Approximately 50% of stroke patients (cerebrovascular accidents) have hypertension. However, reducing blood pressure by 5 mmHg can decrease the risk of stroke by 10%.
Ms. Hoang A., 44 years old, weighing 63kg, residing on Nguyen Kiem Street, Phu Nhuan District, Ho Chi Minh City, suddenly experienced left-sided numbness while using the restroom at 4:30 AM and subsequently collapsed. She was quickly taken to the hospital at 5:10 AM and was diagnosed with right-sided cerebral infarction.
Meanwhile, another 64-year-old male patient, weighing 60kg, living on Xo Viet Nghe Tinh Street, Binh Thanh District, had a long history of hypertension and was under continuous medication. At 2:25 PM on September 15, 2005, while working, he felt fatigued and flushed, then suddenly collapsed, experiencing slurred speech. He was rushed to emergency care at 2:55 PM and was diagnosed with a stroke, hypertension, and lipid metabolism disorder.
The above are some cases of stroke leading to fatalities… Stroke, or cerebrovascular accident, is a general term for damage to a part of the brain.
Over 80% of strokes are due to cerebral infarction. This damage results in a sudden reduction or complete cessation of blood flow to the brain. The lack of blood supply can harm nerve cells, and the function of this organ may be interrupted for a long time.
Stroke is a leading cause of death and disability among the elderly. In developed countries, the mortality rate from strokes ranks just after cancer and cardiovascular diseases.
Recognizing the Symptoms…
Dr. Vo Don from the Neurology Department at People’s Hospital 115 states that symptoms indicating a stroke include:
– Sudden, severe headache, dizziness, altered consciousness such as sluggish response, drowsiness, which can lead to coma.
– Inability to speak suddenly, difficulty articulating words, speaking nonsensically, or confusion.
– Weakness or paralysis in limbs, numbness in the face, arms, or legs on one side of the body.
– Sudden blurred vision, color blindness, which can lead to complete blindness.
– Loss of bladder control, or complete urinary retention.
Treatment
According to Doctors Nguyen Canh Nam, Phan Van Mung, and Phan Cong Tam from the Neurology Department at Gia Dinh People’s Hospital, acute ischemic stroke is an emergency condition. To save brain cells, active and urgent treatment is required, especially within the first 3 hours of symptom onset.
Upon admission, patients will undergo rapid clinical and laboratory evaluations including biochemical and hematological tests, electrocardiograms, and brain imaging via CT scan or MRI. This is the critical window for effective intervention with the thrombolytic drug rtPA, which has been approved by the FDA for treating acute ischemic stroke within the first 3 hours.
This is also a new treatment approach recently applied in Vietnam for stroke patients. Intervention with rtPA helps prevent disease progression, dissolve blood clots, and reduce the risks of disability and death for patients. However, the cost of this medication remains relatively high.
Results from using rtPA in some patients show significant improvement in weakness symptoms within the first 24 hours, with most fully recovering by discharge. Hospital stays were shortened from 6 to 13 days.
It is known that this treatment has not yet been widely applied in medical facilities due to the high cost of the medication, and it has not been officially imported into Vietnam. A standardized treatment protocol for hospitals will require more time to establish.
Prevention
 |
| Heavy smoking – a cause of stroke |
According to Dr. Vo Don, prevention is crucial for avoiding strokes: For individuals who have not experienced a cerebrovascular accident, it is important to address risk factors immediately:
– Treating hypertension is the most critical factor for stroke patients, as approximately 50% of stroke patients have elevated blood pressure. On average, reducing blood pressure by 5 mmHg decreases the risk of cerebrovascular accidents by 10%.
– Treating arrhythmias (such as atrial fibrillation) reduces disease risk.
– Managing diabetes. In diabetic patients, strokes tend to be three times more severe than in non-diabetic individuals.
– Treating hyperlipidemia, especially low-density lipoprotein (LDL) cholesterol, will reduce disease risk.
– Treating obesity: The risk of stroke in obese individuals is 1.5 to 2 times higher than in normal-weight individuals, as obesity often accompanies hypertension, diabetes, and elevated blood lipids.
– Limiting tobacco use: Similar to obesity, smoking increases the risk of stroke by 1.5 to 2 times, with higher risk if smoking more than 20 cigarettes per day. Conversely, quitting smoking for over 5 years reduces this risk. Reducing salt intake brings significant benefits for the elderly.
– Increasing physical activity can lower the risk of cerebrovascular accidents by promoting weight loss, lowering blood pressure, and reducing cholesterol levels.
– For individuals who have previously experienced a cerebrovascular accident: prevention strategies are similar to those for individuals who have never had the disease. Specifically, in cases of ischemic stroke, additional treatment with antiplatelet medications (e.g., aspirin) and anticoagulants for heart valve diseases is required. Patients must be closely monitored to prevent complications from medication use.
NHAT PHUONG
