Time is critical when dealing with a stroke,a leading cause of long-term disability and the third-leading cause of death worldwide. Recent data from Spain underscores the urgency of recognizing stroke symptoms and seeking immediate medical attention, as interventions are most effective within the first few hours after onset. Medical experts are emphasizing that delays in treatment can render even the most advanced therapies useless,highlighting the need for greater public awareness and faster response times.This article details the importance of rapid intervention, symptom recognition, and current treatment options available for stroke patients.
A stroke, or cerebrovascular accident, occurs when blood supply to the brain is interrupted. This lack of blood flow prevents neurons in the affected area from receiving the oxygen and nutrients they need, leading to cell death within minutes. Recognizing the signs of stroke and seeking immediate medical attention are critical, as rapid intervention can significantly improve outcomes.
There are two main types of stroke: ischemic stroke, accounting for approximately 80% of cases, and hemorrhagic stroke, representing nearly 20% of the remaining cases. Ischemic stroke happens when a blood clot blocks or hinders blood flow to the brain, while hemorrhagic stroke occurs when a blood vessel in the brain ruptures, disrupting circulation.
“Regardless of the type of stroke, the speed at which medical care is received after the first symptoms appear will greatly influence the patient’s prognosis, as nearly two million neurons die every minute without blood flow to the brain,” explains Dr. María del Mar Freijo, coordinator of the Stroke Study Group at the Spanish Society of Neurology (SEN).
The neurologist emphasizes that “if you suspect someone is having a stroke, you should immediately call emergency services because it is a medical emergency.”
Recognizing stroke symptoms is crucial for prompt action. These symptoms typically appear suddenly and unexpectedly. While the specific symptoms depend on the area of the brain affected, specialists at the Spanish Society of Emergency and Critical Care Medicine (SEMES) highlight several key indicators:
These include facial weakness, drooping at one corner of the mouth, sudden weakness in the arm and leg on one side of the body, numbness or tingling in the face, arm, or leg on one side of the body (often described as “pins and needles”), sudden vision loss in one or both eyes, a sudden change in speech – difficulty speaking or being understood – and a sudden, severe headache unlike any previously experienced, or intense dizziness that can cause sudden falls or instability.
Ischemic or Hemorrhagic
Once at a medical facility, healthcare professionals will evaluate the symptoms and use neuroimaging tests to diagnose the stroke and determine whether it is ischemic or hemorrhagic, as each type requires different treatment approaches.
Specialists at Hospital Clínic de Barcelona note that, in cases of ischemic stroke, “the primary goal is to restore blood flow as quickly as possible to minimize brain damage.” Treatments to restore blood flow include intravenous thrombolysis and mechanical thrombectomy, and can be used up to 24 hours after the onset of stroke symptoms.
“Intravenous thrombolysis involves administering medication through a vein to dissolve the clot. Mechanical thrombectomy is used when a clot has blocked one of the major arteries supplying blood to the brain. Catheters are inserted through an artery in the groin to reach the blocked cerebral artery and clear it,” they detail.
For hemorrhagic strokes, “if the bleeding is near the surface of the brain, surgical intervention may be performed to evacuate the blood or treat the source of the bleeding, such as in the case of vascular malformations.”
A hemorrhagic stroke occurs when a blood vessel in the brain ruptures, causing bleeding. In these cases, an angiography – a test using X-rays and a special dye to examine the inside of blood vessels – may be necessary. Once the rupture site is identified, the doctor will seal the defective blood vessel using devices such as coils (tiny spirals) or clips (small metal clamps).
“These procedures remove the wall of the damaged vessel from circulation, preventing further bleeding,” explain specialists at Hospital Clínic.
Whether the stroke is hemorrhagic or ischemic, it is essential that the affected person receives medical assistance as quickly as possible.
“We have observed that patients who receive intervention within three hours of stroke onset have significantly better outcomes,” says Francisco Aranda, coordinator of the Neuro Working Group at SEMES, the Spanish Society of Emergency and Critical Care Medicine.
Similarly, specialists at Hospital Victoria Eugenia de Cruz Roja in Seville emphasize the importance of reaching the hospital in time for treatment to be effective.
“There are times when no treatment can be given because the patient arrived too late, and unfortunately, none are effective – either because the clot is already too hard to break down or because, even if blood flow is restored, the neurons are already dead,” they state.
Stroke is a potentially life-threatening condition that can cause significant long-term disabilities. The consequences of stroke can vary widely. Physicians at Hospital Clínic indicate that approximately one-third of patients make a satisfactory recovery, another third are left with severe disabilities affecting mobility, speech, cognition, and daily living, and in the final third of cases, stroke can be fatal, with mortality occurring during hospitalization or in the following months due to medical complications.
