On 29th October every year we observe this day as public awareness day to focus on ways to prevent STROKE and provide updates on available current treatment.
Although the stroke, which is also known as Brain Attack ,is well known as PAKSHAGHAT or LAKAWA in our ancient texts, it’s real acceptance as a remarkable health issue by the world body came only as recently as in 2006 when ‘World Stroke Organization ‘pitched for genuine and focused attention by the WHO .
WHAT IS STROKE?
STROKE is loss of brain or central nervous system functions due to disruption in blood supply. It leads to weakness or loss of sensation in one half of the body and several other features with or without hemiplegia such as loss of speech or difficulty in articulation, blindness or several other losses of functions. Sometimes it is of very minor in dysfunction which quickly improves as in TIA, Transient Ischemic stroke.
This disruption could be due to blockade in the arterial blood flow due to atherosclerotic plaques or embolus arising from ailing heart or diseased great vessels and lodging into distal part of vessel inside brain .This is known as Ischaemic stroke. The other type is due or due to rupture of arteries resulting into Intra parenchymal haemorrhage or bleed or occasionally due to inherited or acquired aneurism rupture. Most intra cerebral bleed is due to poorly controlled high blood pressure due to breaking of very fine penetrating branches of arteries deep inside the brain parenchyma. Stroke due to bleed is more prevalent in our set up due to neglected blood pressure and can be easily prevented by controlling blood pressure .Venous system occasionally becomes a part of stroke in special circumstances such as following pregnancy.
HOW TO PREVENT STROKE?
One in four above the age of 25 will suffer from stroke in their lifetime if we live long enough .This is the third commonest cause of death and probably commonest cause of disability but fortunately 90% of total strokes are preventable.
Now that we know that it’s a vascular disease and therefore all precautions much like coronary artery disease are needed. we have to maintain a normal blood pressure even with the help of multiple drugs, normal blood sugar round the clock, correct lipid level, consumption of enough water, active weight control with exercise, diet containing adequate protein ,vitamins and minerals. Maintaining proper cholesterol ,cessation of smoking, minimising alcohol intake and to keep stress at minimum .Heart is only a specialised blood vessel and therefore should be examined and to be kept fit always, specially by looking for arrhythmia such as atrial fibrillation which is closely related to future stroke.
There has been an immense amount of clarity in approach to stroke management. Much like heart, timing is critical to its treatment and sooner we reach hospital with an updated understanding of the disease better is the outcome. Better imaging techniques and interventions with clot busters and fibre optic balloons to clear the clots are recent interventions in the field.
The Author is Currently Professor of medicine at Manipal Tata Medical College and Formerly Professor and Head, Department of Medicine at Rajendra Institute of Medical Sciences, Ranchi, Jharkhand.