Stroke

Best possible treatment – from emergency first aid to rehabilitative care

As its name suggests, a stroke hits many patients like a blow. Paralysis and sensation or speech disorders can occur suddenly. From one moment to the next you may be confronted with issues such as disability and nursing care. Often, there are economical and social problems to cope with as well.

At Schoen Clinic, we do everything possible to provide you with optimal treatment, from the first moment to rehabilitative care.

Causes & symptoms

Stroke – Causes: How a stroke develops

In eight out of ten cases, a stroke is caused by a blood clot that blocks a blood vessel in the brain. This is referred to as an “ischemic” stroke, which is caused by insufficient flow of blood.

In the other cases, the sudden rupture of a blood vessel causes the stroke. This results in brain haemorrhage.

Both causes lead to similar symptoms and effects: The supply of blood to the regions of the brain behind and around the site of the stroke is compromised. Important brain functions are lost.

Stroke – Symptoms: Warning signs that you should take seriously

In most cases, a stroke isn’t painful. That’s why milder strokes in particular often go unnoticed. The sudden occurrence of the following symptoms can be helpful in recognising a stroke:
  • Weakness or paralysis in one side of the body, one arm or leg, or one half of the face, tingling or numbness in the limbs
  • Trouble with speaking and language, involving unclear, slurred speech, problems understanding speech or the complete inability to speak
  • Impaired vision or blindness in one eye or on one side of the field of vision
  • Double or blurry vision
  • Dizziness accompanied by nausea and vomiting, loss of balance and difficulties coordinating one’s own movements
  • Loss of consciousness or confusion
  • In rare cases, a sudden and very strong headache (“like being struck by lightning”)
Straight to hospital – Every minute counts!
Take these warning signs seriously! Arrange for immediate transportation to hospital (number for emergency services in Germany: 112) as soon as you notice any of these warning signs in yourself or someone else. Immediate medical attention can possible prevent serious complications and ideally result in the symptoms clearing up completely.

Early warning signs of a stroke: temporary disruption of blood flow
In one out of three cases, before a stroke occurs there is a temporary disruption of blood flow, in which the blood clot immediately breaks apart and no lasting damage remains. This “mini”-stroke usually lasts just a few minutes, but it can go on for over two hours in rare cases. Some of the symptoms listed above occur. Even temporary symptoms require immediate medical treatment in a specialised ward for treating strokes (stroke unit).

Diagnostics

Diagnosis: finding the cause of the stroke

In order to quickly start the right therapeutic measures and the suitable treatment, two questions must be answered first: What caused the stroke, and where exactly in the brain did it occur? The latter is answered using two imaging techniques – computed tomography (CT) and magnetic resonance imaging (MRI).

Neurological examinations can also determine which areas of the brain no longer function, and which are only impaired. The neurologist tests reflexes, coordination, memory performance, speech and the patient’s orientation, among other things.

Computed tomography (CT)

CT provides specialised x-ray images of the brain, the bones and the blood vessels. Then the doctor can tell whether a disruption of blood flow or a brain haemorrhage is involved.

Magnetic resonance imaging (MRI)

MRI offers even more detailed images of the brain tissue, and can capture even the smallest changes and abnormalities inside the brain. It can also supply information helpful in finding the cause of the stroke.

Ultrasound examination (neurosonography)

This examination can show the flow of blood through the vessels supplying the brain. Then we can see whether the blood is flowing normally. If the flow of blood is restricted in certain places, it is a sign of artery calcification or vessel occlusion.

Heart examination

In order to find other possible causes of a stroke, precise heart examinations are carried out. These include an electrocardiogram (ECG), Holter ECG, and transoesophageal echocardiography (TEE). These tests can be used to detect any arrhythmias (such as atrial fibrillation) or cardiac structures that could cause blood clots.

Blood tests

The blood tests provide information about the blood clot status and possible lipid metabolism disorders. In rare cases, they can show evidence of autoimmune diseases.

Angiography

Nowadays, the vessels of the brain can be imaged just using CT and MRI. A contrast agent is often required to make the blood vessels stand out clearly. This shows us how much the vessels are narrowed or blocked or whether there are other types of blood vessel damage. In exceptional cases, a catheter is required for imaging.