Eight myths about stroke prevention and treatment Stroke is often referred to as a “cerebrovascular accident,” a concept that is not very scientific and reflects the misconception that strokes are sudden and difficult to prevent. Another common perception is that strokes are a natural result of getting older and cannot be prevented. Myth 1: Stroke is sudden and without aura Stroke is mostly sudden, but that does not mean there is no warning. It is preceded by a transient ischemic attack (TIA), which occurs hours, days, weeks, and months before a full-blown stroke and has the following manifestations: sudden onset of blurred vision or loss of vision in one or both eyes, numbness, weakness, or paralysis of the face or of one or both limbs, difficulty expressing or understanding speech, vertigo, loss of balance or unexplained falls, difficulty swallowing, headache (usually sudden and very severe), or some kind of The episodes last for several minutes and are usually sudden and very severe. Unfortunately, because of the short duration of the attack and the rapid disappearance of the symptoms, it is easy for patients to overlook the fact that a TIA, called a “mini-stroke”, is often a warning of a serious stroke that may follow and should be treated as an emergency. Neurologists should pay more attention to the recognition of TIA to prevent it from developing into a full-blown stroke. Myth 2 Stroke occurs only in the elderly population About 33% of stroke patients are under the age of 65, and in recent years it has become more youthful. In addition to common risk factors such as hypertension, diabetes, hyperlipidemia, smoking and alcoholism, there are also blood disorders, heart diseases, congenital diseases and immune system diseases that should be actively investigated and treated. Misconception 3: It is harmful to emphasize medication and neglect prevention. The primary prevention of stroke is to advise healthy people to quit smoking and excessive drinking, to strengthen mental health care and to eat a healthy diet, and to actively prevent and treat risk factors such as arteriosclerosis, hypertension, diabetes, heart disease and hyperlipidemia. For high-risk groups, especially those with heart disease and atrial fibrillation, oral anticoagulants or anti-platelet aggregation agents can be used to prevent stroke. Oral anticoagulant Warfarin is used for primary prevention in patients with atrial fibrillation, which can reduce the risk of cardiogenic cerebral embolism by more than 2/3. Secondary prevention refers to: prevention of recurrence of TIA and cerebral infarction in those who have already suffered from TIA. Many patients and their families do not want to change their bad habits, but are in pursuit of “special drugs” or a few injections per year. Myth four stroke is incurable treatment of acute ischemic stroke currently has two main ways: one is the vascular pathway, that is, thrombolytic therapy; the other is the cellular pathway, to reduce ischemic neuronal damage protection therapy. There is no need to go back to the past when “pessimism” was prevalent. Myth 5: Stroke is not an emergency Stroke, like a heart attack, should be treated as an emergency within a few hours of the stroke. “Time is brain”. Myth 6 All brain cells in the affected brain tissue die rapidly after a stroke occurs, and studies have shown that irreversible death of brain cells in the infarct center can occur within minutes after an ischemic stroke due to severe ischemia. Between the infarct center and normal brain tissue, there is an “ischemic penumbra” where the cerebral blood flow decreases but the brain cells can still maintain energy metabolism, and the aim of both thrombolytic and neuroprotective treatment is to save the ischemic penumbra. Myth 7 generalizes the indications for certain specific treatments for stroke. Thrombolytic therapy has been controversial to date, with some reports to the contrary, and the main complication is combined bleeding and increased mortality. The duration of rt-PA thrombolysis is 3 hours in the United States and 3 to 6 hours in Europe. Not all are adapted to thrombolytic therapy. Misconception eight ignore the acute phase of stroke rehabilitation treatment for a long time, China’s large general hospitals focus on drug therapy for patients in the acute phase of stroke, almost no real rehabilitation treatment, missing the best time for rehabilitation. Many patients only save their lives, but are left with serious disabilities, and finally can only return to their families, not to society. Abroad, patients are given rehabilitation treatment after 24 to 48 hours. This includes physiotherapy, occupational therapy and speech therapy. The prevention and treatment of stroke is by no means limited to a single hospital treatment, but is a comprehensive system project.