People should be aware of common symptoms of brain stroke so that they can reach hospital during the golden window period to minimise the damage. Dr Madhukar Bhardwaj, senior consultant and HOD, neurology, Aakash Healthcare, New Delhi, tells Kavita Bajeli-Datt that people must make lifestyle changes to significantly lower the risk of stroke, which saw a surge due to Covid-19.
How common is stroke in India?
Acute stroke is a prevalent cause of morbidity and mortality globally. The incidence of acute stroke is annually reported to be around 15 million people, and about five million people die because of acute stroke. In stroke, a part of the blood vessel which gives blood to the brain gets blocked due to a clot, which usually forms since the blood is thick because of specific hypercoagulable causes, which is due to diabetes, hypertension, smoking and hereditary risk factors. Quick treatment is required, otherwise, the brain will suffer irreversible damage. The golden window period is 4.5 hours, during which we can remove the clot mechanically, or we can dilute it with a blood thinner. Most of the people in India are not able to arrive on time because of lack of knowledge. Covid-19 further worsened the situation since it causes hypercoagulability. Covid acted as a risk factor as people were following a sedentary lifestyle while working from home. And those who had diabetes found themselves doubly impacted.
What are the critical risk factors for strokes, and how can individuals assess their risk?
The key risk factors for strokes include having a diet that is high in cholesterol, trans fats and saturated fats, along with increased intake of sodium. Additionally, inadequate physical activity contributes to various health issues like obesity, high blood pressure, high cholesterol and diabetes, all of which elevate the risk of stroke. Moreover, high alcohol consumption raises blood pressure and triglyceride levels, posing a heightened risk of stroke. Tobacco use is also strongly linked to stroke risk, as smoking can harm the heart and blood vessels. At the same time, exposure to second hand smoke increases the likelihood of a stroke. Other factors include genetics, age, race and sex. Also, note that women are more prone to stroke than men.
What are the common symptoms?
Symptoms of a stroke include difficulty speaking or understanding speech, indicated by confusion, slurred speech or inability to comprehend language. Numbness, weakness or paralysis may occur in the face, arm or leg, typically affecting just one side of the body. To assess for stroke, one can raise both arms overhead - if one arm drifts downward, it could signify a stroke. Additionally, facial drooping on one side may be observed when attempting to smile. Vision problems, such as blurred or blackened vision in one or both eyes or double vision, may also occur suddenly. A sudden, severe headache may indicate a stroke, often accompanied by vomiting, dizziness and changes in consciousness. Difficulty in walking, including stumbling, loss of balance, or coordination, can also be a stroke symptom.
Are there lifestyle changes that can significantly reduce risk of stroke?
Lifestyle changes that can significantly lower the risk of stroke include eating a healthy diet rich in fruits and vegetables while avoiding foods high in saturated fats and salt. Regular exercise is also crucial. It’s essential to limit alcohol intake and quit smoking. Additionally, managing conditions like high cholesterol, high blood pressure, diabetes, and heart disease with medication and lifestyle adjustments is vital.
What role do genetics and family history play in stroke risk?
Genetic factors are believed to contribute to conditions like high blood pressure and stroke. Certain genetic disorders, like sickle cell disease, can directly increase the risk of stroke. Individuals with a family history of stroke often share common environments and other potential risk factors, further heightening their susceptibility. When genetic predisposition is combined with unhealthy lifestyle choices such as smoking and poor dietary habits, the likelihood of experiencing a stroke is even greater.
How do regular check-ups and screenings contribute to prevention?
Working closely with healthcare professionals to follow treatment plans and address any concerns is the key. For those who have already had a stroke or TIA (transient ischemic attack), continuing these preventive measures is crucial to reduce the risk of another stroke. Following prescribed medication and lifestyle changes is essential for preventing strokes.
What are the new treatments available for stroke?
Depending on the kind of stroke and the patient’s timing of therapy, different drugs and therapies are employed. Thrombectomy, a minimally invasive procedure to remove blood clots from blocked brain arteries, is one of the most significant advancements in stroke treatment. This technique, particularly effective for large vessel occlusions, has transformed acute ischemic stroke management, significantly improving outcomes. Additionally, clot-busting medications like tissue plasminogen activators (tPA) continue to play a crucial role.