Photo source: livescience.com
How a Stroke Happens
A stroke is an acute cerebrovascular accident in which blood stops flowing to a specific area of the brain. Without oxygen and nutrients, brain cells begin to die rapidly. That's why it's essential to act immediately when stroke symptoms appear.
Rapid recognition of stroke symptoms can save a person's life and improve their prognosis. In medicine, there's a concept called the "therapeutic window" – the first 4-4.5 hours from the onset of the disease, when medical care aimed at restoring blood flow is most effective.
How to Recognize It
The easiest way to determine if someone is having a stroke is to use a test called FAST – Face Arm Speech Test:
- F = drooping face: ask the person to smile. Is the smile crooked or asymmetrical?
- A = arm weakness: ask the person to raise both arms. Does one arm rise slowly or not at all?
- S = speech problems: ask the person to repeat a simple sentence. Is their speech strange and slurred?
- T = decision: if there's at least one sign (provided it wasn't there before), it's time to call an ambulance. The emergency dispatcher needs to be informed of the observed symptoms, and you should wait for the resuscitation team. Stroke treatment can begin right in the ambulance. The longer you delay seeking help, the greater the risk of serious brain damage.
If symptoms disappear after a few minutes, it may have been a transient ischemic attack (TIA). Despite the fact that this condition may pass quickly, TIA, like stroke, requires emergency medical attention and examination, as it's a serious warning sign of a possible major stroke.
What Other Symptoms Are There
Additional stroke symptoms include:
- sudden numbness of the face, arm, or leg;
- sudden problems with speech or understanding it;
- sudden vision problems in one or both eyes;
- sudden problems walking – dizziness, impaired gait, loss of balance or coordination;
- sudden severe headache with no known cause.
Remember – medical help is necessary even if stroke symptoms quickly disappear.
Stroke survivors may experience health problems: difficulties with speech and thinking, memory loss, depression, paralysis of body parts. Some recover quickly, while others require long-term rehabilitation. Patients relearn how to think, care for themselves, communicate with others, and even move.
Causes
A stroke occurs for two main reasons: arterial blockage (ischemic stroke) and blood vessel rupture (hemorrhagic stroke).
Ischemic stroke occurs in 85% of cases. A blood vessel supplying the brain becomes blocked by a blood clot or atherosclerotic plaque, stopping blood flow. The cause lies in deposits on vessel walls or blood clots that travel through the bloodstream to the brain and block the passage.
In a hemorrhagic stroke, a blood vessel ruptures. This happens due to uncontrolled high blood pressure, aneurysm (vessel bulge), excess anticoagulants in the blood, head trauma, and other reasons.
If stroke symptoms appear and disappear within 24 hours (more often – within a few minutes), this is a TIA, or mini-stroke. A vessel becomes temporarily blocked, causing temporary disruption of blood supply to the brain. If something like this happens, it's essential to see a doctor to get vascular health under control. A mini-stroke doesn't cause obvious consequences and for many becomes a discovery during a preventive examination, but it increases the risk of a real stroke later.
Risk Factors
- age over 60 years
- high blood pressure
- diabetes
- high cholesterol levels
- low physical activity
- obesity
- irregular heart rhythm (atrial fibrillation)
- smoking and excessive alcohol consumption
How to Protect Yourself
Not all stroke risk factors can be prevented. But lifestyle also affects stroke probability. Here's what you can do:
- eat a varied diet: more fruits, vegetables, nuts, fish, less processed food;
- exercise regularly: exercise lowers blood pressure, strengthens blood vessels and the heart, helps control weight, and improves mood;
- limit alcohol and smoking: alcohol raises blood pressure, and cigarettes worsen blood supply to small brain vessels;
- monitor blood pressure levels, regularly take antihypertensive medications if prescribed by a doctor;
- control blood glucose levels, take glucose-lowering medications if prescribed by a doctor;
- control heart rhythm, especially with atrial fibrillation, and take blood-thinning medications (anticoagulants) if prescribed by a doctor;
- increase stress resistance – limit information flow;
- get enough sleep (7-8 hours a day).
Stroke Care Services in Russia
In Russia, the problem of stroke prevention and treatment, or acute cerebrovascular accidents (ACVA), is also one of the most pressing: annually, the country experiences 400-450 thousand ACVA cases. This problem has not only medical but also social and economic burden. More than a third of stroke survivors, according to estimates by domestic specialists, need outside help, 20% cannot walk independently, only 8% return to their previous life.
Since the 2000s, Russia has been gradually creating and improving a network of specialized clinics for emergency stroke care: both through government programs and through the efforts of individual public sector players, such as large medical centers from Moscow. Modern vascular centers are emerging, and minimally invasive surgical treatment methods most effective for strokes are being introduced into practice – in addition to conservative drug treatments.
The stroke and other vascular pathology patient care system formed in Russia also includes neurosurgical departments and rehabilitation clinics: they use methods comparable to leading international practices – from high-tech experimental surgical techniques to robotic rehabilitation.
By 2023, 698 specialized vascular departments for treating patients with ACVA were created. In 2019-2024, the state allocated 75 billion rubles for additional equipment for regional vascular centers with CT scanners, MRI machines, and angiography systems, which led to a reduction in hospital mortality from ACVA from 18.6% to 15.8%, and allowed an increase in the number of endovascular interventions for all types of circulatory system diseases from 253 to 325 thousand units. The number of thrombolytic therapy procedures for stroke has increased more than 60-fold since the opening of all vascular programs in Russia – to 26,449 from 2009 to 2022.
The diagnostic system for ACVA patients is also being improved. For example, in Moscow and Primorsky Krai, artificial intelligence is now used to analyze CT scans after hospitalization, which reduces the time needed to diagnose a stroke focus. The rehabilitation stage after stroke is critical. Leading Russian centers use advanced methods: at the Brain and Neurotechnology Center in Moscow, for example, they use biofeedback devices, balance and upper limb function recovery systems, eye tracking, virtual reality, and brain-computer interfaces.