Advances in technology are crucial for the development and modernization of health care treatments around the globe. Such fact can be verified, once again, through a
, increasing the chances of therapy success: telemedicine. The technique provides for the use of modern communication equipment for the dissemination of information and the provision of medical care to patients by health professionals, even if they are not physically close.
Regarding strokes, as previously mentioned, the relevance of the method is due to the possibility of a rapid diagnosis. This is because the main form of acute treatment of the disease, RTPa thrombolysis, is indicated up to 4.5 hours after the first symptoms. After such period, the risk of cerebral hemorrhage becomes greater than the benefit of the medication. Thus, the support of experienced professionals is fundamental in the evaluation of risk-benefit for an individualized treatment, aiming to achieve the best benefit under low risk of complications.
Therefore, if a stroke patient is admitted to a hospital lacking specialists, the new communication technologies will allow a neurologist to evaluate the situation and provide more accurate diagnosis and complete protocols for thrombolysis. Such specialist support, applied in a general medical environment, will certainly optimize the treatment.
Brazil still faces challenges to implement the method, as it is difficult to recognize it as a useful institutional tool for solving a serious public health problem. "One of the great difficulties is finding incentive and budgetary support from hospital institutions and sponsors, be them private or public", explains Daniel Paes, neurologist.
The use of Doppler
As it is known, one of the great allies in the diagnosis and, consequently, in the treatment of stroke, whose indication can be defined remotely at institutions using telemedice, is the Transcranial Doppler, an ultrasound examination that measures the blood velocity in the main arteries of the brain (and, therefore, is able to detect the risk of the disease). According to Paes, "Doppler can provide immediate assistance in the etiological investigation of the cause of stroke, contributing to the monitoring of the treatment and prognostic evaluation, such as risk of cerebral collapse, or early recurrence through monitoring of embolic signs".
Stroke incidence in Brazil
Stroke is the third global leading cause of death and the first cause of disability. Each year, 17 million people have a stroke in the world. Out of these, 6.5 million die, being 100,000 in Brazil, according to data from the World Health Organization (WHO).
With the progressive outlook of population aging, the trend is for strokes to increase. The disease is most common in people over 60 and the risk continues to increase with age, as the arteries harden and are blocked by the accumulation of cholesterol and other debris (atherosclerosis) formed over the years.
The probability of stroke is greater in people in one or more risk groups: elderly, previous history of stroke, hypertensive, cardiac, diabetic, smokers, alcoholics, obese, sedentary, among others.