What is a stroke and how can it be prevented?

What is apoplexy?

Apoplexy is also called a stroke and is defined as a sudden onset of localized neurological deficits of presumed vascular origin lasting more than 24 hours. If the duration of symptoms is less than 24 hours, the condition is referred to as transient cerebral ischemia (TCI). It occurs either due to a blood clot or a hemorrhage in the brain. 

What are the symptoms of apoplexy?

The symptoms depend on which part of the brain’s blood supply and thus which area of the brain is affected, and which functions are affected. In principle, all brain functions can be affected, but some are affected more often than others, for which there is no explanation for the reason. With apoplexy, the symptoms develop over a few seconds, possibly a few minutes.

The typical symptoms are: 

• A half-sided paralysis of the face, arm, hand, leg or body.
• Urinary incontinence.
• Altered speech and/or vision.
• Affected consciousness and orientation.
• Dizziness.
• Lack of control over the body.

What causes apoplexy?

The disease is caused by reduced or interrupted blood supply to an area of the brain and manifests itself in the blood vessels that carry blood to the brain.

In 10-15% of cases it is caused by a hemorrhage in the brain, and in 80-85% of cases it is due to a blood clot in the brain.

50% of blood clots are caused by atherosclerosis in the large and medium-sized arteries with either a local blood clot or a blood clot that is carried with the blood, 25% are caused by atherosclerosis, 20% are caused by a blood clot from the heart, and the last 5% occur due to other reasons, each of which is rare.

The most frequent risk factors are:

• Age
• High blood pressure
• Diabetes
• Atrial fibrillation
• Ischemic heart disease
• Carotid stenosis
• Previous TCI/stroke
• Smoking
• Heavy alcohol consumption
• Physical inactivity
• Overweight
• Elevated cholesterol

How is apoplexy treated?

Stroke must be treated urgently and requires hospitalization, and the treatment is chosen according to the cause. Rehabilitation of the impaired or lost functions is then initiated as soon as possible, preferably within the first 24 hours.

The best function is achieved within 6 months and only half regain normal function and 13% die within the first month. Therefore, it requires intense rehabilitation.

There is good documentation of the effect of a number of specific therapeutic interventions such as strength, conditioning and balance training as well as training in memory and everyday activities. 

How is apoplexy treated?

The course and prognosis of stroke depend primarily on its severity. The more severe the stroke, the longer it takes to achieve optimal function. Patients with bleeding generally have more severe symptoms than patients with a blood clot. However, the subtype of stroke has no direct influence on the prognosis.

There are two things that many people with a stroke struggle with afterwards.

1. It is the ability to fully accept and deal with the new life situation, which naturally takes several years because only half regain normal function and their lives must be adapted to it.
2. In addition, persistent fatigue is seen in ⅓ and the condition is often chronic and significantly affects functional ability and quality of life. 

How can a stroke be prevented?

The best thing you can do to prevent a stroke is to change your lifestyle and go to the doctor and get preventive medication if you can check many of the risk factors mentioned earlier.

A healthy lifestyle involves regular physical activity, including fitness, strength and balance training, cutting back on alcohol, quitting smoking, and a healthy and varied diet.

It can be a lot to change at once, so start slowly with one thing at a time. The most important thing is that you get started and maintain the good changes.

Osteopathy and apoplexy

Stroke often results in structural damage to the brain. Osteopathy cannot cure structural damage to the body. However, we have many stroke patients at the clinics, where we work with the tensions in muscles and connective tissue that have arisen as a result of stroke. We experience that osteopathic treatment can promote well-being in stroke patients.