By
Dr Amith Kumar S, MD (General Medicine), DM(Neurology), Consultant Neurologist, Lourdes Hospital, Kochi
What is a stroke?
External features resulting from disruption of blood supply to a region of brain is called stroke.The two forms of stroke are ischemic – blockage of a blood vessel supplying the brain, and hemorrhagic – bleeding into or around the brain. In an ischemic stroke, a blood clot blocks or plugs a blood vessel or artery in the brain. About 80 percent of all strokes are ischemic. In a hemorrhagic stroke, a blood vessel in the brain breaks and bleeds into the brain. About 20 percent of strokes are hemorrhagic.
What happens when you have a stroke?
When a stroke occurs, the blood supply to part of the brain is suddenly interrupted. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain.
What are the symptoms of stroke?
Symptoms include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble with walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause.
An easy was to remember the symptoms is BE FAST
Balance loss
Eyes – vision loss
Facial Droop
Arm Weakness
Speech
Time
What should I do if I think someone is having a stroke?
During a stroke, bystanders should know the signs and act in time. If you believe someone is having a stroke — if the person loses the ability to speak, to move an arm or leg on one side, or experiences facial paralysis on one side — call stroke services of the nearest stroke ready centre. Stroke is a medical emergency. Immediate stroke treatment may save someone’s life and enhance his or her chances for successful rehabilitation and recovery.
Why is it important to get to the hospital as quickly as possible?
We believe that “Time is brain”. Ischemic strokes, the most common strokes, can be treated with a drug called tPA, which dissolves artery-obstructing clots. The window of opportunity (4 hours 30 mins) to use tPA to treat stroke patients is small, so the sooner stroke patients can get to the hospital to be evaluated and receive treatment, the better their outcome. Stroke patients who receive tPA for their stroke symptoms are at least 30 percent more likely to recover from their stroke with less disability after three months than those who present to the hospital after three hours and are thus unable to receive tPA.
What are risk factors for stroke?
There are things you can do to lower your risk of stroke. High blood pressure increases your risk of stroke four to six times. Heart disease, especially a condition known as atrial fibrillation, can double your risk of stroke. Your risk also increases if you smoke, have diabetes, sickle cell disease, high cholesterol, or a family history of stroke.
What is the treatment for stroke?
Generally, there are three treatment stages for stroke:
Primary prevention,
Acute stroke therapy,
Post-stroke rehabilitation.
Therapies to prevent a first or recurrent stroke are based on treating an individual’s underlying risk factors for stroke such as high blood pressure, cardiac diseases, and diabetes. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Medication or drug therapy is the most common
treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet drugs and anticoagulants or “blood thinners”) and thrombolytics.
What is the prognosis for stroke?
Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one- sided weakness or hemiparesis. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or forming speech. A stroke can lead to emotional problems; patients may have difficulty controlling their emotions or may express inappropriate emotions, and many stroke patients experience depression. Stroke
survivors may also have numbness or abnormal sensations, including pain which is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures. Recurrent stroke is frequent; about 25% of people who recover from their first stroke will have another stroke within five years, if appropriate treatment is not continued. With targeted multipronged post stroke rehabilitation, the majority of stroke survivors reach their pre-disease functional status.
What can be done to reduce the risk of stroke?
Stroke is a leading cause of serious, long-term adult disability. Millions ofglobal citizens are living with the effects of stroke. The length of time to recover from a stroke depends on its severity. Fifty to 70 percent of stroke survivors regain functional independence, but 15 to 30 percent are permanently disabled.
To reduce your risk of stroke, monitor your blood pressure, track your cholesterol level, stop smoking, exercise regularly, and find out if you should be taking a drug to reduce blood clotting.
