Stroke

In Germany, 270,000 people suffer a stroke every year. A condition that in up to 85 per cent of cases has an ischaemic cause (impaired blood flow).

To rule out long-term consequences, swift action is decisive when the need arises. Equally important in the fight against this group of cardiovascular chronic conditions, however, is the right prevention. Our doctors at avi are by your side with this at all our locations.

An ischaemic stroke is diagnosed by localised impaired blood flow and thereby insufficient supply to the brain.

A second form of this condition, the haemorrhagic (bleeding) stroke, is identified by a neurological dysfunction. The causes of this are a bleed (for example from a fall) or the spontaneous rupture of an abnormal vascular dilatation.

The possible triggers of an ischaemic stroke include, amongst others:

• emboli (small blood clots) that arise from, for example, cardiac arrhythmias (atrial fibrillation) or cardiac inflammation, travel to the brain via the bloodstream, and block smaller vessels there
• atherosclerosis
• a splitting and thereby narrowing of the arterial walls (dissection)
• high blood pressure

A haemorrhagic stroke may in turn have the following triggers:

• spontaneous bleeding without identifiable causes
• bleeding due to elevated blood pressure or injured vessels
• diseases of the vessel walls caused by age-related deposits of certain proteins
• medications (such as excessively high dosing of anticoagulants)
• congenital vascular malformations
• tumour conditions
• traumatic brain injuries

You can recognise a stroke depending on the affected brain region by the following typical symptoms, which generally appear suddenly:

• unilateral movement disorders (paralysis of the left foot and arm, with a symptom-free right side of the body)
• speech and visual disturbances (such as difficulties with word finding or impaired fluency of speech)

Additional possible symptoms are:

• sensory disturbances (unilateral or affecting, for example, only the upper or lower limb)
• impairment of fine motor skills (e.g. when writing or grasping)
• gait and balance disturbances

If the lower areas of the brain (cerebellum or brainstem) are affected, particularly severe symptoms occur. These include:

• disturbances of consciousness ranging from delirium to coma
• paralysis of all limbs
• swallowing difficulties
• respiratory paralysis

An acute stroke requires rapid diagnosis and immediate treatment with inpatient admission to the nearest hospital. Ideally, this hospital has a ward specialising in strokes (the stroke unit).

Should the need arise, our experienced doctors will treat you there as follows:

• recanalisation of the affected narrowing by drug-based thrombolysis (dissolution of the thrombus) or mechanically via a small catheter and, where necessary, the placement of a stent
• in the case of a haemorrhagic stroke: pressure relief by draining the blood that has accumulated within the skull

avi also ensures follow-up care for successfully treated stroke through the following measures:

• drug-based prophylaxis
• regular monitoring of blood values and blood pressure

And to prevent a stroke from occurring in the first place — prevention is an important cornerstone for us at avi. This is composed as follows:

• consistent screening for risk factors
• treatment of existing risk factors by adjusting blood pressure, blood sugar, weight, and cholesterol levels to optimal values
• regular physical activity
• abstaining from nicotine and alcohol
• early detection and (drug-based) treatment of cardiac arrhythmias