2021. March 22.

Stroke is a sudden nervous system disorder caused by a disruption of the blood supply to the brain, which can cause permanent damage or death. Two forms are known: cerebral infarction, also known as ischemic brain damage, which occurs in approximately 85% of cases when an area of the brain does not receive enough blood to function due to vascular occlusion; and in approximately 15% of cases, hemorrhagic strokes occur when blood flows into the brain itself or between the membranes (meninges) covering the brain and spinal cord. Dr. Rose Private Hospital’s neurologist, Dr. Sándor Ilniczky, answers the most important questions about stroke.

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What can cause cerebral infarction?

Vascular disease, atherosclerosis, vasoconstriction, heart disease, and increased blood clotting.

What are the most important symptoms of cerebral infarction?

  • On one side of the body, the hand, foot, often the face, numbness and tingling begin.
  • On one side, decreased muscle strength or paralysis develops, hands and feet become weaker, and the face is distorted.
  • Speech disorder: the patient gets stuck in speech, cannot speak, cannot find words, cannot express themself, may not be able to understand the speech addressed to them.
  • Sudden loss of vision in one eye due to blockage of the blood vessel supplying the eye: from one moment to the next, vision is lost from one of the eyes.

The above complaints and symptoms persist in the event of a stroke, though they often last only a short time, possibly a few minutes, and these predict a threatening stroke.

As we do not know how long they will last when symptoms appear, therefore in all cases, if any of these symptoms occur for only a few minutes, a doctor should be consulted immediately. Symptoms should be treated as an emergency, as if a stroke has already developed.

What can cause a hemorrhagic stroke?

In the case of a cerebral hemorrhage, untreated high blood pressure is usually a factor, causing a blood vessel to burst and the blood to hemorrhage into the brain tissues. Another possible cause of a hemorrhagic stroke is that a ruptured vessel, as the result of a vascular developmental disorder, causes the cerebral hemorrhage. When taking an anticoagulant, even for cases of poor liver function, it is easier to trigger a cerebral hemorrhage. Otherwise, the symptoms for this type of stroke are practically the same as those of a cerebral infarction, and the two types of stroke can only be distinguished by an examination with a machine such as a cranial computed tomography (CT) scanner.

Can we prevent stroke with screening tests?

In the case of a stroke, the possibility of treatment is very minimal as very few patients get to a doctor in time. This means that, in the case of cerebral vasoconstriction, only a few hours are available from the onset of symptoms to effective treatment. If the death of brain tissue has developed, it is unfortunately already an irreversible process. Therefore, prevention and screening are important, perhaps more so than for any other disease.

What are the most common precursors and predisposing factors for the development of stroke?

  • Among internal medicine diseases, high blood pressure, diabetes, high cholesterol.
  • Some types of heart disease, including for example some arrhythmias, atrial fibrillation in cases where the patient is unaware of it and remains untreated. Post heart attack conditions include various heart diseases such as cardiomyopathy and some congenital heart disorders.
  • Various disorders of blood clotting which are associated with increased clotting. If this has already been proven to have occurred in the family, it is worth bearing this in mind. 
  • Genetic predisposition, family heredity in general plays a very big role in the development of stroke and other circulatory diseases.
  • Among bad habits, smoking ranks first among the risk factors.

What are the key elements of a screening test?

A vascular ultrasound of the neck, high blood pressure screening, blood sugar and cholesterol monitoring. A cardiological examination is always an important part of neurological stroke prevention because in some cases, heart disease is a factor in cases of stroke. A routine cardiology examination may be supplemented, where necessary, to include cardiac ultrasound as well as 24-hour ECG monitoring. Screening is recommended from the age of 40.

Unfortunately, few patients are taken to a doctor or hospital in time to undergo special treatment ­- which in the event of a cerebral vascular occlusion can be by dissolving the blood clot or catheter-directed removal of the clot. Even among those who are hospitalized on time, there are many patients who are unable to undergo these interventions due to some other disease, and this further narrows the range of those for whom truly effective treatment can be used.

Stroke is typically a disease that is much easier to prevent than to cure. If you feel you have any of the predisposing factors listed, please come along and take part in the screening tests.