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What medicine are you taking?

Blog of Dr. Lindner, Chief Medical Officer World Medical Card  8/2021

Good for you that we knew on the spot that you were taking….
“Grand Ma suddenly dropped her cup of tea out of her left hand and could not properly talk any longer. She also could not move her left arm anymore and her her left corner of the mouth hang down, too”.

This is a typical description and clinical appearance of a “stroke”. Strokes are one of the leading causes of death and disability world- wide and often leave patients disabled. However, there are options to reduce or even prevent persistent handicaps.
Firstly and of utmost importance is the quick recognition and transport to a stroke unit where these interventions can be performed (“time is brain”).

After a fast anamnesis by a physician a CT scan of the head is carried out immediately to evaluate the “nature” of the stroke. In around 80- 85 % of the cases an interrupted circulation of parts of the brain due to a clot is causing the symptoms (“ischemic stroke”) whereas in 15-20 % a cranial bleeding can be found (“hemorrhagic stroke”).

In the first scenario and depending on the time that has been passed since the onset of the symptoms (< 4,5 hrs) a thrombolysis (administering clot- solving drugs) is performed in order to dissolve the obstruction.
To do so, any contraindications have to be checked immediately, reliably and without any delay to save as much brain substance as possible.

A decisive point to adjust the treatment is the intake of any blood thinners (e.g.  in case of suffering from atrial fibrillation or after heart valve replacement) as these can interfere with the medication for thrombolysis and put the patient in danger of bleeding.

It is therefore very important that the treating physicians know if, what kind and when lastly these drugs have been taken.
This is also true in the case of cranial bleeding or bleeding in general as nowadays medicaments are available that are capable of neutralizing the worsening effect of blood diluting drugs on the bleeding if they are given on time.


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