Risk of disability from recurrent stroke

According to the Stroke Center, Bach Mai Hospital, they have just received 7 cases of stroke recurrence for emergency treatment. Many people who should have been able to return to normal life and work, have paid a high price for paralysis, disability, and even death.

Consequences when patients subjectively do not return for re-examination

Not long after being discharged from the hospital, male patient NVT (born in 1993, Ninh Binh) had to be hospitalized again due to a recurrent stroke. The patient is very young, has a history of good health, but 2 months ago, Mr. T suffered a stroke and was transferred to Bach Mai Hospital for emergency care. Due to severe paralysis of the right side of the body, the patient was treated in emergency and intensively treated at the Stroke Center for 10 days, then treated with internal medicine and intensive rehabilitation exercises. After 1.5 months of treatment, Mr. T recovered well and was discharged from the hospital. The doctor prescribed medication to take at home and scheduled a follow-up visit 1 month later because he needed to maintain medication to prevent long-term recurrence.

However, the male patient thought that he was still young, his health was good, and his activities were almost normal compared to before, so he subjectively did not go for a check-up and did not take medication to prevent a stroke recurrence. After 5 days of stopping the medication, Mr. T experienced symptoms of hemiplegia, crooked mouth, slurred speech and was taken to the Stroke Center for emergency care. Here, the doctor diagnosed the male patient with a recurrent cerebral infarction.

“Unfortunately, this time the patient’s paralysis is more severe, with hemiplegia on one side and very poor mobility. The prognosis for recovery is much more difficult than last time,” said Dr. Nguyen Tien Dung, Deputy Director of the Stroke Center, Bach Mai Hospital.

Also admitted to the emergency room for a recurrent stroke was Ms. NTH (44 years old, Kim Bang, Ha Nam) who had a history of mechanical mitral valve replacement surgery and had a stroke 5 years ago but recovered well. Because of her heart disease, she must maintain anticoagulant medication for life and needs to have regular check-ups to adjust the anticoagulant dose. Although she had to strictly follow the doctor's instructions, because she was subjective and thought that she was recovering well, for the past 6 months, Ms. H did not go back for a check-up to adjust the dose, but arbitrarily maintained the same prescription as before.

“This time the patient was hospitalized because of a recurrent cerebral infarction, and the blood clotting index test did not meet the treatment target - this index should have been adjusted more closely, meeting the treatment target would have prevented cerebral infarction better. The patient's prognosis this time is worse than the previous time,” said Dr. Dung.

According to Dr. Dung, the 7 relapses that were just admitted to the emergency room all stopped taking their medication, and were more severe than the previous time, including both young and old people. The subsequent strokes were definitely more severe than the previous ones.

Remember your blood pressure readings like you remember your age.

The Stroke Center, Bach Mai Hospital has 55 beds, but the number of patients coming to the emergency room always exceeds that. On average, the Center receives 50-60 severe stroke cases transferred from other levels each day, including many patients who are very subjective about their health. High blood pressure is the leading risk factor for stroke, but many people are almost unaware of their blood pressure index, do not get examined, and do not measure their blood pressure. Some people even know they have high blood pressure, but subjectively ignore it.

Lying on a hospital bed with severe paralysis on his left side, Mr. NVT (43 years old, Nghe An) discovered he had high blood pressure at the age of 28. He went to the clinic and the district hospital for examination, but the blood pressure medication did not lower his blood pressure, so he got bored and went home. He should have continued to see a doctor to increase the dose of medication to better control his blood pressure. But he did not do so, did not take medication, and did not receive any treatment. Recently, he felt tired, dizzy, had difficulty speaking, had weakness in his right arm and leg, and his blood pressure was up to 230. His family took him to the emergency room and diagnosed him with a brain hemorrhage due to high blood pressure. He was then transferred to Bach Mai Hospital. When he learned that he had a stroke and was likely to be paralyzed on one side of his body, Mr. T was very worried and regretful, but it was too late.

Dr. Dung said that for every patient discharged from the hospital to go home, the doctor reminds both the patient and the family 3-4 times to comply with the follow-up check-up and take medication to prevent relapse, but the patient still skips the medication. Many elderly people do not live with their children, or their children are busy working, so they neglect to take care of their parents taking medication, leading to the elderly quitting their medication and having a stroke relapse. Many people face the risk of disability, paralysis, and difficulty recovering their health.

“According to the American Stroke Association, stroke recurrence is preventable and has a very high success rate, with 80% of stroke patients being able to successfully prevent recurrence. However, in Vietnam, patients are still subjective and have poor adherence to treatment. For those who have had a stroke, they must strictly adhere to taking medication and returning for check-ups if they do not want to become disabled and their loved ones to have to work hard and spend money on care, becoming a burden on the family,” Dr. Dung warned.

In addition, people must know how to recognize stroke symptoms, listen to their bodies and remember the signs of stroke; when they suspect they are having a stroke, they must act quickly and urgently, do not hesitate to waste time and go to the hospital immediately. People should measure their blood pressure regularly (even young people) and remember their blood pressure readings as they remember their age to prevent stroke and other complications of high blood pressure such as heart failure, aortic aneurysm and dissection, myocardial infarction, etc.