Simple questions about stroke diagnosis

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Three questions enable laypersons to diagnose strokes quickly

In the event of a stroke, quick action is particularly important to prevent permanent brain damage and, in the worst case, fatal outcome for those affected. Often, however, the symptoms are not associated with a stroke and unnecessary time is lost before the stroke patients receive medical attention. Three simple questions can also give laypersons an assessment of the situation. If these confirm the suspicion of a stroke, an emergency doctor should be called in as soon as possible.

Around 270,000 people in Germany suffer from a stroke every year, the experts from the Center for Stroke Research at the Berlin Charité estimate. According to the Federal Statistical Office, almost 70,000 patients die in Germany each year from the consequences of a stroke. A stroke is also the most common reason for acquired disabilities in adulthood, reports the chairman of the foundation of the German stroke help, Karl Max Einhäupl. The stroke usually affects older people, said Einhäupl, who is also the CEO of the Charité Universitätsmedizin Berlin. According to the expert, around 80 percent of those affected are over the age of 60.

Rapid help lowers the risk of permanent damage in the event of a stroke. The cause of a stroke is usually sudden reduced blood flow to individual areas of the brain (clogged blood vessels) or bleeding in the brain (ruptured blood vessels). Due to the undersupply of the brain cells with oxygen, nutrients and other substances, they are no longer functional and threaten to die. The longer the undersupply exists, the greater the risk of permanent damage to the brain or, in the worst case, even fatal. Rapid action, on the other hand, can save the threatened brain cells and thus significantly improve the outlook for patients, the experts report. "The chance that a person can recover from it without lasting mental or physical consequences increases significantly with the speed at which help approaches," explained neurologist Karl Max Einhäupl. It is therefore important that as many people as possible know the typical symptoms of a stroke and how to react.

Three questions as a rapid stroke test The three-question test for rapid stroke diagnosis can be used not only by paramedics, but also by laypersons to gain an assessment of the situation. First of all, it is checked whether the patients can shape their mouths into an even smile. Then it is necessary to test whether both arms can be held up evenly with the palms of the hands. And finally, the patients have to repeat a simple sentence. If all tests fail, according to the experts, "there is a 95 percent stroke and the affected person has to go to the hospital immediately." However, abnormalities in only one of the questions should also give rise to alarming the emergency doctor.

In the event of stroke symptoms, call 911 immediately. Possible symptoms of a stroke include visual disturbances, speech disorders, severe dizziness, feelings of numbness in individual parts of the body, symptoms of paralysis and severe headaches. The general secretary of the German Stroke Society, Otto Busse, said: "If you suddenly notice one of them suddenly with yourself or others, choose 112." Here the principle applies, "rather the emergency services once too much than once too little" call. In any case, those present do not have much more options than dialing the emergency call. It is only important that those affected get to a clinic as quickly as possible. When hospitalization is given, the cause of the stroke is first determined on the basis of computer tomography (CT) or magnetic resonance imaging (magnetic resonance imaging, MRI). According to Busse, this is "poor blood flow to the brain due to a vascular occlusion in 85 percent of all cases."

Treatment options for stroke As a countermeasure, there are fundamentally different approaches to hemorrhage and poor circulation. While blood clots, which are the cause of vascular blockages, are usually resolved in the clinic with the help of an infusion of anticoagulant medication, cerebral hemorrhages generally require coagulation-promoting medication. However, according to the secretary general of the German Stroke Society, the dissolution of possible blood clots has to happen "at the latest four and a half hours after the first symptoms appear, otherwise the procedure is too dangerous and hardly effective." Hurry. "This also has to be done as quickly as possible," emphasized Busse. It is advantageous if the clinic includes a so-called stroke unit, which specializes in the treatment of strokes. However, only 229 clinics across Germany currently have a corresponding unit.

Stroke units at the clinics specialize in strokes Rehabilitation begins practically on the first day after the stroke, according to the experts. The hospitals with stroke unit are also relatively well positioned in this regard. Here the patients would be looked after around the clock by a team of neurologists, cardiologists, neurosurgeons and vascular surgeons as well as radiologists. They also advise possible approaches to rehabilitation with the patient. "The stroke unit has the character of an intensive care unit," explained the specialist for neurology, Peggy Ehrlich, from the Vivantes Auguste-Viktoria-Klinikum in a lecture at the stroke center of the Berlin Charité at the end of September. Here, important vital functions such as heart activity, blood pressure, breathing, blood sugar and body temperature would be closely monitored, with the aim of “achieving the best possible setting of these parameters” and in this way protecting the brain from further damage. (fp)

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Image: Martin Büdenbender /

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