[이데일리 이순용 기자] Stroke is a disease caused by blockage or rupture of blood vessels in the brain, and most strokes are caused by slow blood vessel disease due to risk factors such as high blood pressure, diabetes, hyperlipidemia, smoking, excessive alcohol consumption and lack of exercise for a long time.
Stroke affects approximately 15 million people worldwide each year, of whom approximately 6 million die. The number of domestic patients is also steadily increasing. According to the public interest disease statistics, the number of patients diagnosed with stroke has increased by more than 25,000 in 3 years, from 595,000 in 2018 to 620,000 in 2021.
Stroke is the third leading cause of death in Korea and the leading cause of physical disability in people over the age of 60. Stroke, a disease that leaves terrifying neurological sequelae such as hemiplegia, aphasia, visual field disturbances and dementia, has long been known as a difficult disease to treat.
◇ Increased incidence after 55 years
It is known that people with high blood pressure are 4 to 5 times more likely to have a stroke than people without high blood pressure. Atherosclerosis, which is formed by the accumulation of fat components and inflammatory cells on blood vessel walls caused by hypertension, diabetes, hyperlipidemia, and smoking, narrows the blood vessels, causes blood circulation problems, and causes thrombosis to block the flow of blood, resulting in brain damage Also, in the case of arrhythmias or heart valve abnormalities, blood clots form in the heart, which then rupture and block blood vessels in the brain.
Professor Soon-Eok Kwon of Neurology Department of Asan Medical Center (Chairman of Korean Stroke Society), who is in charge of Stroke Center of Asan Medical Center, said, “Strokes mainly occur in the elderly, but when the body is dissected, arteriosclerosis, the leading cause of stroke, is already beginning to be discovered in the 1930s and 1940s.Although the symptoms of stroke appear to have occurred suddenly, they are actually the result of a worsening of the underlying disease years or decades ago.If you have a stroke at age 55, it means that the cause could be arteriosclerosis that has progressed since your 30s.
◇ You need to know the symptoms of a stroke
A stroke can be fatal if delayed. Therefore, it is of utmost importance to identify stroke patients early and receive treatment early.
If you suddenly experience a severe headache in your daily life, if you keep falling over with dizziness, if you suddenly have trouble seeing part of your field of vision, if you have numbness in your arm or leg, if you are unable to speak and your pronunciation is slurred, you should suspect a stroke. If you suspect stroke symptoms, ask for help around you or call 119 immediately and tell them that you have a stroke, then quickly move to the hospital according to the actions of the paramedics and get treatment without spending the golden time.
◇ Stroke prone to recurrence, prevention is important
One in three stroke survivors will live with a disability for the rest of their lives. Patients who have had a stroke once have a high chance of recurrence. Arteriosclerotic cerebral infarction, the leading cause of stroke, is closely related to hypertension, diabetes, hyperlipidemia, smoking and alcohol consumption.
To prevent the stroke from recurring, it is also important to take the medicine well so that the blood vessels in the brain do not worsen and blood clots do not form in the damaged blood vessels. However, taking medication alone is not enough. Professor Soon-Eok Kwon said: “The deadliest thing is alcohol and cigarettes. For brain health, in particular, you should never smoke. It was said that a small amount of alcohol could prevent dementia, but it is better not to drink because the effect can be different for each person and blood flow can be sufficiently improved in other ways.
◇ The last hope for hard-to-treat intractable patients
Asan Medical Center Stroke Center has established a cooperative consultation system with various related departments, including neurology, neurosurgery, radiology, vascular surgery, rehabilitation medicine and emergency medicine, for effective treatment of stroke patients. It has been established that active interaction among the stroke treatment team is needed in order to apply the continuously developing stroke treatment technique to patients more safely.
Stroke Center of Seoul Asan Medical Center performs various cerebrovascular procedures for difficult-to-treat incurable patients in every local hospital. In particular, a stroke intensive care unit in the neurology department is equipped with a 24-hour monitoring system of blood pressure, oxygen saturation and electrocardiogram, where professional nurses and doctors are present to monitor and treat stroke patients professionally.
In addition, we operate an intensive care unit for the intensive monitoring and treatment of severe stroke patients, such as patients requiring emergency surgery due to cerebral infarction or cerebral hemorrhage, patients requiring ventilatory treatment, and patients undergoing to interventional radiotherapy or surgical treatment.
In order to provide timely and more effective treatment to stroke patients visiting the emergency room, the emergency room has a dedicated bed exclusively for acute stroke patients so that they can focus on treating stroke patients regardless of the congestion in the emergency room. rescue.
Stroke attempts to reopen blocked blood vessels using thrombolytic drugs as soon as symptoms occur, but in severe cases, treatment is done with procedures or surgery. Coil embolization is done to treat at-risk aneurysms.
Seoul Asan Medical Center started the first brain aneurysm operation in 1989, performed the first aneurysm neck ligation in Korea in 1991, and in 1996 Professor Kwon Do-hoon of Neurosurgery performed embolization using a GDC coil for the first time in Korea. Efforts have been made to treat brain aneurysms.
Stroke is treated by intravenous injection of a thrombolytic agent within a short time of symptom onset (usually within 3 hours) and intra-arterial administration of a thrombolytic agent (usually within 6 hours). On the other hand, for severely narrowed blood vessels, balloon angioplasty and stenting are done, and for aneurysms with a risk of bleeding, coil embolization is done to block off dangerous areas. Carotid endarterectomy to widen the narrowed carotid artery, cerebrovascular anastomosis to improve blood flow by connecting blood vessels to the blocked area, brain decompression surgery to lower intracranial pressure in case of severe brain edema as a complication of stroke, hematoma to remove a large brain hemorrhage. Aneurysm removal or brain aneurysm ligation may be done to remove the aneurysm.
Soon-Eok Kwon, head of Stroke Center at Asan Medical Center, said, “After a stroke, the most important thing is to ensure that rehabilitation treatment is done quickly at the right time. Gain maximum functional independence and promote return to family and society through comprehensive treatment including social work and occupational rehabilitation as well as rehabilitation treatments such as gait training, daily living movement training, cognitive rehabilitation , speech therapy and swallowing rehabilitation Our goal is to improve the quality of life by improving the quality of life,” stated the goal of treating stroke patients.
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