction of a blood vessel (mostly by a blood clot)
• Bleeding in the brain (brain haemorrhage)

The lack of blood supply means that the brain tissue no longer receives enough oxygen and dies.

Risk factors

• High blood pressure is the most important risk factor for a stroke
• Arterial calcification (i.e. build-up of calcium in the arteries)
• Smoking
• Diabetes mellitus
• Obesity
• High blood fat levels
• Lack of exercise
• Stress
• Advancing age
• Heart diseases (heart arrhythmia, in particular atrial fibrillation)

Further treatment by your doctor / in hospital

Possible tests

• CT scan (computed tomography)
• MRI (magnetic resonance imaging)
• Ultrasound of carotid arteries

Possible therapies

• Medication to dissolve the blood clot (“thrombolysis”)
• Arterial catheterisation: Very thin tubes are inserted into a vein in the groin and guided to the blocked artery in the skull where the blood clot is removed or dissolved
• Operation (mechanical removal of blood clot)
• Rehabilitation and physiotherapy after a stroke
  

What can I do myself?

• Balanced Mediterranean diet
• Avoid being overweight
• Sufficient exercise
• Don't smoke

When to see a doctor?

• On suspicion of a stroke, the doctor or emergency services must be called immediately (emergency number 144). In particular for:
  • Sudden paralysis
  • Sudden speech problems

The time frame for successfully restoring blood flow is only three to four-and-a-half hours (“time equals brain cells”).

Further information

Swiss Heart Foundation (Schweizerische Herzstiftung)
www.swissheart.ch