October 29 is the 17th "World Stroke Day", and the theme of "World Stroke Day 2022" released by the Chinese Stroke Society is "Identify Stroke Symptoms and Seize Precious Time". Experts remind that stroke is acute and the disease progresses rapidly, and the golden time for stroke diagnosis and treatment is within 6 hours after the onset, and the earlier the treatment, the better the effect. Therefore, we should keep in mind the "120" mantra, learn to recognize the symptoms of stroke, and once you find the symptoms of stroke, you must immediately call the emergency number and seek medical attention immediately.
The harm of stroke should not be underestimated
Stroke, commonly known as "stroke", is an acute cerebrovascular disease, a group of diseases caused by the sudden rupture of blood vessels in the brain or the inability of blood to flow into the brain due to blockage of blood vessels. Stroke has the characteristics of "five highs" with high morbidity, high recurrence rate, high disability rate, high mortality rate and high economic burden, and is one of the main chronic non-communicable diseases that threaten the health of the mainland people.
Professor Zhang Yuhu, Deputy Director of Guangdong Institute of Neuroscience and Director of the Department of Neurology of Guangdong Provincial People's Hospital, said: "Stroke is usually divided into two categories: ischemic stroke and hemorrhagic stroke, of which ischemic stroke accounts for the majority. Hemorrhagic stroke usually occurs when emotions are agitated and blood pressure rises suddenly. However, some ischemic strokes occur at night when sleeping, blood pressure is low, blood flow is slow, and they are only discovered when they wake up. ”
Professor Zhang Yuhu, Deputy Director of Guangdong Institute of Neuroscience and Director of Department of Neurology, Guangdong Provincial People's Hospital
Stroke is acute and progresses rapidly, which can lead to limb paralysis, speech disorders, dysphagia, cognitive impairment, mental depression, etc., which seriously affects the quality of life of patients and causes a huge burden on families and society.
"Stroke 120" and "8+2" mantras should be remembered
"Why do you keep emphasizing the stroke treatment time, one is that everyone does not recognize this stroke symptom enough, and the second is that even if it can be recognized, it may not be possible to send the patient to the hospital as soon as possible." Instead, it is customary to self-medicate, rest for a while, and wait for the condition to ease before deciding to go to the hospital. The treatment of stroke is a race against time, and once delayed, it will lead to aggravation of the disease or even miss the treatment window. Professor Zhang Yuhu said.
So how do we quickly identify stroke? The "Stroke 120" mantra is a strategy for people to quickly identify strokes and act immediately:
"1" means "see 1 asymmetrical face";
"2" means "check whether both arms have unilateral weakness";
"0" stands for "listen (zero) whether the speech is clear".
If any of these symptoms occur and you suspect that the patient has had a stroke, call the emergency number 120 immediately.
Not only that, in the past two years, the international community has added two more symptoms to be recognized: the body is difficult to balance, and the eyes cannot see clearly. These two increases in symptoms can increase the rate of self-identification of stroke at home from 70% to more than 90%. In 2021, Continental officially released the "BE FAST mantra" to identify the early symptoms of stroke, the first 5 letters each represent an early symptom, and the last 1 letter is to remind that once stroke symptoms are found, you should immediately call the emergency number and seek medical attention immediately:
"B" – Balance means loss of balance, balance or coordination, sudden onset of difficulty walking;
"E" - Eyes refers to the eyes, sudden changes in vision, difficulty in seeing;
"F" - Face refers to the face, the face is asymmetrical, the corners of the mouth are crooked;
"A" - Arms refers to the arm, which suddenly feels weak or numb, usually on one side of the body;
"S" - Speech refers to language, speech is vague and cannot understand the language of others;
"T" - Time refers to time, the above symptoms indicate that a stroke may occur, do not wait for the symptoms to disappear on their own, call 120 immediately for medical assistance.
Dr. Zhang Bin, Department of Neurology, Guangdong Provincial People's Hospital, reminded that the "BE FAST mantra" summarizes some of the directional symptoms of stroke, as long as one of the 5 symptoms occurs, patients and families should be highly vigilant, do not need to judge whether it is a stroke, as long as they suspect, immediately come to the hospital, stroke treatment, the principle is rather wrong than missed, because the consequences of missing the golden treatment time cannot be remedied.
Strokes are terrible, but preventable and treatable
Stroke can be prevented and treated, and modifiable risk factors include hypertension, diabetes, dyslipidemia, atrial fibrillation, smoking, alcohol intake, unreasonable diet, overweight or obesity, lack of exercise, psychological factors, etc. So how should we prevent the tiger from having a stroke? Ma Guixian, deputy director of the Department of Neurology of Guangdong Provincial People's Hospital, pointed out that now that there are more people with three highs, stroke is easy to occur, regardless of occasion, time, and place. Reducing the three highs, reducing high blood pressure, high blood sugar, and high blood lipids is very good for preventing cerebral stroke. Reasonable diet, moderate exercise, quitting smoking and alcohol, and psychological balance are also very important. He recommended that citizens aged 30 and above should have their blood pressure tested at least once a year, and once hypertension is diagnosed, they should be actively treated; For people over 40 years old, it is recommended to add carotid ultrasound and transcranial Doppler ultrasound on the basis of routine items during physical examination to find vascular stenosis in time and formulate corresponding treatment plans to prevent stroke.
Ma Guixian, deputy director of the Department of Neurology, Guangdong Provincial People's Hospital
It is reported that thrombolysis and thrombectomy are still the most effective treatments for acute attacks of stroke, and both have strict time windows. Intravenous thrombolytic therapy is generally within 4.5 hours after onset, intravascular thrombectomy is best performed within 6 hours after onset, and a small number of special patients can be extended to 24 hours. Li Changmao, deputy chief physician of the Department of Neurology, Guangdong Provincial People's Hospital, introduced that the purpose of acute cerebral infarction thrombolysis and thrombectomy is to open blood vessels as soon as possible, restore blood supply to the brain, and reduce damage. If the cerebral infarction is blocked by small blood vessels, there is a greater chance of recanalizing it through intravenous thrombolysis, which is commonly known as "one injection and one injection". For patients with blockage of larger blood vessels or poor thrombolysis, intraarterial thrombectomy can be used to restore blood vessels and save brain tissue.
Li Changmao, deputy chief physician of the Department of Neurology, Guangdong Provincial People's Hospital
Deputy chief physician Li Changmao said that in the past, patients with stroke onset time of more than 6 hours were generally no longer given thrombectomy. Nowadays, with the advancement of technology and the deepening of clinical research, some patients have been strictly evaluated and the treatment of thrombectomy has been expanded to within 24 hours of the onset of stroke. Recently, Chinese scholars have confirmed that patients with posterior circulation large-vessel occlusive stroke within 24 hours can also benefit from thrombectomy.
Written by: Zeng Wenqiong, reporter of Nandu
Intern: Jiang Yuan
Correspondent: Jin Ting