Stroke: causes, symptoms and first aid

Strokes are the third leading cause of death in western industrialized countries. In Austria, about 24,000 people suffer a stroke each year. The risk of stroke increases exponentially with age. However, new study data show that more and more young people are also affected by a stroke.

  • Causes of Stroke
  • Who is at risk of stroke?
  • Symptoms of stroke
  • Fast test to detect a stroke
  • First aid for stroke
  • How do you prevent a stroke?

Causes of Stroke

The most common cause of stroke is the clogging of a vein in the brain (transient ischemic attack, TIA). Due to the lack of oxygen, the nerve cells can no longer carry out their activity and adjust it. But our brain needs constant blood supply to provide vital oxygen and nutrients. If the circulatory disturbance only persists for a short time, no or only a few nerve cells die off, most of them can resume their activity if the blood circulation recommences after a few minutes.
If the circulatory disturbance lasts longer, many nerve cells and thus also the affected brain tissue can die off. Then one speaks of an ischemic cerebral infarction. Stroke can also be caused by bleeding (hemorrhage). Here one of the cerebral vessels ruptures, blood enters the surrounding brain tissue and restricts the blood circulation there. This is also known as a bloody or red stroke.

Who is at risk of stroke?

More than 80% of all stroke victims are older than 60 years. The older you are, the higher the risk of suffering a stroke. But other factors such as smoking or physical inactivity can increase the risk of stroke. Genetic predisposition also plays a role. If close relatives have already had a stroke, you should actively counteract and maintain a healthy lifestyle to reduce the risk: diabetes, high blood pressure and high cholesterol are just as risky as overweight and lack of exercise. In addition, you should severely restrict the alcohol and stop smoking (aeriosclerosis).

Symptoms of stroke

Often, there are already signs of a circulatory disturbance before the stroke. For example, a TIA can last up to 24 hours. The sooner one recognizes the stroke, the lower the consequential damage or the higher the chances of survival. In case of doubt always: call the rescue or the emergency doctor!

  • Unilateral paralysis: The arm or leg is suddenly weak or completely paralyzed
  • Numbness: Arm, leg or a half of the face suddenly feel numb and tingling, the corner of the mouth of a face hangs
  • Sehst rung: One sees everything blurry, double or restricted
  • Speech disorder: confused stuttering, slurred pronunciation, repetition of words and long pauses to the complete speech blockade
  • Illogical behavior: Those affected can no longer follow simple instructions and express themselves meaninglessly
  • Dizziness and balance disorders
  • unconsciousness
  • Severe headache: sudden headache that is difficult to endure
  • dysphagia
  • Fast test to detect a stroke

    A simple test for the detection of a stroke by lay people is the Cincinnati Prehospital Stroke Scale (CPSS). With this test even inexperienced people can detect a stroke relatively reliably within a minute:

    • Ask the person to smile. (The face is distorted unilaterally in paralysis.)
    • Challenge the person to a simple sentence such as, "I feel good and do not need help." (The sentence must be repeated correctly, the language must not be washed out.)
    • Ask the person to lift both arms forward at the same time, palms up. (In case of paralysis, an arm can not be lifted or sinks or turns)

    If the affected person has problems with any of these tests, immediately call the emergency physician to describe the symptoms on the phone.

    First aid for stroke

    • If the above symptoms have occurred (one to two are enough), immediately call 112 (always reachable in Europe).
    • Notify the ambulance on arrival of all symptoms and the time of the notes
    • Do not leave the person alone, say goodbye to him and calm down
    • Loosen tight clothing, remove dentures and braces
    • Never give anything to eat or drink, as swallowing may cause difficulties
    • Store the affected person's upper body slightly higher, eg with a pillow under the back
    • In case of unconsciousness or vomiting, place in stable lateral position
    • If the affected person loses breathing or pulse, immediately start resuscitation

    How many strokes can you survive?

    But there is no rule of thumb on how many strokes a person can survive. There are people who have survived 4 or more strokes, it always depends on the severity. However, even the first stroke can be fatal.
    The sooner the patient is taken to the hospital, the better the chances of survival. The biggest problem is that many patients are disabled after a stroke. They can no longer walk, talk or eat and are in need of care.

    How do you prevent a stroke?

  • First and foremost, one should try to reduce excess weight, to move regularly and to eat healthily.
  • Anyone who gives up smoking lowers the stroke risk to that of a non-smoker just five years after the last cigarette.
  • People with diabetes, cardiac arrhythmia, high blood pressure, or high cholesterol should urgently talk with their doctor about how to reduce the risk of stroke.
  • Avoid alcohol!
  • How is a stroke treated?

    When a stroke patient is taken to the hospital, doctors are primarily concerned with protecting the brain. Thereafter, the treatment aims to restore the impaired functions. This usually happens in the form of a rehabilitation. By means of a systemic thromolysis (lysis) one tries to restore the blood circulation of the brain areas. For this, a blood clot-dissolving agent is administered via the veins. This should be given no later than 3-4 hours after the onset of the first stroke symptoms. After four and a half hours, such therapy is no longer permitted in Europe. However, the lysis therapy is controversial, as it has a significant influence on the blood clotting. For example, an acute danger to life may originate from cerebral hemorrhages, the risk of which increases as a result of the reduced coagulation factor.

    When does the rehabilitation begin?

    Ideally, the rehabilitation begins on the first day of hospitalization – as far as the condition of the patient allows. Above all, stroke units (special stroke monitoring units) and neurological wards ensure targeted early rehabilitation. Further information on the stroke monitoring units can be found under Stroke-Unit). The therapies are based on a doctor's prescription and are carried out by certified physiotherapists, occupational therapists and ergotherapists as well as speech and language therapists.