Stroke is a common disease. Many people think that it only happens to older people. In reality, stroke can happen at any age, and there is a trend toward it occurring more in younger people, especially working age people. Data from the Ministry of Public Health reveals that in 2020, Thailand had over 8 hundred thousand stroke patients with over 40,000 deaths or 5.58%. Stroke is a disease that requires urgent treatment in order to increase the chance of survival and return to good quality living.
What is stroke?
Stroke is a condition in which the brain suffers a shortage of blood supply due to occlusion or rupture of blood vessels, which leads to brain tissue damage and partial or total dysfunction of the brain to the point that paralysis, paresis or even death can occur.
Stroke can be divided into 2 major types: ischemic and hemorrhagic stroke.
· Thrombotic stroke is caused by accumulation of fat in the blood vessels, leading to decreased ability to transport blood, while embolic stroke occurs as a result of blood clot from the heart obstructing a blood vessel in the brain.
· Hemorrhagic stroke is caused by blood vessels that have become fragile due to high blood pressure caused by fat accumulation in the blood vessels, which make them easy to rupture. It can cause brain hemorrhaging followed by brain damage.
5 Warning Signs of Stroke
· Numbness or weakness in half of the body that occurs suddenly around the face, hands and feet or loss of balance.
· Loss of ability to control the lips, palsy and slurred speech or water dripping out of the corner of the mouth after drinking water.
· No energy to walk or grab objects.
· Abnormal vision, double vision or loss of vision in one eye.
· Acute and sudden headache.
Although stroke can cause paralysis and paresis and is one of the top causes of death, the risk of this disease can be decreased. Advances in medical knowledge in care and prevention has made it possible to screen for risks and while providing fast diagnosis after onset of symptoms to deliver fast treatment. In particular, if the patient arrives in the hospital quickly enough, the chance is high that there will only be minor brain damage.
Comprehensive Stroke Center (CSC)
Phyathai 2 Hospital recognizes the importance of this problem and knows well that the treatment and diagnosis of stroke patients is complex and requires the use of effective tools in order to provide appropriate treatment for the long-term benefit of patients.
24-Hour Stroke Treatment Center
The Comprehensive Stroke Center can treat patients with acute stroke and admit patients for care at the stroke unit according to the standard criteria of the Comprehensive Stroke Center. We can also provide 24-hour treatment for patients in cases that require surgery or endovascular intervention treatment.
Endovascular Intervention Treatment for Stroke
Endovascular intervention therapy is a technology used to treat ischemic stroke. A stent is inserted to extract the blood vessel obstruction without requiring surgery. This procedure has to be performed by an expert in blood vessels, an endovascular expert, and a team of specialists.
The Comprehensive Stroke Center is staffed by neurosurgeons and teams of nurses and experts ready to provide 24-hour service or who can provide care to patients at the hospital within 30 minutes. They can also provide other treatment such as stenting or angioplasty for the arteries inside the brain and cranium.
Advanced Stroke Diagnosis at Phyathai 2 Hospital
Upon discussing stroke diagnosis, the first thing we think about is probably computers and various advanced technologies. At the Comprehensive Stroke Center of Phyathai 2 Hospital, in addition to having a team of medical specialists to provide diagnosis, we also use high-quality tools to ensure the most accurate diagnosis.
1. Magnetic resonance imaging (MRI): This test uses a diffusion-weighted magnetic field to test the arteries and veins, and patients who experience symptoms can have 24-hour access to it.
2. Computed tomography angiography (CTA): This is a technique that can be used to test blood vessel disorders in every part of the body. The patient may also undergo computed tomography perfusion or CTP, which can selectively screen sites of blood vessels suspected of having abnormalities in order to determine blood flow rate.
3. Cerebral angiography: This is a standard test technique for diagnosing aneurysm and congenital anomalies of the cerebral arteries, arteriovenous fistula (AFVs) surgery and obstruction in the blood vessels of the brain inside and outside of the cranium.
4. Ultrasound screening for stroke: For example, carotid duplex ultrasound is performed to screen the blood vessels outside of the cranium and around the neck such as the carotid arteries and vertebral arteries. Meanwhile, transcranial doppler ultrasound is used to test large blood vessels located at the base of the skull in order to identify blood vessel thrombosis and embolism. It is also used to test for shrinkage of blood vessels in patients with subarachnoid hemorrhaging.
5. Echocardiography: In addition to standard testing the heart with transthoracic echocardiography (TTE), in necessary cases, the Comprehensive Stroke Center can also test the heart by using transesophageal echocardiography (TEE), because TTE has high sensitivity in testing for heart disease pathologies, such as blood clots in the left atrium, lumps in the heart valve where there is regurgitation and the nature of arterial stiffness at the aortic arch.
Stroke can be treated at Phyathai 2 Hospital with the help of these medical specialists:
· Neurologist and neurosurgeon with expertise in carotid endarterectomy (CEA).
· Radiologist with expertise in diagnostic radiation.
· Medical specialist in interventional endovascular neuroradiology.
· ER doctors, nurses and staff.
· Radiological technologists.
· Professional nurses for caring stroke patients.
· Medical specialists in different areas such as in critical patient care or critical neurological patient care, echocardiography and ultrasound tests of the blood vessels such as carotid duplex ultrasound and transcranial doppler ultrasound.
· Doctor specializing in rehabilitative medicine and physical therapist.
· Nurse case manager.
Because the Comprehensive Stroke Center has to provide care for complex stroke patients, in order to ensure effective patient care, Phyathai 2 Hospital has prepared personnel and facilities to be ready for patient care, such as a brain and neurological ward (neuro ward) in which stroke patients can receive care from a multidisciplinary team of personnel specializing in stroke, such as rehabilitative medical care from the moment of hospital admission covering physical therapy and speech therapy.
Moreover, we also have a brain and neurological intensive care department because some patients need constant close care and attention, such as major stroke patients, patients with subarachnoid hemorrhaging, who may need the help of a breathing tube or respirator or arterial catheterization or ventriculostomy, including measurement of pressure inside of the brain. Therefore, relatives of stroke patients and people in the risk group do not have to worry when they require emergency treatment. They can call an ambulance by dialing 1772 for to receive 24-hour treatment immediately.
