Stroke – Global challenges, local solutions
Published by Dietmar Schmitz, Hilmar Bading
Current Advances, Challenges, and Opportunities in Stroke Research, Management, and Care
Julius Valentin Emmrich, Samuel Knauss and Matthias Endres ML
Stroke is the second leading cause of death worldwide and a major cause of disability. It leads to a considerable loss of years of life and enormous social and economic costs. Diagnosis and treatment of stroke is thus an important field of research. Typical symptoms of stroke include sudden onset of unilateral weakness and numbness in the face and arm as well as altered speech. In ischaemic strokes, the arterial blood supply to the brain is interrupted by an embolism or thrombosis. Less frequently, strokes are caused by bleeding in the brain. Imaging techniques, especially computed tomography (CT), can reliably distinguish between an ischaemic stroke and a haemorrhage. CT scans with contrast medium can locate large vessel occlusions and identify brain tissue that can still be saved by restored blood flow. The treatment of an acute ischaemic stroke then focuses on the rapid reperfusion of the affected brain tissue. For this purpose, vascular occlusions are dissolved with medication or surgically removed. Further treatment in a specialised stroke unit and rehabilitation increase the patient's chances of survival and reduce permanent impairments. A stroke caused by bleeding is treated in hypertensive patients by lowering blood pressure to prevent the bleeding from expanding. In some cases, haemostatic drugs or surgery may also be useful. Recurrent strokes are best prevented by lifestyle changes along with control of high blood pressure, blood lipids, diabetes and smoking. Targeted interventions depend on the individual causes of the stroke. Possible interventions include blood-thinning medications, inhibiting blood clotting in atrial fibrillation, surgically restoring the patency of the carotid artery or inserting stents, and surgically closing an opening between the atria.
doi:10.34714/leopoldina_nal-live_0002_01000
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