Would you know if you just suffered a heart attack? Would you know what to do if it struck you? To think you don’t need to be prepared is being foolhardy. Globally, cerebrovascular disease (stroke) is the second leading cause of death. It is a disease that predominantly occurs in mid-age and older adults.
The World Health Organisation (WHO) estimated that in 2005, stroke accounted for 5.7 million deaths worldwide, equivalent to 9.9 per cent of all deaths. Over 85 per cent of these deaths will have occurred in people living in low and middle income countries and one third will be in people aged less than 70 years.
But more recently in a study by Global and Regional Burden (1990-2010 study) of Stroke, revealed more than 83,000 people below 20 years are affected by stroke each year globally.
Stroke - a condition traditionally associated with old age - is increasingly affecting young and middle aged people.
Knowing a stroke
A stroke is caused by the interruption of the blood supply to the brain, usually because a blood vessel has burst or has been blocked by a clot. This cuts off the supply of oxygen and nutrients to the brain, causing damage to the brain tissue. The WHO clinically defines stroke as ‘the rapid development of clinical signs and symptoms of a focal neurological disturbance lasting more than 24 hours or leading to death with no apparent cause other than vascular origin’. Stroke is a clinical syndrome divided into two broad categories that define its pathophysiology:
Ischemic stroke accounts for about three-quarters of all strokes and occurs when a blood clot, or thrombus, forms that blocks blood flow to part of the brain. If a blood clot forms somewhere in the body and breaks off to become free-floating, it is called an embolus. This wandering clot may be carried through the bloodstream to the brain where it can cause ischemic stroke.
A hemorrhagic stroke occurs when a blood vessel on the brain’s surface ruptures and fills the space between the brain and skull with blood (subarachnoid hemorrhage) or when a defective artery in the brain bursts and fills the surrounding tissue with blood (cerebral hemorrhage).
The outcome after a stroke depends on where the stroke occurs and how much of the brain is affected.
Speaking to City Express, neurologist Dr S Raghavendra, said, “Stroke prevention is the key factor. Only few patients reach a centre with facilities for dissolving the clot within the window period of three hours. More over only 50 per cent of thrombolysed patients get the benefit of fatal hemorrhage. Identifying of risk factor and correcting them with appropriate measures therefore assures a major role in stroke prevention.”
To spot and treat
With the age stroke patients reducing in India, prevention detection of symptoms and effective treatment of stroke has become imperative and can be a life-saver.
Symptoms:
Trouble with walking: One may stumble or experience sudden dizziness, loss of balance or loss of coordination.
Trouble with speaking and understanding: One may experience confusion or have difficulty understanding speech.
Paralysis or numbness of the face, arm or leg: One may develop sudden numbness, weakness or paralysis in the face, arm or leg, especially on one side of the body. Try to raise both arms over the head at the same time. If one arm begins to fall, one may be having a stroke. Similarly, one side of the mouth may droop when one tries to smile.
Trouble with seeing in one or both eyes: One may suddenly have blurred or blackened vision in one or both the eyes, and one may see double.
Headache: A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate you’re having a stroke.
If one experiences any of the symptoms it is critical that one seeks immediate medical attention and emergency treatment.
Lowering risk
Avoidable lifestyle-based factors are responsible for the increased risk of a stroke. These may include:
High blood pressure: High blood pressure (hypertension) is the most important known risk factor for stroke. High blood pressure can cause damage to blood vessel walls, which may eventually lead to a stroke.
Cigarette smoking or exposure to second-hand smoke: Smoking can increase your risk of stroke or further stroke by increasing blood pressure and reducing oxygen in the blood.
High cholesterol: High cholesterol (hyperlipidemia /dyslipidemia) - contributes to blood vessel disease, which often leads to stroke.
Being overweight or obese- Being overweight or obese can increase the risk of stroke. Too much body fat can contribute to high blood pressure, high cholesterol and can lead to heart disease and Type 2 diabetes.
Poor diet and lack of exercise: Being inactive, overweight or both can increase your risk of high blood pressure, high blood cholesterol, diabetes, heart disease and stroke. A balanced diet that includes eating fresh foods where ever possible is recommended. It is also important to maintain a balance between exercise and food intake; this helps to maintain a healthy body weight.
Heavy or binge drinking: Drinking large amounts of alcohol increases your risk of stroke.
Use of illicit drugs such as cocaine and methamphetamines.