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Thursday, December 3, 2009

Stroke Sense

Posted: Wednesday, Dec 02, 2009 at 1956 hrs

Dr Monica Saini
What is Stroke and when does it occur?
Stroke is a life-threatening neurological disease which damages the brain and retards the ability to walk, talk, see, think, imagine and feel. Also called ‘Brain Attack,’ stroke occurs when a blood vessel carrying oxygen and nutrients to the brain is blocked by a clot or bursts, depriving the brain of oxygen and causing the nerve cells to die. This is a disaster for the body because dead brain cells cannot be replaced. As the brain controls the rest of the body, the death of certain brain cells often means a loss of functioning elsewhere.

What is the incidence of stroke?
India’s annual rate of brain stroke incidence is 220 per lakh population. Due to lack of awareness, only about 10 per cent return to their original active state, while approximately one-third are left with significant disability requiring prolonged and expensive care, dependence and vocational impairment.

What are the causes of stroke?
There are two main types of stroke. The first is called an Ischemic Stroke. It is caused by a blood clot that blocks a blood vessel supplying oxygen to the brain. In India, 80 per cent of the strokes are of this kind. The second type is known as hemorrhagic stroke and is caused by a blood vessel in the brain that breaks and bleeds.

What are the symptoms of stroke?
Symptoms of stroke range from numbness of face, weakness of arm or leg, blurred vision, slurred speech, dizziness, and staggering gait to sudden and severe headache. Stroke usually goes undetected because people lack awareness about its symptoms and often confuse stroke with heart attack.

What are the risk factors for stroke?
Stroke can affect anyone at any age! But the risk of stroke goes up with age, with two-thirds of all strokes occurring in individuals 65 years or older. Twenty-eight per cent of strokes occur in people under the age of 65.

People with high BP, high cholesterol, heart disease, diabetes, obesity, smoking and drinking habits are highly vulnerable to stroke. In addition, certain blood disorders, stressful life, sedentary lifestyle, family history of stroke and previous heart attack also act as predisposing factors. Also, people who have suffered from a “mini stroke” or a Transient Ischemic Attack (TIA) are at a high risk of suffering from another stroke. Up to 10 per cent of patients with mini stroke suffer from a stroke within the next few days.

How can stroke be prevented?
Almost four out of every five strokes are preventable. Controlling the risk factors for stroke and appropriate medical treatment can help in lowering the risk of stroke. Early treatment, within minutes of a mini stroke cuts down the risk by 80 per cent. Early diagnosis of stroke and its causes can help to administer appropriate treatment, and minimize disability like paralysis, memory loss, impaired judgment and speech etc. Moreover, ascertaining the exact causes can help to prevent the onset of another stroke.

Can stroke be treated?
Today, much can be done to treat stroke and rehabilitate those who suffer from its devastating consequences. Proper treatment and care can greatly improve chances of recovery and minimize the long-term disabling effects of stroke. Early treatment, within four-and-a-half hours of onset, using a clot-busting drug minimizes the extent of damage. Rehabilitative services minimize disability after stroke and improve quality of life. Patients who are immediately removed to a stroke unit have much better chances of survival than those who don’t, with mortality rate being 8 percent only compared to 40 percent otherwise.

Control your blood pressure: The risk of a stroke increases in proportion to the degree by which the blood pressure is elevated.

Quit smoking: Chances of suffering from a stroke can be greatly reduced by giving up smoking.

Reduce alcohol consumption: Alcohol raises blood pressure and increases stroke risk. Therefore drink moderately.

Control your sugar level: Diabetes causes the small vessels to close prematurely. When these blood vessels close in the brain, small strokes may occur. Good control of blood sugar is important in decreasing the risk of stroke .

Check your weight and cholesterol: Lose excess weight and control your cholesterol. A healthy diet can help in controlling weight, cholesterol, sugar level and blood pressure.

Do not ignore a mini stroke: Mini stroke should be taken seriously. Early assessment and treatment can lower your risk of stroke by 80 per cent.

Get treated for heart diseases: Leaving cardiac diseases untreated can increase chances of stroke.

Minimize stress: Minimize the stress in your life. Smile!

(Dr. Monica Saini heads the Stroke Clinic at Alchemist Hospital, Panchkula. She is one of the very few stroke specialists in the country.)
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