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Stroke - Every Minute Counts!

A stroke constitutes the third leading cause of death in the Western world, following cancer and heart diseases, and is the primary cause of disability among the elderly population. Stroke is a major factor in mortality and morbidity in the Western world. In Israel, approximately 15,000 people suffer from strokes each year, with only a small percentage receiving timely and proper treatment, often due to delays in reaching the triage room.

Dr. Hoorani Nizar, Neurologist, Leumit Health Services, and Senior Specialist in the Brain

An adult couple holding hands in the park

There are two types of strokes:

  1. Ischemic Stroke - caused by a sudden blockage in one of the blood vessels leading to or within the brain. The blockage occurs due to the accumulation of atherosclerotic plaques on the blood vessel walls or as a result of a blood clot originating from the heart or one of the major arteries. This type accounts for approximately 85% of stroke cases.
  2. Hemorrhagic Stroke - caused by a rupture in one of the brain's blood vessels, leading to bleeding into the brain itself.

Symptoms of a Stroke:

Stroke symptoms are sudden and sharp, including:

  • Weakness or paralysis on one side of the body (in three-quarters of cases, paralysis or weakness on one side is the primary sign).
  • Facial drooping.
  • Incomprehensible speech or speech difficulties, such as slurred speech.
  • Difficulty finding words.
  • Difficulty completing sentences.
  • Difficulty swallowing.
  • Double vision.
  • Occasionally, severe headache (in some cases of hemorrhagic stroke).


The appearance of stroke symptoms requires immediate hospitalization, urgent diagnosis, and immediate treatment to minimize the risk of disability and neurological deficits.

Risk Factors:

The most common risk factors for stroke include heart disease, diabetes, high cholesterol levels, and high blood pressure. Genetic factors (a family history of stroke or vascular diseases) also play a role. Less common risk factors include blood clotting disorders, inflammation of blood vessels, and injuries to the neck and head. When multiple risk factors accumulate, the risk increases significantly.
Despite the perception that stroke primarily affects the elderly population, children and young adults can also suffer from strokes. However, the average age of stroke patients is 69. Neurological association data indicate that approximately 25% of stroke patients are under the age of 60, and about 8% are under the age of 50.

Diagnosis and Treatment of Stroke:

The rapid diagnosis of stroke is achieved through brain CT imaging and CTA (angiography - a test that examines blood flow in the blood vessels). Sometimes, an MRI scan is performed.
Acute stroke treatment includes pharmacological treatment with a clot-dissolving drug administered via intravenous infusion (tissue plasminogen activator) and/or endovascular treatment involving brain catheterization to remove the clot or open the blocked artery.

The Need for Rapid Treatment:

In a stroke, every minute without treatment leads to the loss of approximately 2 million brain cells.
The time window for treatment from the onset of stroke symptoms is up to four and a half hours for pharmacological treatment and up to ten hours for surgical treatment (urgent catheterization).
The speed of arrival at the hospital after the appearance of stroke symptoms is critical for saving the patient's life and minimizing disability.
It is important to note that a stroke event is not necessarily painful. The affected individual may be unable to call for help, may have difficulty speaking, and may not even be aware of their impairment.
When there is a sudden appearance of any of these warning signs of stroke, immediate arrival at the triage room and relevant assessment is crucial to receive urgent treatment.

 

Warning Signs Everyone Should Recognize


It is essential to emphasize the warning signs of a stroke that should trigger an immediate response, including calling an ambulance and heading straight to the hospital:

  1. Sudden weakness or paralysis usually occurring on one side of the body – in the face, hand, and/or leg on one side. This is the most common and prominent sign. It can manifest as difficulty walking, using a hand, or a lack of sensation in the affected area.
  2. Sudden difficulty speaking or comprehending spoken language. This symptom may appear for a very brief moment, just a minute when you feel like you're "stuck" while speaking. Even if it passes quickly, it remains a warning sign.
  3. Sudden disturbance in vision characterized by sudden darkness in the visual field, similar to a dark screen descending over one eye.
  4. Alternatively, this symptom can manifest as a sudden appearance of double vision.
  5. Sudden impairment in coordination and balance.
    Loss of consciousness (more common in hemorrhagic strokes).

Remember, with a stroke – every minute counts!