Cases of cerebrovascular accident (CVA) tend to increase in the summer, Orlando Maia, a neurosurgeon and interventional neuroradiologist at Hospital Quali Ipanema, in Rio de Janeiro, told Agência Brasil.
According to the doctor, a series of factors predispose humans to stroke at this time of year. One of the main ones is the heat itself, which generates natural dehydration of cells which, in turn, causes an increase in the possibility of blood clotting. “And this has a greater potential to generate a stroke, because the stroke is linked to a clot,” said the doctor.
There are two types of stroke. One is hemorrhagic stroke, which is the rupture of a cerebral vessel and represents the minority of cases, around 20%. The other type, which dominates the number of cases, is ischemic stroke, caused by the formation of a clot and blockage of a vessel. Orlando Maia explained that, as the blood becomes thicker, more concentrated due to dehydration, this favors thrombosis, which is the formation of a clot and, therefore, has a greater predisposition to stroke.
Blood pressure
There are other causes that would be related to blood pressure. “Our blood pressure in the summer has a tendency, due to the heat, to decrease due to vasodilation. In other words, our vessels, in order to compensate for the heat, dilate. And this dilation causes a decrease in pressure, which also favors the formation of clots and another cardiological situation, called arrhythmia. It is the heart beating out of rhythm”, explains the doctor.
When this happens, it also favors the formation of a clot in the heart, which, once it enters the bloodstream, has a great predisposition to go to the brain because 30% of all the blood that leaves the heart goes to the brain.
Another cause of stroke, also common in the summer, is that people take less care of themselves on vacation, which promotes an increase in alcohol consumption, which, in turn, increases dehydration.
Orlando Maia stated that alcoholic beverages also increase the possibility of arrhythmia. Negligence can also lead a person to forget to take medication, which contributes to increasing the risk of a stroke.
Typical diseases
Added to this are typical summer illnesses, such as heat-related gastroenteritis, which causes diarrhea, heatstroke and physical exertion. “All of this combined makes people more likely to have a stroke in the summer,” he emphasizes.
The neurosurgeon recalled that smoking also contributes to this. “Smoking today is one of the biggest external causes of stroke.” Smoking contributes to the formation of a cerebrovascular disease called aneurysm, which is closely linked to nicotine.
“Nicotine blocks a protein in our vessels called elastin, reduces the elasticity of the vessel, so it can promote hemorrhagic stroke, as well as causing an inflammatory process in the vessel itself, favoring the adhesion of cholesterol plaques in the long term and clogging of the vessels. Therefore, tobacco is directly proportional to the situation of both hemorrhagic stroke and ischemic stroke”, recommends the doctor.
For the doctor, the modern lifestyle – combined with smoking and uncontrolled chronic diseases – means that more and more people under the age of 45 develop the disease.
This summer, Hospital Quali Ipanema, for example, sees around 30 patients per month, twice as many as normal times of the year. Maia says that stroke is a very common disease.
“If you take stroke as an isolated disease, forgetting that there are several types of cancer that can be separated, the most common disease in humanity is stroke. And one in every six people will have a stroke in their lifetime”, he highlights. The doctor said it is very important for people to find out who has had a stroke in their family and friends because they are not isolated cases.
Doctor Orlando Maia warns of disease risks in summer Photo: Personal Archive
Deaths
Stroke is one of the leading causes of death and disability in the world. “When it doesn’t kill, it leaves the person incapable. I say it’s a disease that doesn’t affect the person, but the family, because at least two people will have to dedicate themselves to caring for that patient with a stroke. In addition to mortality, it is an extremely disabling disease. The person is left unable to walk properly, unable to speak properly, unable to feed themselves. It’s an extremely critical illness. When you see a person walking with difficulty, it’s because they’ve already had a sequel or consequence of a stroke. They’re paralyzed on one side or unable to speak properly, without seeing, if you focus on the area of vision, because the brain is a large computer. It will depend on the area affected by the problem”, assures the doctor.
According to Orlando Maia, prevention can prevent a stroke. “It’s a disease that we have to shout for everyone to hear that there is prevention and treatment. Prevention [envolve] a healthy lifestyle, regular physical exercise at least three times a week, healthy eating, controlling blood pressure, taking medication correctly and not smoking. And there is treatment.”
In the past, as there was no treatment, when a person arrived with a stroke, there was nothing to do except control the pressure. Today, there are two forms of treatment and the faster the person gets to a hospital, the more effective the treatment will be. The first is the infusion of a medicine. “You put medicine in the vein that dissolves the clot and, in most cases, the medicine resolves it”, he teaches.
When this doesn’t happen, or in other more select cases, Maia said doctors enter the person with a catheter in the groin and use a plunger. This method removes that clot, through aspiration inside the vessel, releasing circulation back. With this, the person returns to normal.
Catheter
Orlando Maia also clarifies that the medicine has a characteristic: “it can only be given up to four and a half hours from the onset of symptoms. The catheter that is aspirated enters a vessel in the groin, through a device and, in selected cases, can be used up to 24 hours from the onset of symptoms.” He stressed that the sooner the person has the symptom and goes to a hospital, the better the result may be.
Symptoms indicating that a person is having or will have a stroke include sudden paralysis of one limb or both limbs on one side, or slurred speech, or loss of vision on one side, or extreme dizziness.
“These are the main symptoms of a person who is having a stroke. They will have difficulty moving, speaking, seeing or have a sudden loss of consciousness. It is a disease that happens, most of the time, from one moment to the next. In this situation, you don’t have to wait at all. The person has to be taken to a hospital because it is a medical emergency”, concludes the neurosurgeon.
