In connection with ‘World Stroke Day’ on Thursday, October 29, the following authors have decided to compile this piece, to stimulate awareness for Cerebro Vascular Accidents (CVA) or stroke in Surinamese society. According to WHO, strokes are the 2ecause of death in Suriname1. A recent survey, which was conducted locally, shows that 3 in 100 people have had a CVA in Paramaribo2.
A CVA occurs as a result of a blockage or tear in a brain blood vessel, as a result of which a part of the brain is not supplied or not sufficiently supplied with blood, often resulting in (irreversible) damage to a part of the brain that passes through the relevant blood vessel. is provided.
In 80% of the cases it concerns a cerebral infarction or ischemic CVA, in which a narrowing / blockage of a brain blood vessel occurs due to arteriosclerosis or a blood clot. The remaining 20% is a tear in a brain blood vessel, and is referred to as a cerebral haemorrhage or hemorrhagic CVA.
Depending on the location of the damage in the brain, people can develop complaints such as paralysis symptoms on one side of the body (arm / leg and face), speech and comprehension disorders, visual complaints and coordination disorders.
In order to minimize brain damage in stroke, it is important to treat patients by means of thrombolysis as soon as possible after the above complaints have arisen.
With thrombolysis, a strong blood thinner (rT PA / alteplase) is injected directly into the blood within 4.5 hours after the symptoms develop, so that the blood clot in a blood vessel is dissolved and the damage to the brain tissue is limited or does not occur at all.
In severe and irreversible damage to the brain, disability occurs, which in most cases makes one dependent and requires the help of another person, also known as a caregiver.
A small study carried out by medical students of ADEKUS, led by A. Jarbandhan (Physiotherapist), among members of the ‘Vereniging Verder na strokte’, shows that most people are familiar with a combination of diabetes mellitus (diabetes) and hypertension (55.6 % of members). In addition to, among other things, increased age, smoking and hypercholesterolaemia, these 2 conditions are among the greatest risk factors for developing a CVA.
Because of the often quite intensive care that a stroke patient requires, informal caregivers often become overburdened. People who have suffered a CVA are also often incapacitated for work due to residual symptoms and / or permanent disability. This also has an impact on the financial situation within the family. Maintaining a healthy and more balanced lifestyle is therefore a challenge in this group.
Furthermore, the above-mentioned study has shown that the risk of developing a stroke is increased from the age of 40, with a peak between 51-60 years, while the average age in Europe and the United States is much higher, usually around 70- 80 years. A healthy lifestyle is therefore extremely important to prevent it; ‘Healthy aging’ is therefore important. Eating enough fruit and vegetables, exercising daily and not smoking are important advice for this.
According to the neurologists affiliated with the Academic Hospital in Paramaribo (AZP), people with a previous stroke report much too late to the Emergency Department (A&E), which means that fast and adequate treatment / medical intervention to prevent irreversible damage to the brain and long-term disability. , is not possible.
It is therefore extremely important that people with complaints that are consistent with a stroke (oblique mouth angle, one-sided paralysis symptoms in the arms and legs, slurred speech or comprehension disorders) register as soon as possible and preferably within 4 hours after the symptoms arise. the ER of the AZP.
People who have undergone a CVA and their family members can register with the Vereniging Verder after a Stroke, which among other things is engaged in maintaining mutual contacts between this group of people and possibly. guidance on obstacles in daily life in this group.
More information to the community will help to better understand the risk factors for developing a stroke, but at the same time recognize its symptoms, so that medical attention can be sought as soon as possible to prevent irreversible damage and long-term disability.
It is also important that there is more understanding in society for the group of people who have experienced a stroke.
On October 29, 2020 is World Stroke Day / World Stroke Day, where the consequences and causes of a CVA are discussed worldwide.
By means of this article, the authors want to stimulate awareness of CVA in society.
Authors and submitted by:
- mw drs. W. Koendan, Neurologist, AZP
- mw A. Jarbandhan, Physiotherapist, FMeW ADEKUS
References
1. Organization PAHOaWH. Country report: Suriname: Pan American Health Organization; 2018.
2. A. V. Jarbandhan MJMH, R. Buys, F. S. Diemer, S. M. Baldew, J. Aartman, L. M. Brewster, G.A. van Montfrans, G.P. Oehlers, H.E.J. Veeger, J.Toelsie, L. Vanhees. Prevalence of self-reported stroke in association with ethnic background within a multi-ethnic population in Paramaribo, Suriname: Results from the HeliSur study. Neurology Asia 2016;21:303-10.
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