Recently, the Stroke Center at Bach Mai Hospital has received many stroke patients who are very young (under 45 years old), accounting for 15% of the total number of patients being treated there.
The number of young people suffering strokes is increasing.
A 31-year-old male patient, TDQ, was admitted to the Stroke Center in a comatose state, intubated, and with persistently high blood pressure of 180/100 mmHg. His blood pressure did not decrease even with intravenous medication.
Based on the patient's medical history, since 2020, the patient has had a history of left hemisphere cerebral hemorrhage due to hypertension. After treatment, the patient was discharged home to take medication to treat hypertension.
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After a while, the patient noticed their blood pressure was normal and mistakenly thought the disease was cured, so they stopped taking their medication on their own. The patient has a history of using tobacco, beer, and alcohol.
Dr. Nguyen Tien Dung, Deputy Director of the Stroke Center, said that upon admission, the patient's blood pressure was continuously high. X-ray results showed that the patient was continuing to bleed from the opposite side of the brain, the right side, and this time the volume was larger and there was blood in the cerebral ventricles.
After consultation with specialists, it was determined that the patient was unlikely to undergo surgery due to bleeding in both sides of the brain and deep coma.
The patient was re-admitted to intensive medical care. The patient continued to have a high fever, impaired consciousness, was in a coma, could not be weaned off mechanical ventilation, and had a poor prognosis.
According to experts, brain hemorrhages are usually sudden and progress rapidly. Hypertension accounts for 80-85% of brain hemorrhage cases, while 15-20% are secondary to ruptured vascular malformations, brain tumors, vasculitis, etc.
Vietnam is among the countries with the highest rates of stroke. When a blood vessel becomes blocked or ruptures, the affected part of the brain is unable to function, leading to a stroke.
Stroke has two basic forms: ischemic stroke (accounting for 80%) and hemorrhagic stroke (accounting for 20%), with varying degrees of severity, from very mild (self-recovering, no sequelae) to very severe (life-threatening or immediate death).
Although cerebral hemorrhage occurs less frequently than cerebral infarction, the mortality rate is higher, and surviving patients suffer severe dementia and disability as a result.
Stroke incidence in young people (under 45 years old) accounts for approximately 10-15%, and in those under 50 years old it is 15-20% of all stroke cases. Globally , for every 100,000 people under 50 years old, 15 will experience at least one brain hemorrhage.
Everyone, including young people, should get screened for stroke because the rate of stroke among young people has been and is increasing.
Young people often underestimate the problem, rarely monitor their blood pressure, exercise infrequently, have unhealthy eating habits leading to overweight or obesity, and don't get regular health checkups. Only when they become ill or suffer a stroke and are hospitalized do they realize they have cardiovascular diseases, hypertension, etc.
If hypertension has been diagnosed, it is necessary to maintain regular, lifelong medication, strictly adhere to the doctor's treatment plan, and have regular check-ups to adjust medication and detect complications early.
Dangerous complications of shingles
Tam Anh General Hospital has successfully treated a female patient whose eyes were affected by shingles, and who had a history of chickenpox on top of diabetes for many years.
According to Dr. Nguyen Hoang Anh, Department of General Internal Medicine, Tam Anh General Hospital, Ho Chi Minh City, the patient had red, raised, blister-like lesions appearing on one side of the face, with a tendency to spread, coinciding with the anatomical location of the facial nerves.
The disease progressed very rapidly. Just two days prior, the patient experienced a gritty, itchy, stinging, and uncomfortable sensation inside the right eye, for no apparent reason. Subsequently, the eye became increasingly swollen, red, painful, and blurry, with excessive tearing. Simultaneously, blisters appeared and spread around the eye.
According to Dr. Hoang Anh, shingles attacking the eye and causing severe keratitis, as in the case of the patient above, is a serious matter.
The longer it is left untreated, the deeper the virus attacks the inner layers of the eye or spreads to other organs. The risk is even higher when combined with diabetes. There is a high risk of uncontrolled blood sugar, severe bacterial superinfection, facial nerve paralysis, and even myocardial infarction, stroke, and severe stress, all of which are extremely dangerous.
The patient was admitted for emergency treatment. A multidisciplinary consultation involving internal medicine, neurology, dermatology, ophthalmology, endocrinology, and diabetes was held, and the doctors prescribed medical treatment for the patient.
