Interview with Dr. Stoycheva for Stroke.bg
We are talking with Dr. Daniela Stoycheva, Head of the Neurology Department at Rahila Angelova Hospital - Pernik.
AIA: Dr. Stoycheva, could you introduce yourself to the Bulgarian patient community?
Dr. Stoycheva: Hello, I graduated from the Medical University of Sofia in 1991 and specialization in neurology in 1999. I have acquired additional certificates in highly specialized activities in electroencephalography, Doppler sonography, electromyography, acupuncture and laser therapy, and otoneurology. In addition to my clinical work, I actively participate in clinical trials in the field of peripheral and central nervous system disorders. Neurological Department at "R. Angelova" Hospital, Sofia. Pernik
AIA: Dr. Stoycheva, could you explain what a stroke is and what are the main causes that provoke it?
Dr. Stoycheva: Stroke is an acute cerebral circulation disorder that causes severe physical, cognitive and emotional damage. Within minutes, brain cells begin to die and damage can occur. Strokes are the second leading cause of death in the world and the main cause of disability. The main causes leading to stroke are: arterial hypertension, diabetes mellitus, lack of physical activity, stress, depression, anxiety, excessive alcohol use, smoking, and strokes in young people are observed with the use of drugs.
AIA: Temperatures outside are rising rapidly. How can summer, summer diet, and the activities we usually do this season increase the risk of stroke?
Dr. Stoycheva: In the summer, the vessels dilate, usually the blood pressure decreases, but sometimes the blood pressure rises, which leads to ischemic strokes or hemorrhages. Excessive alcohol consumption, exposure to heat, sudden changes in temperature (for example, the temperature of air conditioners should not be lower than 10 degrees from the outside temperature), jumping into pools with a sharp temperature difference, and dehydration lead to thickening of the blood and an increased risk of blood clots.
AIA: Can we recognize the onset of a stroke? What are the clearest signs of a stroke and how should we react to them?
Dr. Stoycheva: Sudden weakness of limbs, speech disorders, facial distortion, sudden loss of vision or hearing, severe headache that does not respond to anything. In the presence of these symptoms, help should be sought immediately.
AIA: The management of Rahila Angelova Hospital is constantly striving to improve the conditions in the medical institution and the treatment options. Could you share in this regard what access to modern stroke treatment is provided in the Pernik region and how it is implemented?
Dr. Stoycheva: The most modern treatment of ischemic stroke in the world is thrombolysis, which is already being applied in our hospital. The neurological department that I manage collaborates with an X-ray department with the possibility of timely diagnosis of diseases of the central nervous system, an anesthesia and intensive care unit, where severe cases are placed on intubation, a neurosurgery sector at the operating block, where cerebral hemorrhage surgeries are performed.
AIA: On 13.05.2024, you participated in a blitz conference "Stroke – A Look in the Black Box", organized by our association with the support of the Bulgarian Stroke Society. You greatly impressed the participants with the implementation of a joint project of the Rahila Angelova Hospital and the Sofia District Hospital "St. Anna". Could you tell us more about this project?
Dr. Stoycheva: Since 2022, the Neurology Department of Pernik has been participating in a telehealth platform from the world's leading healthcare company based on artificial intelligence. We are participating in a pilot project together with St. Anna Sofia Hospital. The implementation of this project is happening for the first time in Europe with us. Since the fall of 2022, artificial intelligence has processed over 2000 images. An alarm signal is immediately sent to the phones of fellow neurologists, neurosurgeons and radiologists and whether the particular patient has a hemorrhage, whether it is ischemia and the optimal treatment for the victim is assessed. In cases where thrombolysis is required – it is performed on the spot, and when it comes to thrombectomy, according to a pre-prepared protocol, the patient is transported to Sofia to St. Kliment Ohridski Hospital. Anna". There he was met by a team prepared and known for the case. Thus, in practice, at the moment, without having specialists to perform thrombectomies, we cover the needs of the area extremely successfully.
AIA: At the moment, what are the conditions in the department you manage? What do you need?
Dr. Stoycheva: We need a modern magnetic resonance imaging machine, as well as young nurses and doctors, for whom we provide an opportunity for specialization in the field of neurology.
AIA: You share the need for young specialists. In this regard, what opportunities for professional realization does the Rahila Angelova Hospital - Pernik offer?
Dr. Stoycheva: Our department is a base for specialization of doctors. We are the only neurological department in the region. I have already shared about our collaboration with St. Anna. The experience that a young doctor can gain here can be useful for his entire professional experience.
AIA: What are the most common myths and misunderstandings related to stroke that you encounter in your practice?
Dr. Stoycheva: Patients most often come late after the time when we can effectively treat. In the interval of up to 4.5 hours after the onset of the stroke, the most modern method can be carried out - thrombolysis. And patients wait for it to pass and come in a day or two, when the stroke has already developed. They should deny it, and when asked if they raise their blood pressure, they should answer positively. This means that patients do not consider arterial hypertension (high blood pressure) to be a disease, and it is the leading cause of stroke.
AIA: In your opinion, what is the importance of the patient organization in the fight against stroke in Bulgaria and what is the role of the family and the community in the process of recovery after a stroke?
Dr. Stoycheva: Stroke is no longer a disease of the elderly. In 2019, 63% of strokes were in people younger than 70 years of age. This should sharpen the attention of society to the problem. We need to start perceiving stroke as an immediate and real threat to ourselves and our loved ones. The Association for Stroke and Aphasia is making a lot of efforts in this direction. stroke. As far as I know, your patient organization is the only one in Europe that has created an INFOBOT for stroke. This is an extremely handy stroke guide, with the help of which you can first prevent a stroke by taking into account personal risk and learning about risk factors; Symptoms can be recognized, the right actions can be taken, but also support can be obtained after a stroke. The Association for Stroke and Aphasia is also actively working on the issues of ensuring quality life after a stroke. All this is a huge contribution!
AIA: Thank you for your kind words! In conclusion, what are the most important stroke prevention tips that you would share with our readers?
Dr. Stoycheva: Pay attention to high blood pressure. Today it can be easily controlled with medications that are financed entirely or in a high percentage by the Health Insurance Fund. Pay attention to your blood sugar by examining it periodically. If it rises, consult your GP. Diabetics are more at risk of stroke, so they need to be more vigilant and responsible for their health. Young people should not forget, that, among all other harms, systematic drug use can also lead to stroke.
Today, stroke is now curable. More than 80% of cases are ischemic strokes, which can be treated with thrombolysis until complete cure. The application of this treatment depends mainly on the patient getting within the fourth hour to the neurological clinic. Remember that if you get speech disorders, weakness of limbs, facial distortion, you should immediately go to the emergency room, because every minute is precious. Every moment after the accident, neurons die, resulting in serious damage.
stroke.bg
2024