Stroke is a disease that annually leads to the death of many people. After heart disease, stroke ranks as the third most frequent cause of death. While in most developed countries consistent prevention in the past twenty years has led to a significant decrease in the mortality of stroke, the Czech Republic still does not rank among these countries. Around 30 000 inhabitants struggle with stroke annually and 40% die of this disease within one year. Nearly one half of the rest is subsequently disabled. Stroke is defined as a rapidly progressing disorder of cerebral functions, especially a unilateral disorder of mobility or a disorder of sensory perception lasting more than 24 hours. It is due to the rupture or occlusion of a cerebral artery and damage to cerebral tissue due either to the pressure exerted by blood from the ruptured artery or to insufficient oxygen and nutrient supply.
Symptoms
The symptoms of stroke depend on the localisation of the affected cerebral region. It may present as a speech disorder or paralysis of one side of the body. Frequently, patients may present with disorders of equilibrium, falls or even loss of consciousness, a sensation of tingling in the extremities, problems with thought processes, confusion. In the most severe cases, there is loss of consciousness, paralysis or even sudden death. Alongside a typical course with clearly expressed symptoms, the neurological signs may be mild or inconspicuous. In the case of brain haemorrhage, characteristic manifestations include increased intra-cerebral pressure- headache, vomiting and disorders of consciousness.
Causes
Stroke is divided into two main categories according to the type of cerebral artery involvement. The first category is so-called ischaemic stroke, whereby the brain lacks sufficient blood perfusion. It is most frequently due to the stenosis or occlusion of arteries as a result of atherosclerosis. Ischemia is responsible for 80% of all cases. The second category is brain haemorrhage. This is due to damage of the cerebral arteries by high blood pressure or to the rupture of a congenital aneurysm. In both cases, perfusion of the region of the brain supplied by either the occluded or ruptured artery is interrupted. Brain cells exhaust their supplies within four minutes and then begin suffering from acute lack of oxygen and nutrients. If blood flow and the supply of oxygen and nutrients cannot be renewed, the brain cells die rapidly.
Prevention
Preventive measures, especially regular checks of blood pressure that should be decreased to optimal levels, must be initiated if there is an increased risk of stroke. Restriction or cessation of tobacco product smoking is another significant preventive measure. Cigarette smoke directly narrows arteries and this subsequently increases blood pressure inside the brain. Regular exercise strengthens the heart and blood circulation, and helps control weight, which is why rapid walking, swimming or cycling is recommended. Those who suffer from diabetes are at a significantly higher risk of stroke, which is why they should try to achieve optimal blood sugar levels.
A suitable diet and appropriate dietary supplements recommended by a physician represent further measures for significantly restricting the risk of stroke.
Treatment
Treatment of patients who have suffered a stroke should always be complex. This means that physicians, nurses, physiotherapists, speech therapists as well as other specialists should participate in the process. Patients with a severe stroke or those in a coma are hospitalised in intensive care units. We should try and remove the underlying cause of the disorder and renew adequate blood supply to the brain as fast as possible. If blood flow is insufficient, we administer drugs that lead to the dissolution of blood clots. In the case of haemorrhage, treatment options depend on its localisation and extent. Some haemorrhage can be operated, some haemorrhage is allowed to reabsorb. The most important component of treatment is physiotherapy, which aims to renew mental and physical functions. Physiotherapy starts in early convalescence. The first measures include positioning of the patient on the bed and prevention of muscle stiffening. This is followed by training of active movement and practising of routine daily activities. Apart from physiotherapy, speech therapists help train patients with speech disorders.
How can GenScan reveal the risk of stroke?
GenScan analyses genes that affect both important aspects of stroke induction- blood coagulation and vascular function. A strong causal relationship has been shown to exist between the genes analysed and the risk of stroke. On the basis of the GenScan analysis, which also determines the risk of other disease, the physician recommends appropriate preventive measures that will significantly curb the risk of stroke.