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Treatment of Stroke and Prevention of Recurrence

A stroke, also known as paralysis or hemiplegia, is a dangerous and urgent condition that can affect both the elderly and working-age individuals. It can result in death or permanent disability. Therefore, proper diagnosis and treatment by a neurologist specializing in stroke can significantly increase a patient’s chances of survival.


The treatment and prevention of stroke recurrence are essential for sustainable health care and improving the long-term quality of life for stroke survivors.


Learn about the symptoms and warning signs of stroke. For more information

https://www.praram9.com/en/stroke-understanding/


What Is a Stroke ? (Cerebrovascular Disease)

A stroke, also known as cerebrovascular disease, occurs when blood flow to the brain is interrupted due to a narrowing, blockage, or rupture of blood vessels. This leads to brain tissue damage, impairing part or all of the brain’s functions. Symptoms typically appear suddenly.


What Are the Types of Stroke?

There are two main types of stroke:


1. Ischemic Stroke

Ischemic stroke can be treated effectively, allowing patients to recover fully without any lasting disabilities or paralysis. The key is to quickly transport the patient for treatment immediately after symptoms appear, ideally within a 4.5-hour window. The doctor will diagnose the condition following the outlined procedures and provide urgent care.


The goal of treatment is to restore normal blood flow in the brain, which can be achieved through various methods. One common treatment is the administration of a clot-dissolving medication (IV rtPA; alteplase) via intravenous injection. This medication can dissolve blood clots that obstruct the brain in approximately 30-50% of patients, leading to minimal or no disabilities, depending on how quickly treatment is initiated.


After receiving thrombolytic medication, patients need to be admitted to the Intensive Care Unit (ICU) or a stroke unit for close monitoring by medical staff for at least 24 hours.


However, if a patient has symptoms for more than 4.5 hours, administering thrombolytic medication increases the risk of bleeding in the brain by approximately 6% compared to patients treated promptly after the onset of symptoms (based on studies).


2. Hemorrhagic Stroke

The primary goal of treating a hemorrhagic stroke, or acute rupture, is to control the amount of blood leaking into the brain to maintain stable blood pressure. If the patient has a significant amount of bleeding in the brain that leads to increased intracranial pressure, they may require emergency surgery immediately upon arrival at the hospital.


In cases where the patient has a small amount of bleeding, surgery may not be necessary. Instead, supportive care can be provided. After treatment, the patient should also be monitored in the Intensive Care Unit (ICU) for at least 24 hours.


For treating hemorrhagic strokes caused by ruptured cerebral aneurysms (subarachnoid hemorrhage from ruptured aneurysm), immediate surgical intervention is required upon hospital admission to reduce the risk of re-rupture of the aneurysm.


Recognizing Stroke Symptoms Using the FAST Principle

Stroke symptoms often occur suddenly. If symptoms are detected promptly, it can increase the chances of survival, reduce the risk of paralysis, and help restore brain function to normal.


You can recognize stroke symptoms using the FAST principle, which includes:


  • F (Face): The patient may have facial drooping or an uneven smile on one side. Some patients may experience symptoms while eating, such as food or saliva leaking from one corner of the mouth. A simple test is to ask the patient to smile or show their teeth and check for facial asymmetry or drooping at the corners of the mouth.
  • A (Arms): Weakness may occur in the arms or legs. The patient may not be able to move one side of the body, either the leg or both the arm and leg on the same side. A simple test is to ask the patient to raise both arms or legs; if one side droops, it indicates a problem.
  • S (Speech): The patient may have slurred speech, sound unclear, or have difficulty speaking or understanding speech. Some may even struggle to follow simple instructions, which might lead relatives to believe the patient is confused. A simple test is to ask the patient to repeat a phrase, like the name of a city, or point to an object such as a pen or a clock and ask them to name it. You can also give them simple instructions like “raise two fingers.”
  • T (Time): Time is the most critical factor in stroke treatment. If you suspect someone is having a stroke based on the FAST principle, take them to the nearest hospital immediately. The faster they receive treatment, the more brain damage can be prevented, as brain cells are lost with every passing second. Rapid treatment can significantly reduce brain damage.

Currently, if an ischemic stroke patient receives treatment within the “Golden 4.5 hours,” doctors can administer clot-busting medication to open the blood vessels and restore normal brain function in the affected area.


Treatment and Prevention of Stroke Recurrence

Patients who have previously had a stroke are at a higher risk of recurrence compared to the general population. To treat and prevent another stroke, the following measures should be taken:


  • Reduce and control risk factors, such as high blood pressure, high cholesterol, and diabetes.
  • Medication: Doctors may prescribe antiplatelet drugs or anticoagulants to help prevent stroke recurrence. These medications work by preventing blood platelets from clumping together, thereby reducing the risk of blood clots that can block brain vessels.
  • In cases where the patient experiences repeated episodes of ischemic stroke, they may need to take multiple antiplatelet medications. However, this can increases the risk of abnormal bleeding in different parts of the body, such as gastrointestinal bleeding or bleeding in the brain. Therefore, it is crucial that these patients are treated under the care of a neurologist. Patients should never self-medicate, as doing so could be life-threatening.

