Brain Stroke – When the Brain suffers an Attack

Stroke, (paralysis) or a brain attack is a disabling brain disorder that affects more than 20 million people across the world and causes nearly 5 million deaths per year. Stroke   is caused when there is a block in the blood flow within the blood tubes, (ischemic stroke which amounts to nearly 80% of strokes) or when there is damage to the tubes carrying blood within the brain (haemorrhagic stroke). Stroke incidence is increasing in the third world regions, due to the increase in the incidence of diabetes, hypertension, brain infection and road traffic accidents and has become the third leading cause of death globally. Depending on the area of the brain that has suffered the attack, stroke can result in mild symptoms such as numbness or could lead to coma or eventually death. Management and rehabilitation of stroke patients has seen lots of improvement in the past one to two decades, and at present most strokes can be efficiently treated and prevented to a great extent. However, it is important for patients to receive medical attention within the Golden Hour after they develop symptoms of stroke if they have to be benefitted.

The Golden Hour

Stroke can often be a silent or a painless disease which occurs suddenly. It is important to recognize the symptoms of brain stroke at the earliest by patients and their relatives, to get the effective treatment in a specific time which in a significant number of people can be of great help in survival and preventing long term disability. Acute stroke if treated within a time period of 4.5 hours by clot buster injection which opens up the blocked blood tubes, and by removing the blood clot if they reach within 12 -18 hours, can significantly help in improving from this devastating problem. However, most of the public are not aware of the early symptoms of stroke and the available modalities of treatment. These 4.5 hours are referred to as ‘The Golden Hour’ in stroke treatment. Patients who get this treatment at the earliest after the stroke symptoms develops, will get the maximum benefit. In case the patient goes without treatment beyond the golden hours, it increases the risk of irreversible damage to the brain. These injections cannot be given to patients who develop stroke due to bleeding in the brain, which are treated by other modalities.

Common Symptoms of Stroke:

• Speech difficulties
• Sudden and acute headache
• Confusion
• Vision loss
• Inability to balance
• Change in the state of consciousness
• Weakness of one part of the body

Risk Factors for Stroke

Certain associated illnesses can make a person to be at a higher risk of having stroke. For example, people with long term high blood pressure, heart disease, diabetes, obesity, high cholesterol, tobacco smokers, excessive alcohol consumers are at an increased risk of getting a stroke attack. All of these are preventable to a greater extent. Other non-modifiable risk factors for stroke are genetic factors, age and gender (stroke may affect females slightly more due to hormonal differences). The risk of developing a stroke increases as a person gets older and most of the time it occurs to individuals beyond the age of 55-60 years, however this trend is slowly changing due to the increase in unhealthy lifestyle habits and around 25% of all brain strokes are seen in to people under the age of 40years.Among the risk factors, high blood pressure tops the list and even small reduction in blood pressure can significantly reduce the incidence of stroke.

Managing the above risk factors effectively can prevent brain stroke in nearly 75-80% of people, hence it is important for all the healthcare personals, NGOs, media and Govt. bodies to plan various programs to create awareness about the risk factors of stroke and manage them effectively.

Given the current stroke burden, there is therefore a need for better equipped hospitals with exclusive stroke care units and separate rehabilitation centers to cater to such patients. Long term recovery from stroke requires medications and specialized rehabilitation facilities, which may be available only in major healthcare facilities.

Dr. Sreekanta Swamy, Lead Senior Consultant – Neurology, Aster RV Hospital