In Germany, about 270,000 strokes occur every year – not seldom with a fatal outcome. Therefore, the maxim for a stroke is "time is brain": every minute counts. Those affected must be treated as quickly as possible to reduce the risk of permanent damage. The nationwide "Day against the Stroke" takes place on 10 May.
In case of a stroke, every minute counts. Also Professor Doctor Karin Weißenborn and her patient Günter W. know this.
On this occasion, Professor Doctor Günter Höglinger reminds us how important it is to act immediately at the first sign of a stroke. This also applies in Corona times. "There is no reason to hesitate. Hospitals do everything they can to avoid infection with the corona virus, so patients need not fear infection," explains the director of the Department of Neurology with Clinical Neurophysiology at Hannover Medical School (MHH).
In a stroke, also known as apoplexy, a clot causes a vessel in the brain to become blocked. The consequences are circulatory disorders, acute functional disorders of the brain and the death of brain cells. In the case of symptoms such as sudden speech disorders, signs of paralysis, sensory disturbances, visual disturbances and attacks of dizziness, those affected and other people should become aware and act immediately – dial 112 and call the emergency doctor.
This is what Günter W. from Hanover did. The 88-year-old suffered a stroke on 15 March, his engagement day. "My wife and I wanted to celebrate the day with a little coffee in our garden cottage," he recalls. But on the way from the house to the gazebo, he suddenly felt dizzy and black in the face. He collapsed. "Luckily, my wife found me quickly," says W. But the dizziness was still severe, and besides, he could only speak in a slurred manner. "I couldn't stand up either. Then it was clear to us that I had to go to hospital immediately," the elderly gentleman reports. He was taken to the MHH by ambulance. He arrived there in time for successful treatment.
"In order to keep the damage caused by a cerebral vessel occlusion as low as possible, the blood supply to the brain must be restored optimally within a maximum of 4.5 hours after the stroke," explains Professor Doctor Karin Weißenborn, head of the certified supraregional stroke unit at the MHH Department of Neurology. The stroke unit is a special ward for the treatment of strokes. Last year, about 1,100 patients with apoplexy were treated here. Around 1,800 patients were also treated via the MHH Teleneurology Network. The MHH neurologists cooperate with colleagues in partner clinics. In so-called teleconsultations, they exchange information online about neurological emergencies in the partner clinics. With the help of image data of the brain and live video streams of the affected patients, the MHH neurology department provides support in diagnosis and therapy decisions. In this way, rapid and best possible care for stroke patients is to be guaranteed from Hanover to the surrounding area.
"The treatment of stroke patients is always teamwork, with many disciplines and professions cooperating," emphasises Professor Weißenborn. This includes doctors and nurses from neurology, neuroradiology, anaesthesiology, neurosurgery, internal medicine and cardiology and angiology as well as vascular surgery. In addition, there are specialists from physiotherapy and occupational therapy, speech therapy and social work.
The stroke unit offers all diagnostic and therapeutic procedures for stroke patients around the clock, 365 days a year. The clot in the cerebral artery can either be dissolved by a drug therapy, lysis, or removed by a mechanical procedure, thrombectomy. Thrombectomies are performed in neuroradiology. The method has brought enormous progress in stroke treatment in the past ten years. It is mainly used for severe strokes when large blood vessels in the brain are blocked. It was also used on patient Günter W. The elderly gentleman is now in a rehabilitation clinic and on the road to recovery.
The probability of suffering a stroke increases with age. "The peak age is 75 years," says Professor Weißenborn. "But we also have many younger patients, and in rare cases even children." Risk factors for apoplexy include severe obesity, diabetes mellitus, high cholesterol, atrial fibrillation, high blood pressure and smoking.
The fast and high-quality care of stroke patients is a special concern for Professor Höglinger. "One of our next goals is to be certified as a neurovascular network," says the Clinic Director. For this, further qualitative and structural requirements have to be fulfilled – for example, further training of the emergency medical services. "We want to achieve that stroke patients are safely identified in an emergency and immediately taken to a stroke unit. Because a diversion via another hospital, where the affected person cannot be properly cared for, costs valuable time. And patients with a stroke don't have that."