No time to lose in dealing with stroke

By Yoon Ja-young

Doctors stress that patients should be transferred to a hospital within two or three hours when signs of stroke occur. / Korea Times file

Margaret Thatcher, a former British prime minister who was also known as the “Iron Lady,” passed away this week. Earlier this month, Bori, a famous Korean photographer and Park Sang-gyu, a popular singer and TV show host, also died. As all three died of strokes, people are wondering what causes these and how to prevent them.

Strokes happen when blood flow to the brain is stopped. An adult’s brain weighs around 1,400 grams, or around 2.5 percent of the body weight, but it needs around 20 percent of the blood that flows from the heart. This demonstrates how dependent the brain is on blood — it uses oxygen and glucose supplied in it to make energy necessary for it to function. Hence, when there are cerebrovascular problems, the functions of the brain are directly affected. As the brain is the regulatory center of the body, comparable to a computer’s CPU, problems in the blood supply can lead to diverse dysfunctions affecting consciousness, articulation, eating and drinking, and cause hemiplegia or paralysis on one side of the body.

There are two types of strokes. Ischemic strokes happen when blood clots block blood vessels in the brain. These are usually seen in patients with arteriosclerosis when vessels become narrower, or in patients with heart disease where the blood clot flows to block vessels in the brain. Hemorrhagic strokes, meanwhile, happen when blood vessels break and bleed inside the brain. This usually happens in patients with hypertension or those who have cerebral arteries swollen in a particular spot. A weak spot may break at some point, causing a stroke.

Doctors say that it is crucial to immediately go to a hospital when there are warning signs. “Once the signs are noticed, an extra minute, or a second can extend the life of a patient. They should arrive at the hospital that has a neurology unit or neurosurgery doctors, within two or three hours to save their life or avoid becoming handicapped,” said Prof. Heo Ji-hoe at the Severance Hospital.

In the event of a hemorrhagic stroke, one should get rid of the blood clot in the brain through surgery if there is considerable bleeding. Prof. Heo says that in many cases this can be done by using a hypodermic needle instead of complicated surgery. If there is a subarachnoid hemorrhage, however, most patients need surgery because there can be additional bleeding in problematic blood vessels.

In the event of an ischemic stroke, a blocked vessel should be unclogged as soon as possible. Prof. Heo said treatment should start within three hours. “When considering the time needed for an examination and a CT scan to confirm an ischemic stroke, patients should arrive at the hospital within at least two hours of onset. Of course, the sooner, the better,” the professor said.

Warning signs include sudden weakness or numbness in one arm or leg, sudden trouble in speaking or hearing, poor pronunciation, dizziness, staggering, sudden loss of vision in one eye or two, or severe headaches.

When such signs occur, patients should be immediately transferred to a hospital. According to a report by the Severance Hospital, however, only 20 percent of ischemic stroke patients reach a hospital within three hours.

The following are tips by Prof. Huh Seung-kon of the Severance Hospital regarding what people should do until an ambulance arrives. After dialing 119, a family member or a friend should call the nearest general hospital, tell the doctor about the symptoms and ask for advice. The most important thing to remember is that patients should have clear airways. Hence, stroke patients should lie down with their heads raised by 10 to 20 degrees. Ties should be loosened and buttons on shirts undone. If a patient vomits and food enters the lungs it can be very dangerous. Thus a family member or friend should put a finger into the mouth to remove vomit. However, never use water to do this, the professor warns.

Regarding a recent surge of stroke patients, Heo explained that it has to do with an increase in chronic diseases such as hypertension, diabetes, hyperlipidemia and obesity. People with such chronic diseases are at two to five times greater risk of stroke than people without them.

Heo said that the prevention is crucial and recommends controlling blood pressure and getting appropriate treatment for diabetes. One should avoid too much drinking or smoking as well as food with a lot of cholesterol or excess salt. The doctor says that 75 percent of strokes can be prevented with such lifestyle changes. Daily exercise exceeding 30 minutes also helps reduce the likelihood of strokes.

Advice: Prof. Heo Ji-hoe, Prof. Huh Seung-kon at Severance Hospital