Conclusion

In the past, strokes were primarily associated with the elderly. However, it is now evident that even younger individuals and those in the workforce are increasingly at risk of experiencing a stroke. Since stroke symptoms often occur suddenly, timely recognition of these symptoms can significantly enhance the chances of survival, reduce the risk of paralysis, and improve the likelihood of restoring normal brain function.


Moreover, strokes can be prevented by managing controllable risk factors. Regular annual health check-ups are essential to identify and address potential risk factors that may lead to stroke.

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Calcified Plaque in the Coronary Arteries: The Silent Killer!

Understanding the Causes of Blockage Many people believe that coronary artery disease develops only with age. However, coronary artery problems can begin much earlier in life. The risk starts in youth when fatty deposits (fatty streaks) begin to form in the coronary arteries. Over time, these deposits thicken, eventually leading to artery blockages. Dr. Anupong Parinayok, a cardiologist at Praram 9 Heart and Vascular Institute, explains that the problem begins when the inner lining of blood vessels becomes inflamed and dysfunctional, often due to chronic conditions such as diabetes, high blood pressure, and high cholesterol. Lifestyle factors, such as smoking, also play a significant role. These factors make the blood vessel walls more prone to inflammation, allowing oxidized LDL cholesterol to infiltrate and accumulate within them. Over time, this buildup forms plaques and calcium deposits in the coronary arteries. If these plaques rupture, they can trigger the formation of a blood clot, leading to an acute heart attack. At this stage, quick medical intervention is crucial to prevent life-threatening complications. Ideally, however, it is best to prevent reaching this stage.

Fear of the Sun? It Could Be Putting You at Risk for “Osteoporosis”

When people thinking of Thailand, many picture the sun, and just imaging it can make you want to grab an umbrella. But did you know that sunlight is more important to Thais than you might think? The gentle sunlight of the early morning and late afternoon not only warms the body but also helps produce vitamin D, which is crucial for strengthening bones, reducing the risk of osteoporosis. Many people view sunlight as harmful, causing skin damage, wrinkles, and hyperpigmentation, leading them to overlook its benefits. Studies show that sunlight is essential for preventing osteoporosis and vitamin D deficiency. Exercising under soft sunlight in the morning allows the body to absorb vitamin D, which strengthens bones and reduces the risk of osteoporosis. In Thailand, 2.5-3% of the population of all genders and ages suffer from osteoporosis. Dr. Peeraphong Sawatdipong, an orthopedic surgeon specializing in knee and hip replacements at Praram 9 Hospital, revealed that vitamin D deficiency is highly prevalent in Thailand, affecting 30-40% of patients. The primary cause is an excessive fear of sunlight, leading to fragile bones and a higher risk of fractures, particularly among the elderly and postmenopausal women. In reality, morning sunlight, when absorbed through the skin, significantly helps the body produce vitamin D, which strengthens bones and reduces the risk of osteoporosis later in life.

Why Are Young, Active People Still at Risk for Sudden Cardiac Arrest?

Recently, we’ve often heard of athletes—seemingly healthy and young—suddenly passing away, raising concerns about the true cause of sudden cardiac arrest (SCA) in athletes and young adults. Is there a connection with exercise? And how can we handle such situations to prevent unforeseen tragedies for ourselves and our loved ones? The Real Causes of Sudden Cardiac Arrest Dr. Phonpitchaya Boondee, a cardiologist at the Praram 9 Cardiovascular Institute, explains that the incidence of sudden cardiac arrest tends to increase with age. Among younger people, it occurs at a rate of 1:100,000, which rises to 50:100,000 in middle-aged adults and up to 200:100,000 in those over 80 years old. Additionally, men are more at risk of coronary artery disease than women. In young individuals with no underlying conditions, the primary cause of sudden cardiac arrest are usually electrical disturbances of the heart and hypertrophic cardiomyopathy. These are often genetic heart conditions that may present no prior symptoms, leaving individuals unaware they have heart disease.

