IMPACT test: recognize in a minute
You don't have to be a doctor to suspect a stroke. Four simple checks are enough - they are easy to remember by the word IMPACT.
- У — Улыбка. Попросите улыбнуться. При инсульте улыбка кривая, один угол рта не поднимается.
- Д — Движение. Попросите поднять обе руки вперёд и удержать. Одна рука опускается или не поднимается вовсе.
- А — Артикуляция. Попросите произнести простую фразу. Речь невнятная, спутанная, или человек не понимает вопрос.
- Р — Решение. Если есть хотя бы один признак — немедленно вызывайте скорую и запомните точное время начала симптомов.
Two different strokes
Stroke comes in two fundamentally different types, and they are treated in opposite ways. It is impossible to distinguish them without a computed tomography scan - this is the main reason why no medications should be given before being examined by a doctor.
- Ischemic stroke (cerebral infarction) - about 80% of cases. The artery is blocked by a blood clot, leaving a section of the brain without blood flow. Here, in the first hours, the blood clot may dissolve.
- Hemorrhagic stroke is a rupture of a vessel with hemorrhage into the brain tissue or under its membranes. Blood thinners are deadly with it.
A separate issue is transient ischemic attack (TIA) - the same symptoms, but they disappear within 24 hours without lasting consequences. This didn’t “go away”, but a direct warning: the risk of a full-blown stroke in the coming days is very high. TIA requires examination immediately, and not “when there is time.”
What to do before the ambulance arrives
- Call an ambulance and clearly say: “suspicion of stroke”, name the time of onset of symptoms
- Lay the person down with their head and shoulders raised approximately 30 degrees
- Provide air access, unfasten tight clothing, open a window
- When vomiting, turn your head to the side to avoid aspiration
- Measure the pressure and record the value, but DO NOT try to reduce it sharply
- Do not give anything to eat or drink - swallowing may be impaired
Who's at risk
- Arterial hypertension is the main manageable risk factor
- Atrial fibrillation (atrial fibrillation) is a source of blood clots and increases the risk several times
- Diabetes mellitus and lipid metabolism disorders
- Smoking and alcohol abuse
- Previous TIA or stroke
- Age, male gender, heredity, obesity and inactivity
The peculiarity is that most factors are controllable. Blood pressure control, treatment of arrhythmia and smoking cessation reduce the risk of stroke more than any “vascular” drip courses.
Treatment and recovery
In the hospital, the first thing they do is a CT scan to determine the type of stroke. For ischemic stroke, within the therapeutic window, it is possible to administer a drug that dissolves the clot, and in some cases, mechanical removal of the clot. In hemorrhagic cases, treatment is aimed at stopping bleeding and reducing intracranial pressure; sometimes surgery is required.
Then begins an equally important stage - rehabilitation. It gives the best results when started in the first weeks: restoration of movements, speech, swallowing, and household skills. At the same time, secondary prevention is selected to prevent a recurrent stroke.
- Physical therapy and movement restoration work
- Classes with a speech therapist for speech and swallowing disorders
- Physiotherapy and massage as prescribed by a doctor
- Control of blood pressure, sugar and lipids; for arrhythmia - anticoagulants
- Prevention of recurrent stroke is a lifelong task, not a monthly course
