[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 drinking, and lack of exercise for a long time.
Stroke affects about 15 million people worldwide each year, of whom about 6 million die. The number of domestic patients is also steadily increasing. According to the statistics of diseases of public interest, the number of patients diagnosed with stroke 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 is the most important 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 disorder, and dementia, has long been known as a difficult disease to treat.
◇ Increased incidence after age 55
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. Arteriosclerosis, which is formed by the accumulation of fat components and inflammatory cells on the walls of blood vessels caused by high blood pressure, diabetes, hyperlipidemia, and smoking, narrows the blood vessels, causes problems with blood circulation, and causes thrombosis to block the flow of blood, resulting in brain damage. causes In addition, in the case of arrhythmias or heart valve abnormalities, blood clots form in the heart, and then the blood clots break and block blood vessels in the brain.
Professor Soon-Eok Kwon of the Department of Neurology at Asan Medical Center (President of the Korean Stroke Society), who is in charge of the Stroke Center at Asan Medical Center, said, “Strokes occur mainly in the elderly, but when the human body is dissected, arteriosclerosis, the main cause of stroke, is already in the 30s and 40s. starting to be discovered. Although stroke symptoms 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 the age of 55, it means that the cause may be arteriosclerosis that has progressed since your 30s.”
◇ It is necessary to know the symptoms of a stroke
A stroke can lead to fatal outcomes if it is delayed. Therefore, it is of utmost importance to identify stroke patients in advance and receive treatment early.
If you suddenly feel a severe headache during daily life, if you keep falling down with dizziness, if you suddenly have trouble seeing part of your field of vision, if you have numbness in one arm or leg, if you cannot speak and your pronunciation is slurred, you should suspect a stroke. do. If you suspect stroke symptoms, ask for help around you or call 119 right away and tell them that you have a stroke, and then move quickly to the hospital according to the actions of the paramedics and receive treatment without passing the golden time.
◇ Stroke prone to recurrence, prevention is important
One in three survivors of a stroke 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 biggest cause of stroke, is very closely related to high blood pressure, diabetes, hyperlipidemia, smoking, and drinking.
In order to prevent recurrence of stroke, it is also important to take medicine well so that cerebral blood vessels do not get worse and blood clots do not form in damaged blood vessels. However, taking medication alone is not enough. Professor Soon-Eok Kwon said, “The most lethal thing is alcohol and cigarettes. For brain health, especially, you should never smoke. There was a story 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 intractable patients who are difficult to treat
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 was determined that active interaction between the stroke treatment team is necessary in order to apply the continuously developing stroke treatment technique to patients more safely.
The Stroke Center of Asan Medical Center in Seoul performs various cerebrovascular procedures for incurable patients who are difficult to treat at each local hospital. In particular, a stroke intensive care unit in the neurology ward is equipped with a 24-hour monitoring system for blood pressure, oxygen saturation, and electrocardiogram. Professional nurses and doctors are stationed there to professionally monitor and treat stroke patients.
In addition, we operate an intensive care unit for intensive monitoring and treatment of severe stroke patients, such as patients requiring emergency surgery due to cerebral infarction or cerebral hemorrhage, patients requiring ventilator treatment, and patients who have undergone interventional radiation or surgical treatment.
In order to provide prompt and most 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 emergency room congestion.
Stroke attempts to reopen clogged blood vessels using thrombolytic drugs as soon as symptoms occur, but in severe cases, treatment is performed with procedures or surgery. Coil embolization is performed to treat at-risk aneurysms.
Seoul Asan Medical Center started the first cerebral 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. Since then, efforts have been made to treat cerebral aneurysms.
Stroke is treated by intravenous injection of a thrombolytic agent within a short period of time after symptom onset (usually within 3 hours) and intraarterial administration of thrombolytic agent (usually within 6 hours). On the other hand, for severely narrowed blood vessels, balloon angioplasty and stent insertion are performed, and for aneurysms with a risk of bleeding, coil embolization is performed to block 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 the case of severe brain edema as a complication of stroke, hematoma to remove large cerebral hemorrhage Surgery to remove the aneurysm, or cerebral aneurysm ligation to remove the aneurysm, can be performed.
Soon-Eok Kwon, head of the Stroke Center at Asan Medical Center, said, “After a stroke, the most important thing is to ensure that rehabilitation treatment is carried out quickly at the right time. Gain maximum functional independence and promote return to family and society through comprehensive treatment including social work and vocational rehabilitation as well as rehabilitation treatment such as gait training, daily life movement training, cognitive rehabilitation, speech therapy, and swallowing rehabilitation It is our goal to improve the quality of life by improving the quality of life,” said the treatment goal of stroke patients.
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