Holidays are undoubtedly an exciting time, but all the hustle and bustle can also bring the unexpected. medical problems, including an increased risk of heart attack and stroke. It is therefore important to know symptoms and not delay in seeking medical attention.
A stroke is a stroke that affects approximately 15 million people worldwide. In the Philippines, nine in 1,000 people develop a stroke, the majority of which is due to vascular obstruction (obstruction a blood vessel, usually with a clot) or what is called an acute ischemic stroke. The stroke remains be the leading cause of disability among Filipinos and the second leading cause of death in the country.
A stroke is a medical emergency in which blood flow to the brain is suddenly interrupted while either two mechanisms: bleeding inside the brain or occlusion of blood vessels inside the brain. Patients who presented with a sudden onset of focal neurologic deficits should be rushed to the nearest stroke-ready hospital for immediate neurological management.
Symptoms of sudden sagging on one side of the face, weakness or numbness on one side, slurting of speech, imbalance and doubled vision are the first signs of a stroke.
Time is the brain: nothing more precious than time
In the event of sudden occlusion of the vessels inside the brain, the brain tissue may be saved if blood flow is restored soon after the onset of an acute ischemic stroke. Intravenous thrombolysis using recombinant tissue plasminogen activator or (rtPA IV) is an anticoagulant drug which has been the standard of care since 1995. In 2008, the FDA approved its extended use up to 4.5 ischemic stroke onset times.
But since 2015, the standard of care for stroke has changed dramatically with the introduction of mechanical thrombectomy as an effective treatment modality. It is a direct intra-arterial mechanical removal or recovery of the clot inside the brain vessel which otherwise will turn out to be resistant to standard intravenous rTPA anticoagulant.
A team of specialists who can recognize and hastily address patients who may have a possible Strokes are also able to effectively deliver a drug that could restore the occluded blood to flow. In the Philippines, studies have shown that treatment with rTPA leads to increased independence patient outcomes or functionality after 90 days of stroke. This means that despite a stroke, more patients could still do the things they could do before illness, and more patients can return to their old way of life. The caveat is that it cannot be given in a limited window of opportunity.
In the heart of one of Metro Manila’s busiest streets, The Medical City (TMC) Ortigas has an ace up his sleeve to provide the best possible outcomes for stroke patients that may come beyond 4.5 hours after the onset of stroke thanks to its robust 24/7 mechanical thrombectomy service. As one of the very few medical institutions in the Philippines capable of performing this procedure, TMC boasts of a 73% survival rate among those who have undergone mechanical intervention thrombectomy and 80% of those who survived had excellent functional results.
Transform stroke care, prevent brain damage
Mechanical thrombectomy, which is relatively new not only locally but internationally, is a image guided therapy where a clot that had blocked a large blood vessel in the brain is manually extracted by stent and catheter devices to quickly restore perfusion to the brain tissue – a sophisticated procedure that can literally save billions of neurons that has never been before possible. International studies have shown its ability to be beneficial even up to 4 p.m. early symptoms with some even able to achieve favorable neurological results in patients for up to 24 hours after onset of symptoms. This extended time window is an opportunity for patients with ischemic stroke to have good neurological results even though their symptoms have been present beyond six hours. It dramatically reduces hospital stay and has a faster recovery rate.
Any patient with signs and symptoms of a possible stroke rushed to a stroke-ready hospital may be assessed for severity of stroke. A stroke severity scale called a NIHSS rating is used to determine how serious the stroke is. Patients with moderate to severe stroke can greatly benefit from mechanical thrombectomy. Prior to the advent of mechanical thrombectomy, patients with severe stroke and those who had presented beyond six hours would have no other way to save the deprived brain tissue aside routine post-stroke care and prevention to reduce the risk of another stroke. After the onset of mechanical thrombectomy, such major disabilities, including late awakening strokes that typically reach hospitals beyond 4.5 hours can now lead to less disability and with greater chance of reversing symptoms – a major medical breakthrough that has never been seen for over two decades. Mechanical thrombectomy has been shown to be effective, efficient and superior in terms of increase the survival of large vessels or patients with ischemic stroke.
Dr Erwin Jocson is an interventional neuroradiologist present who initiated the series of case of successful mechanical thrombectomy for TMC. It, alongside a highly efficient brain attack team, helped reverse major deficits of critically disabling and life-threatening diseases Acute stroke unit ischemic strokes.
“Mechanical thrombectomy has totally changed the way we treat stroke today,” said Dr. Jocson.
If there is a hospital capable of performing a systematic and highly organized workflow for mechanical thrombectomy, it is the TMC company with a mother vessel model from Main (Ortigas) that works closely with its facilities in Clark. , South Luzon and Iloilo in a seamless expert workflow coordination. in particular its stroke team, emergency services and radiological facilities. All three TMC hospitals have state-of-the-art neurocatheterization laboratories where mechanical thrombectomy procedures are performed.
“The nearest hospital might not always be the right hospital,” said Dr Jocson citing the importance of accessing a stroke-ready hospital with workflow and results. proven to provide such a neurological intervention.
At TMC, the workflow begins with triage, team activation, transportation and case preparation. A patient with symptoms of stroke is immediately sorted by qualified emergency physicians who will activate the stroke team. The team is made up of a neurologist, neuro-interventionist, neurosurgeons and stroke nurses trained to accurately identify stroke patients by adapting standard neuroimaging, the rapid administration of thrombolysis with rTPA within the golden time frame of 4.5 hours and, when deemed eligible, may perform mechanical thrombectomy. provide the best possible care for stroke, even for patients for whom anticoagulant drugs could not be given due to contraindications.
Dr Joann Soliven, TMC neurologist and head of the acute stroke unit, said stroke cases are on the rise and are affecting even the younger population.
“We need to be more vigilant in promoting stroke awareness in the community. Everything starts from the community, so we must spread knowledge about stroke and its prevention. Nearby hospitals that receive possible stroke patients who may benefit from thrombolysis or mechanical thrombectomy can take them urgently to the nearest stroke-ready hospital, such as The Medical City, ”said Dr Soliven.
TMC’s emergency line is 689-8153. To learn more about the services of the Department of Neurology, Institute of Neurological Sciences, please call 9881000 ext. 6270.
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