Ovarian Cysts: A Hidden Threat Every Woman Should Know

These days, who would have thought that “ovarian cysts” would become a silent danger women need to be aware of? What’s even more concerning is that ovarian cysts often present no clear warning signs. Many women may be unaware that they have an ovarian cyst until they experience severe symptoms such as intense menstrual cramps, irregular periods, abdominal bloating, noticeable lumps in the pelvic area, or severe pain during intercourse. If left untreated, this condition can potentially be life-threatening. Unveiling the Secrets of Ovarian Cysts with a Specialist Professor Emeritus Dr. Sangchai Preutthipan, a specialist in reproductive medicine and laparoscopic surgery from Praram 9 Hospital, explains that the “ovaries” are small, thumb-sized organs responsible for producing eggs each month. With each ovulation, a fluid-filled sac forms around the egg. Sometimes, these sacs don’t dissolve as they should, leading to cyst formation. There are several types of ovarian cysts, including those caused by ovarian dysfunction, tumor-related cysts, endometriosis cysts (also known as chocolate cysts), cysts resembling other body tissues, and even cancerous cysts. Dr. Sangchai further notes that women of reproductive age up until menopause are at risk for ovarian cysts. Around 30-35% of women develop cysts due to ovarian dysfunction, while 20% develop tumor-related or chocolate cysts. Approximately 15% may have cysts that resemble other tissue types, and 1-5% are diagnosed with cancerous cysts. Each type of cyst carries different health risks.

Kidney Transplant Surgery Procedure, Recovery, and Complications to Monitor

Kidney transplantation is a surgical procedure that involves transplanting a kidney from a living donor or a donor who is brain-dead into a patient with chronic kidney failure, without removing the patient’s existing kidneys. The new kidney takes over the function of the damaged kidneys. The success rate of kidney transplantation is relatively high, and after the procedure, patients can experience a significant improvement in their quality of life. Therefore, kidney transplantation is considered the best treatment for chronic kidney failure. However, it is a major surgery with complex procedures. Before the operation, the donor kidney must be carefully matched to the recipient with chronic kidney failure, ensuring compatibility of blood and tissue between the donor and recipient to prevent rejection. Once a suitable kidney is found, the surgeon will perform the transplant on the patient. During and after the surgery, patients may face the risk of serious complications, so they must be closely monitored by a medical team. After the surgery, patients need to recover in the hospital to ensure that the new kidney is functioning properly and effectively.

Protect Yourself from Monkeypox: Know the Signs and Stay Safe

The World Health Organization (WHO) has declared a global health emergency due to a severe outbreak of monkeypox across Africa, where more than 450 deaths have been reported. Previously, in 2022, the WHO declared a public health emergency due to an outbreak of Clade 2, which is known for its milder symptoms. Although Clade 2 spread to over 100 countries, including Europe and Asia, it resulted in more than 87,000 cases and 140 deaths, with a mortality rate of 4%. The outbreak was primarily concentrated among the LGBTQ+ community, which allowed for targeted vaccination efforts to contain it effectively. This time, however, the outbreak involves Clade 1, which is much more severe, with a mortality rate of up to 10%. According to the Africa Centers for Disease Control and Prevention (Africa CDC), more than 14,500 monkeypox cases and over 450 deaths were reported between early 2024 and July, This represents a 160% increase in infections and a 19% increase in deaths compared to the same period in 2023.

How Long Can A Kidney Transplant Recipient Live After Surgery?

The kidneys are vital organs in the body, making kidney disease a significant issue that affects both the patient’s quality of life and the lives of those who care for them. Today, there has been an increase in kidney disease cases compared to the past, with a growing number of patients reaching end-stage chronic kidney failure and requiring urgent treatment. Kidney transplantation is considered the best treatment option for restoring the patient’s quality of life.

Thyroid Disease Symptoms! Which type of thyroid disease do these symptoms indicate?

The thyroid gland is a butterfly-shaped organ located at the front of the neck. Its main function is to produce thyroid hormones, which are crucial for the body’s metabolic system. These hormones also contribute to growth and regulate heart rate, body temperature, and other hormonal functions. When the thyroid gland malfunctions, it can affect the levels of thyroid hormones in the body, leading to conditions like hyperthyroidism (excess thyroid hormone), hypothyroidism (insufficient thyroid hormone), or other thyroid disorders. Patients with these conditions may exhibit different symptoms. This article will explain the symptoms of various types of thyroid diseases to help you recognize them early. If you suspect any issues, it’s important to consult a doctor for prompt diagnosis and treatment.

Cardiac Arrhythmia : A warning sign that may lead to heart failure

The heart is an essential organ that works tirelessly all the time. On average, the heart beats around 100,000 times a day. Nowadays, heart disease is becoming increasingly common and close to us. We often hear news of people we know, or those close to us, passing away due to heart disease, or instances of athletes collapsing during competitions caused by irregular heartbeats. Cardiac arrhythmia is considered a type of heart disease that is frequently mentioned today. An irregular heartbeat causes abnormal heart contractions. If severe and left untreated, it can lead to heart failure. Therefore, taking care of heart health is extremely important and should not be neglected.

Gynecologic Laparoscopic Surgery: A Great Option for Women

When it comes to women’s surgeries, besides the anxiety about the results, the pain from the surgery and the scars afterward are other significant concerns. Nowadays, medical advancements have provided women with treatment options that yield good results while leaving only small scars. The pain from the surgical wound is minimal, recovery is quick, and there are no severe complications. One such option is gynecologic laparoscopic surgery.

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