Stroke

A stroke is the brain's equivalent of a heart attack. It happens when the blood flow to the brain is suddenly disrupted. There are two main ways this happens, either the blood flow is suddenly blocked , eg. by a blood clot, or by a sudden bleed in the brain. Either way, it is a medical emergency.

Sometimes, there are warning signs , where a person can have a very early stroke that is transient, and then recover. These are called transient ischaemic attacks ( or TIAs).

Many people fear they are having a stroke when they suddenly feel very giddy. There are many causes of giddiness. The form which causes the room to spin around, or make you feel unsteady, like you are on a boat, is called vertigo. Causes of vertigo can be central ( the brain) or peripheral ( the balance receptors in the ear). A sudden giddiness, loss of balance, or difficulty in coordination or walking can be a sign of a stroke. Other symptoms include sudden numbness or weakness over one side of the face, arms or legs ( usually only one-sided, because of the way the blood is supplied to the brain), difficulty seeing in one or both eyes, sudden confusion, problems in speaking or understanding speech, and a very bad headache with no known previous cause. If you or someone you know suddenly experiences these symptoms, it is best to seek medical advice quickly as stroke is an emergency.

What does a stroke do to you ?

Stroke damages the brain, affecting the entire body . The resulting disabilities can range from mild to severe . These include paralysis, problems with thinking, problems with speaking, and emotional problems.

Can anything be done ?

Yes ! Most definitely. New treatments are available that greatly reduce the damage caused by a stroke. But you need to arrive at the hospital within 60 minutes after symptoms start to prevent disability.

Can we do anything to prevent a stroke ?

There are certainly ways to reduce one's risk of having a stroke. The conditions that increase one's risk include : having high blood pressure, smoking, diabetes and being overweight. So if you have high blood pressure, take your medication regularly. If you don't, get checked for it regularly. Often, high blood pressure does not cause any symptoms and people tend to forget to take their medication, or give reasons for why their pressure is high that day eg. lack of sleep, stress etc. Whatever the reason, high blood pressure increases the risk of stroke. Don't smoke. I can't think of any real health benefits to smoking. But the bad effects are well-known. So stop ! People don't realise they have diabetes either as they seldom feel it. Get checked for it, and take the medication regularly. Maintain a sensible lifestyle of eating in moderate amounts and exercising regularly.

How is it treated ?

In the initial stages, drugs that break down the blood clot can be used. If it is done in time, the blood flow can be restored to the affected part of the brain. It can only be done if the stroke is due to a block, not if it was caused by a bleed. The doctor needs to be certain before treatment is initiated. A CT scan of the brain may be done.

Treatment after the initial stage is directed at preventing further strokes, and rehabilitation. Treatment can include drugs to control blood pressure and diabetes, and drugs to keep the blood from clotting. In some cases, an irregular heart beat can cause blood clots to go to the brain. For these cases, treatment of the heart rhythm and drugs to keep the blood "thin" ( less likely to clot) are needed. Surgery is sometimes used if there are plaques in the carotid arteries ( the large arteries that go from the heart to the brain, they are found in your neck) to remove the plaques.

Finally, rehabilitation is extremely important for a stroke patient. The intensity depends on how severe the stroke was. Patients who have had strokes are prone to depression, especially if they have been left significantly disabled as a result. Physiotherapists work with patients to help them sit up and walk . Occupational therapists help patients to cope with activities of daily living, which they may have trouble with after a stroke. For example, what used to be taken for granted like feeding or bathing themselves may now be affected. Modifications may need to be done to the home environment to make it easier and safer. Speech therapists may need to be involved as well if the patient has difficulty in swallowing or speaking. It is a long road and patients and their families need a lot of support.

In summary, it is important to be able to recognise the signs and symptoms of a stroke as early medical treatment can make a big difference. Prevention is better than cure. And once a stroke has occured, it is important to prevent recurrent strokes. Rehabilitation is extremely important in contributing towards the recovery of a patient after a stroke.