A stroke, commonly called paralysis or brain attack, occurs when blood circulation to the brain fails.
Though strokes were first recognised 2,400 years ago by Hippocrates, the father of medicine, advances in treatment were made only in last few decades. Around 17 million people experience stroke each year. Six millions of these strokes are fatal. Every six seconds, someone dies of stroke. Stroke is the second commonest cause of mortality after coronary heart disease and is responsible for more deaths annually than those attributed to AIDS, tuberculosis and malaria combined.
There are two broad categories of stroke. Ischemic stroke occurs when arteries are blocked by blood clots or fatty deposits. About 85 per cent of all strokes are ischemic. Haemorrhagic strokes occur, when the blood vessel in the brain ruptures leaking blood in to the brain matter. Haemorrhagic strokes account for approximately 15 per cent of all the strokes.
Everyone has some stroke risks. Some risk factors are beyond our control, such as old age, family history of strokes etc. Medical risk factors for stroke risk are high blood pressure, diabetes, high cholesterol, heart disease and carotid artery disease. These can be controlled and managed with appropriate medical treatment.
life style risk factors include smoking, being overweight and drinking too much alcohol. Women are more at risk for stroke than men because of additional risk factors like use of birth control pills, hormone replacement therapy, pregnancy related hypertension and diabetes. One in five women will have stroke in her life time as compared to one in six men. A majority of the strokes can be prevented by adopting a healthy life style and management of the risk factors.
After stroke, eight out of ten people develop paralysis of the body, opposite to side of brain damaged. There are other symptoms to look for such as drooping of face to one side, slurred or confused speech, sudden visual disturbance, giddiness, imbalance or sudden severe headache.
Sometime a TIA (Transient Ischemic Attack) is a warning of stroke that produces transient stroke like symptoms usually lasting for less than five minutes. One in ten such patients will develop stroke in next three months, if not identified or treated.
From the moment, a person starts experiencing stroke symptoms, the clock start tickling. Sooner a stroke victim gets to the hospital, the better is his treatment as he or she gets life saving treatment. A CT scan or MRI of the brain will help to identify whether it is ischaemic or haemorrhagic stroke. If the person has ishaemic stroke, a clot busting drugs, called tissue plasimonogen activator (TPA) will improve the chance of recovery, but only if the patient reaches the hospital within first 4.5 hours.
Two million brain cells die each minute during stroke, increasing the risk of permanent brain damage, disability or death. Hence, with regard to stroke treatment, it is said that ‘time is brain.’ Unfortunately awareness regarding this is lacking in general population and many patients end up going to quacks for treatment out of ignorance, losing the crucial window of opportunity in stroke treatment.
After a disabling stroke, easing back to life requires positive attitude to overcome difficulties. A physiotherapist can help to restore the strength and reduce stiffness of muscles. Regular follow up with the physician or neurologist, taking medicines as prescribed is important to improve the outcome and prevent the recurrence of stroke.
Many myths surround the stroke. Many believe stroke cannot be prevented and there is no treatment is available. In fact 80 per cent of strokes can be prevented and treatment is available if the patient reaches the hospital on time.
Tips
1. How to prevent strokeIJ
Adopt a healthy life style: Healthy diet and regular exercises, weight control, no smoking, moderate alcohol consumption, stress reduction and regular health checkup
2. How to recognize strokeIJ
Face drooping, arm weakness, and speech disturbances, time to seek emergency help (Mnemonic FAST)
3. Is treatment available for strokeIJ
Yes, a clot bursting drug can be given if patient reaches the hospital within first 4.5 hours of onset of stroke, which improves chances of recovery.
(Dr Subhransu Sekahr Jena, MD, DM, DNB, MNAMS is a consultant in Neurology, Care Hospital, Bhubaneswar)