The 74-year-old grandmother Wang suffered from hypertension and coronary heart disease for more than 10 years and had two stents put in her heart. One day at noon, the elderly suddenly felt weakness in the right lower limb, standing up very difficult, she thought it was the old problem of lumbar disc herniation, did not pay much attention. After two days, the symptoms suddenly worsened, the right side of the body could not move, and was sent to the hospital, found to have a cerebral infarction. After the hospital, it was found that she had a cerebral infarction. After all the efforts to save her life, she could not move her right arm. In the clinic, we sometimes encounter such patients, inexplicably appearing lower limb weakness, can not walk, many people do not take it seriously, always think that rest will be fine, especially the elderly who suffer from lumbar disc herniation or bad legs, often mistakenly thought that it is caused by back disease. In fact, the sudden weakness of the lower limbs may be a precursor to a stroke. The early weakness of Wang’s right lower limb was actually caused by transient cerebral ischemia, which is often referred to as “mini-stroke”, and if attention was paid to timely hospital treatment, the prognosis was much better. There are many causes of lower extremity weakness, such as lumbar spondylosis, low blood potassium, lower extremity venous thrombosis, stroke, etc. Due to the similarity of symptoms, it is difficult for patients to identify them. Due to the similarity of symptoms, it is difficult for patients to identify them, which makes it easy to misdiagnose and delay treatment. Generally speaking, the weakness of the lower limbs caused by hypokalemia is manifested by the patient’s complete inability to walk; the weakness of the lower limbs caused by lumbar disc herniation is often accompanied by a sense of numbness and pain; the weakness of the legs caused by the precursor of stroke or mini-stroke is weakness without obvious pain, which develops into complete immobility within 1-2 days in serious cases, with both unilateral limbs possible. Zhang Zhiwen said that although the symptoms of a mini-stroke are mild, it is often an early warning sign of a stroke. According to statistics, 1/3 of patients with a mini-stroke will have a stroke, with 50% of them having a stroke within two days of the mini-stroke. Especially for patients with diabetes, hypertension and hyperlipidemia, the “three highs” should be taken more seriously. Six hours after stroke is the best time for thrombolytic therapy to restore brain function, and the longest time should not exceed 24 hours. All patients suspected of stroke or mini-stroke should not have the ideas of “resting at home may be fine” or “waiting for a better time before going to hospital”. “This will only delay the treatment and miss the best time for brain function recovery. Vascular ultrasound screening for stroke first pass (related links) We all know that stroke (commonly known as stroke) is associated with atherosclerosis. Stroke is divided into cerebral hemorrhage and cerebral ischemia. It is well established that 1/3 of cerebral ischemia is caused by intracranial artery stenosis, and another 1/3 is caused by carotid stenosis. The vast majority of patients with carotid and intracranial artery stenosis have no symptoms before the onset of the disease. They can only be detected by professional screening. Therefore, high-risk groups must be actively examined and screened early to avoid or reduce the tragic occurrence of disability and death from stroke. The so-called high-risk groups are those with risk factors such as hypertension, high cholesterol, hyperlipidemia, diabetes, obesity, advanced age, and atrial fibrillation. Vascular ultrasound is the first hurdle in standardized screening for stroke. A simple transcranial Doppler ultrasound (TCD) and carotid ultrasound can detect the degree of stenosis, find atherosclerotic plaques, assess the degree of stenosis and whether the plaques have ulcers, etc. Compared with angiography and MRI, it is inexpensive and has a high screening rate. It is important to note that both tests should be done for the first screening in high-risk groups to initially determine whether the lesion is intracranial or extracranial through combined screening. If the first test shows smooth arteries with no significant stenosis or plaque, a repeat vascular ultrasound can be done 1-2 years apart. If either ultrasound shows plaque or stenosis, it is important to follow the progression of the disease as recommended by the doctor and to review the carotid or cranial arteries regularly for symptomatic treatment.