Ictus has several forms of presentation, but the most frequent is difficulty speaking, weakness in an arm, a leg, some alteration of consciousness, dizziness, blurred vision or double vision.
His most frequent way of presenting himself is suddenly, when he is walking, watching a movie, sitting in front of the computer, etc. Its onset is sudden, sometimes the first symptoms occur with a tingling in an arm, in a part of the face, in the leg or some difficulty to swallow.
There is a close relationship between diseases of the heart and the brain, there are heart diseases that can cause strokes or stroke, arrhythmia, heart alteration, atrial fibrillation, which allow thrombi to form and they detach from the heart, reaching brain and covering a glass, producing an embolism and this in turn produces the death of a part of the brain, as a result of this a hemiplegia occurs, this being the most frequent way of presenting.
There is another relationship between the heart and the brain that is caused by atherosclerotic plaques in the coronary arteries, which are clogged by arteriosclerosis and these same plaques of atheromas as they occur in the coronary arteries, can arise in the carotid arteries and in the cerebral arteries. We must conclude that everything that prevents arteriosclerosis and cardiovascular diseases also prevents cerebrovascular diseases and stroke.
Let's say in general terms you could recommend physical exercise one hour three times a week, a balanced diet in which the individual is well nourished but maintain their body weight properly. In addition to weighing, people must measure their abdominal circumference, increase the consumption of fruits, vegetables, fibers and vegetables, etc. And then comes the prevention of habits such as smoking or alcohol intake.
Not especially, the stroke is a cerebral infarction, if we compare it with the heart infarction, there are differences, because the heart infarction is obstruction of a coronary artery and the coronary artery is normally obstructed in 90% of the cases by arteriosclerosis.
However, the obstruction of the cerebral arteries can occur due to many causes besides arteriosclerosis, there may be diseases in the blood, diseases that modify red blood cells, embolisms, that is, many causes that can cause cerebral infarction. Therefore, it is important to consult the internist every year, because he is the only one who can provide a general checkup to the patient. Nothing is superior to prevention.
¿At what age could Ictus or cerebrovascular accident occur?
"One could say less than 45 years old, when there is a stroke in those ages, the first thing you think about is a hemorrhage, but there may also be infarction or cerebral ischemia. A person who is in that age range and presents a stroke, it is necessary to investigate if he has consumption of illicit drugs, specifically cocaine. "
What would be the indicated therapy in the case of stroke and to what extent can sudden death occur with the Stroke?
"When the person dies suddenly, the doctor, not having performed an autopsy, presumes that the patient died of a heart attack.
There is a third form of consequence, based on the brain over the heart, that is, a person suffers from cerebral infarction and as a consequence it gives an alteration in the heart. Because there are sympathetic connections when there is extensive damage to the brain, which can almost immediately produce an arrhythmia or a heart attack and the person can die. As for treatment therapies, this is an area of medicine that requires more research.
The best thing is prevention, the treatment has two phases, in the first try to recanalize the artery that has been obstructed and in the second, protect the brain that does not get oxygen. The drawback that exists is that to be able to give an adequate treatment, you must work in the first hours because time is crucial, so that there is less brain loss. For a person suffering from a stroke, it is not the same to give a treatment in the first hours, than to give it from 12 to 24 hours when the damage is much longer.
Healthily, a pre-hospital organization must be made, so that people have access to an ambulance network, then to a unit or hospital that specializes in treating this type of patient, either with a mobile stroke device or a stroke unit . And then when the individual leaves the hospital, he can receive adequate rehabilitation. However there are few who can access this type of therapy, what is more usual is to give them neuroprotection and this goes through the control of the blood sugar of the patient, oxygenate it well, prevent the patient from getting complicated.
When we observe a patient with Stroke, which is really an emergency, we try to save the patient's life, but if we save our lives and the patient is incapacitated, we have done less than half the work. In addition to saving life, we must try to redistribute capacity. The patient may be talking poorly, being left with a weakness in one leg, not walking or walking with much difficulty and being dependent on other people to do activities of daily living and some patients may be left with vascular dementia or weakness or paralysis in the face.
Finally, what are your considerations regarding the specialist who has to take care of this type of patients and the relatives who have to take care of it?
Patients who evolve better have a family, because many of them can not access medical care. The patient or his family member, however, can not choose which doctor to see, usually as an emergency the logical thing would be to have an ambulance system. In the Domingo Luciani Hospital, of 300 patients who can arrive with Ictus in a year, 175 arrive by their own means, almost nobody arrives in the ambulance.
In the Hospital, the internists must assume that responsibility, what is needed is a doctor interested in the patient and that is well documented. I do not know a welfare state other than chaos, for thirty years I have worked in the midst of chaos. Expecting that society is organized, is utopia, here what really matters is motivation.