By Askar Mohammad
June is Stroke awareness month, so now is a good opportunity to remind and educate ourselves about this disease. In this article I will briefly discuss strokes, their prevention, the symptoms and what course of action is recommended in case someone suffers from one.
What does it mean to have a stroke?
Strokes (Lakwa in Urdu) are also referred to as a ‘brain attack’ because of their similarity to heart attacks. It is like having a heart attack in the brain. It means that the blood supply to the brain is disrupted which leads to brain dysfunction. There are two major types of strokes; A) An Embolic or ischemic stroke: this happens when a small blood clot that may be formed some where else becomes lodged in small blood vessels that supply blood to the brain or by plaque formation in it that decreases the size or caliber of the blood vessel. B) A Hemorrhagic Stroke: this occurs when blood vessels, that are supplying blood to the brain, are ruptured. As can be seen, in both the cases the blood supply to the brain or a part of the brain is affected. This affectation leads to brain dysfunction and depending on the region of the brain that is affected, patients suffer the / outcome.
In North America, strokes are the third largest killer after cancer and cardiovascular disease. In the past 3 decades there has been a steady decline in stroke cases because of the advent of better treatment, however, this decline has now hit a plateau and there are 700,000 new cases in the US every year. In India, according to a World Health Organization report published in 1990, 73 stroke related deaths are reported per 100, 000 adults. However, because of the limitation in diagnoses and treatment in developing countries, this data may have been underestimated. Sadly, there are indications that incidence of having a stroke may start to rise in coming years due to the aging of our population and unhealthy lifestyles. The good news is that there are better chances of survival more now than ever before, but timely action is required.
What are the risk factors that can cause a stroke?
The risk factors for a stroke and a heart attack are similar. Here I will try to list a few. However, one should keep in mind that these are merely risk factors and will not necessarily lead to a stroke.
Risk factors that can be controlled:
1. Hypertension
2. High blood cholesterol
3. Heart disease
4. Diabetes
5. Being overweight
6. Excessive alcohol consumption
7. Physical inactivity
8. Smoking
9. Stress
Risk factors that cannot be controlled:
1. Age
2. Gender: Males over the age of 55 and post menopausal women
3. Family History: If a blood relative has suffered a stroke
4. Ethnicity: Native Americans and South Asians (like us) are at higher risk due to more incidences of diabetes and hypertension in these races.
5. Prior history: Which means if one has had a transient ischemic attack (TIA) or mini stroke in the past, that person is at a high risk of having another one.
As mentioned before there are some risk factors that we can control. Taking control of these will not only benefit us in lowering the risk of having a stroke but by also lowering the incidence of a number of other diseases that can occur based on our lifestyle. There are also certain risk factors that we can do nothing about but of which we should be aware of.
What are the Symptoms of a stroke?
The symptoms may be encountered in an otherwise healthy person and can be deemed normal upsets. However, if a combination of these five symptoms is experienced, then there is due cause to be alarmed.
1. Weakness
2. Trouble speaking
3. Vision problems
4. Headaches
5. Dizziness
Some times these symptoms are only experienced on one side of the body.
What’s the course of action to take when someone suffers Stroke?
Call emergency services IMMEDIATELY.
TIME is of paramount importance if someone suffers a stroke. The longer we take to bring the patient into the care of professionals, the worse the impact on the patient’s life later will be.
What are the treatment options for a person who has suffered a stroke?
Treatment depends on the type of stroke. This is determined using different tests like a CT scan, MRI, angiogram etc.
1. Clot busters: A drug called tissue plasminogen activator (tPA) can be administered to a patient who is suffering from an embolic/ischemic stroke. However, according to medical guidelines, this drug can only be administered within 2 hrs of the onset of symptoms. Needless to say, again, TIME is of great importance.
2. Surgery: Some times surgery is required to limit the damage to the brain or, if lucky, to even prevent a stroke. Some surgeries are performed to repair damaged blood vessels after a hemorrhagic stroke.
The recovery of Stroke Patients
There have been several cases where patients have fully recovered after suffering a stroke. However, realistically speaking, there is a significant change in lifestyle in the case of a majority of patients. Patients who recover from stroke may have a varying degree of lifestyle change depending on how much of the brain was affected by the stroke. There are rehabilitation services available in hospitals that can help patients improve the quality of their life while recovering.
What does the future hold?
Research that has been done in the field of strokes is quite advanced. There are a number of devices that are under clinical study to help in having a better and faster for stroke patients. A number of drugs are also being studied currently that can benefit patients in coming years. Another interesting field is stem cell research. Stem cells are special types of cells that are referred to as ‘naïve’ cells. It means that these cells are like babies who can be trained to do certain specialized functions when they mature. Therefore, if we train or program these cells so that they can repair blood vessels that are damaged by strokes then the recovery will be quicker and with even less side effects. However, a lot of research is required before we can reach the stage where stem cells can be used as a treatment option.
Conclusions:
In conclusion, we should be aware of the risk factors for strokes and its symptoms. This will help us make quick decisions at the time of need. The importance of time can never be over-emphasized in the event of stroke. The chances of survival of stroke patients are good, though we should be realistic about the extent of recovery. When around stroke survivors, we should be aware of their limitations and appreciate their will power and struggle.
Note: You can visit websites of organizations like American Stroke Association (ASA), Heart and Stroke Foundation of Canada (HSF) or WebMD for detailed information on strokes. Some of the information quoted in this article was from HSF Canada website.
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The author is a Research Scientist with the Stroke Research Program at the University of Alberta, Edmonton, Canada.