Treatment involves a combination of antiviral, antibiotic, anti-inflammatory, and pain-relieving medications, along with blood sugar control. Simultaneously, it's crucial to monitor for the risk of the Varicella Zoster virus continuing to spread and causing other complications of shingles.
After five days of intensive treatment, the patient's health gradually recovered, the inflammation and redness in the right eye decreased, vision gradually improved, and the skin lesions also subsided.
The patient did not develop any other complications due to shingles. All laboratory tests were within normal limits.
According to Dr. Hoang Anh, shingles and chickenpox are closely related, both caused by the Varicella Zoster virus.
Even after treatment for chickenpox, the virus can remain dormant in nerve ganglia for months or even years.
When favorable conditions arise, such as weakened immunity, stress, or physical exhaustion, the virus becomes active again (awakens), leaves its resting place, travels along the nerves to the skin, and causes shingles.
Individuals who have previously had chickenpox and experience symptoms suggestive of shingles, such as rash, pain, fever, fatigue, and insomnia, should seek prompt examination and treatment at a general internal medicine, neurology, or dermatology specialist.
Delaying treatment can lead to many dangerous complications, even death. Vaccination with Shingrix is an effective measure to prevent shingles and the dangerous complications caused by the Varicella Zoster virus.
Dangerous complications of diabetes
Diabetes is becoming an epidemic, posing a significant risk of stroke, heart attack, amputation, or kidney failure.
Mrs. NTS (70 years old, Thai Binh province ) had half of her left foot amputated and a stent placed in her left femoral artery due to complications from diabetes. Recently, she developed heel ulcers and lost sensation in both her hands and feet, prompting her to seek medical attention.
Upon admission to Bach Mai Hospital ( Hanoi ), doctors stated that Mrs. S. was experiencing numerous complications due to poor blood sugar control, non-adherence to dietary restrictions, and only taking medication when blood sugar levels rose. The patient required hospitalization for monitoring of blood sugar and disease complications.
Mr. NTV (71 years old, from Nam Dinh) was admitted to the hospital with blood sugar levels 3-4 times higher than normal.
This patient was diagnosed with diabetes but did not take their prescribed medication or attend regular check-ups. Upon admission, the patient was fatigued and experiencing shortness of breath.
The doctor diagnosed heart failure and kidney failure as complications from diabetes. Not only was the patient's blood sugar high, but their blood lipid levels were also abnormally high.
According to Dr. Nguyen Quang Bay, Head of the Department of Endocrinology and Diabetes at Bach Mai Hospital, late diagnosis and non-adherence to treatment lead to severe complications in patients, appearing earlier than usual.
Diabetes has many complications. High blood sugar permeates every blood vessel, leading to damage to both large and small blood vessels.
Microvascular complications include:
Retinopathy is the leading cause of blindness.
Damage to blood vessels in the glomeruli causes kidney failure and requires dialysis. In Vietnam, one-third of end-stage chronic kidney disease cases requiring dialysis are due to diabetes.
Damage to the nerves, and most frighteningly, the cause of foot ulcers leading to amputation…
Major vascular complications are the most dangerous because they cause the highest number of deaths.
Coronary artery complications can lead to myocardial infarction.
Carotid artery vascular complications can cause stroke.
Lower extremity vascular occlusion, foot ulcers, amputation.
It is estimated that, worldwide, one person has to have a leg amputated every 30 seconds due to complications from diabetes.
Dr. Bay recommends that people with diabetes should have regular check-ups with their doctor, at least every 6-12 months, to screen for all complications.
Elderly diabetic patients are vulnerable and need to be careful to avoid hypoglycemia, hypotension, and drug interactions due to taking multiple medications.
Even if it's not yet time for a check-up, if you notice any unusual symptoms such as blurred vision, swelling, chest pain, or numbness in your limbs, you should see a specialist immediately.
Elderly diabetic patients often have many other comorbidities such as hypertension, dyslipidemia, and obesity, and all of these factors need to be controlled.
Patients should regularly test their capillary blood glucose daily using a capillary blood glucose meter or continuous glucose monitoring (CGM) device, avoiding relying on their own feelings.
Never stop taking your medication when your blood sugar and blood pressure return to normal, because those results are due to the medication.
Adhere to a healthy diet and lifestyle, including exercise, and avoid overeating, overeating, undereating, or extreme dieting.
Source: https://baodautu.vn/tin-moi-y-te-ngay-712-gia-tang-so-nguoi-tre-mac-dot-quy-d231873.html
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