debate, debate | Our summer dream is for people to call 113 in case of severe symptoms

Suddenly Bjørg (74) feels a little weird in the summer heat. Isn’t there a little gray on one side of the field of view, and does one arm feel heavy and a bit strange…? Damn, it’s hard to talk too. But she can use her other arm to pour the coffee and manages to walk over to the sofa – where she lies, waiting for her to pass by. There is no point in telling anyone, it is not certain that something serious is going on. or…?

Treatment of acute stroke It begins the moment a person experiences the first symptoms of what could be a stroke. Don’t “wait and see”, don’t “sleep on it” until the next day! Call 113 one time too many! Those who work at 113 and in the ambulance are well trained in the assessment of acute illness. With the introduction of a new project where ambulance workers learn to use the same stroke scale as hospital doctors, the assessment of who must go to hospital and who can safely stay at home will be raised yet another notch in the form of the eSTROKE project. The project will be implemented in the near future in collaboration with the Norwegian Air Ambulance Corporation and Oslo University Hospital, thanks to operating funding from Helse Sør-Est.

In recent years there has been a revolution when it comes to stroke treatment. Most strokes are caused by areas of the brain that receive too little oxygen due to a blood clot in one of the major blood vessels leading to the brain. We have the option of offering clot-dissolving therapy, dissolving the clot, but this treatment is urgent! Unfortunately, less than half of all stroke patients come to our hospital in Lillehammer within the prescribed treatment time of 4.5 hours.

probability of a successful outcome It increases the speed with which treatment is received, and those who receive coagulant therapy during the first “golden” hour often do not have lasting problems. On the other hand, if you don’t have a clot, but there is bleeding in the brain, or if it’s been a long time before treatment, clot-dissolving therapy can make your pain worse. statistics Which records stroke treatment throughout Norway shows that both Lillehammer and Jovik provide rapid anticoagulation treatment for most patients who arrive on time.

Because it is critical To differentiate blood clots from bleeding in the brain, the patient should undergo a CT scan of the head as soon as possible. In Helles-Nord and in Ill in Hallingdal, remote CT machines are being tested at local medical centers so that treatment can begin before a patient is taken to hospital. We think this should be possible at local medical centers indoors, too.

in up to one in three cases of thrombosis Thrombectomy, otherwise called thrombografting, can also be a possible method of treatment. This is more effective than a blood thinner. Today, thrombolysis is done at Akershus University Hospital and Oslo University Hospital, as well as a few other hospitals in the south, west and north of the country. In the long-term plan to step up stroke treatment at the Stroke Center in Lillehammer, we aim to perform thrombolysis on Einlandt patients. This will result in a shorter transfer time and thus a higher chance of a good outcome for the patient.

What can you do on your own? Stroke is one of the leading causes of functional impairment, inability to work and death in Norway. The risk of stroke increases with age and if you have high blood pressure, diabetes, smoke or are overweight. Simply lowering slightly elevated blood pressure by a few units reduces the risk of stroke. It is also important to stop smoking and adjust your blood sugar and cholesterol levels. Physical activity, for example walking for 30 minutes five days a week, can actually help with high blood pressure.

It can be hard to perceive that you have had a stroke – not least because the brain has partially stopped working. In addition, the signs can be indistinct, with many strokes not showing up on the typical ‘lift’, ‘smile’, ‘talking’ scale. An example is sudden blindness in one eye – which can actually be a small “stroke” in the eye. At Lillehammer we are collaborating with ophthalmologists in a research study to provide blood clot dissolving therapy to patients in which the ophthalmologist quickly detects such a blood clot in the major blood vessels of the eye. Treatment can only be given if the ophthalmologist confirms the presence of a blood clot in the eye and the patient can be with us at the Lillehammer Hospital within 4.5 hours after the occurrence of blindness. We often use the phrase “time is the brain”. In such cases we can say that “time is sight”!

Fortunately, Bjørg made up her mind and called 113. Ambulance workers, working with the emergency department, discovered she was suffering from low blood sugar and dehydration – not a stroke.

It can be very difficult To distinguish a stroke from other sudden changes in the body. Our summer dream is for more people to lower their blood pressure and reduce their risk factors, and to quickly call 113 in case of acute symptoms. Further on the wish list are the funds to build and operate a CT machine in areas far from the hospital, as well as the potential for trompe l’oeil hunting here inland.

Annette Hughes-Farmin and Kaja NyquistHead of the Department of Physician Ph.D., Department of Neurology SI Lillehammer
Julia VoglumMD, Senior Physician, Department of Neurology SI Lillehammer
Hanna Marie Utterholt BekisethSenior Physician, Project Director SI eSTROKE, SI Lillehammer Department of Neurology