A stroke strikes an individual every 40 seconds globally, positioning it among the top causes of mortality and disability. As we observe World Stroke Day 2024, it’s time to raise our voices, spread awareness, and empower ourselves with knowledge. With the theme #GreaterThanStroke, this year’s campaign challenges us to take action—because understanding strokes, recognizing the warning signs, and adopting healthier lifestyles can make all the difference.
There are two primary types of strokes:
Ischemic Stroke: This type is the most frequent, making up approximately 87% of all strokes. It happens when a blood vessel that supplies blood to the brain gets blocked. The two main categories are:
1. Thrombotic Stroke: This type results from a blood clot developing within a brain artery, typically as a consequence of atherosclerosis.
2. Embolic Stroke: This occurs when a blood clot or debris dislodges from another part of the body, usually the heart, and obstructs a blood vessel in the brain.
Hemorrhagic Stroke: This type occurs when a blood vessel in the brain breaks, leading to bleeding in or around the brain. This bleeding can create pressure on brain tissue and is often linked to high blood pressure.
The FAST method serves as a valuable acronym for identifying the essential symptoms of a stroke:
☆ Face Drooping: Look for any drooping or numbness on one side of the face. Request the person to smile; an uneven smile might indicate a stroke.
☆ Arm Weakness: Check if one arm appears to be weak or has a sensation of numbness. Request that they raise both arms. If an arm hangs down or feels weak, it may signal a stroke.
☆ Speech Difficulty: Listen for slurred or unclear speech. Tell the person to repeat a basic sentence. Trouble with this might indicate a possible stroke.
☆ Time to Call Emergency Services: If you notice any of these signs, it’s essential to contact emergency services right away. Taking swift action can greatly enhance the effectiveness of treatment outcomes.
Other symptoms may include:
Sudden Confusion: Feeling completely lost or having difficulty grasping what others are saying.
Severe Headache: An intense headache that strikes suddenly and feels like the worst headache imaginable, with no apparent reason.
Balance Problems: Experiencing unexpected dizziness, trouble walking, or difficulty staying steady on your feet.
If a stroke is not treated promptly, it can lead to severe and life-threatening consequences:
• Brain Damage: Brain cells can die within minutes, resulting in permanent disabilities.
• Physical Disabilities: Patients may face paralysis, mobility issues, and loss of fine motor skills.
• Cognitive Impairment: Untreated strokes can cause long-term memory loss and difficulties with reasoning.
• Speech Problems: Severe language impairments (aphasia) may develop, impacting communication.
• Emotional Effects: Many survivors experience depression and anxiety due to lifestyle changes.
• Increased Stroke Risk: Failing to address risk factors can lead to subsequent strokes.
• Death: Untreated strokes can ultimately result in death due to complications.
Diagnosing a stroke involves several key steps, each essential in determining the nature and severity of the stroke for appropriate treatment.
Medbound Times contacted Dr. Anto Ignat Stany, Neurologist at St. Martha's Hospital, Bengaluru, for his insights on stroke diagnosis.
How is a stroke diagnosed, and what tests are typically performed?
Dr. Anto Ignat Stany: When patients present with symptoms or signs of a stroke, a plain CT scan is done to differentiate whether the stroke is due to a blood clot or bleeding. A CT Angiography is then done to look for any large clots in the blood vessels supplying the brain. A CT scan done within the first 24 hours of stroke onset may not clearly show the area of brain damage, especially when the area of brain damage is very small (lacunar stroke). In such cases, an MRI is also done to exactly localize the area of damage. Stroke evaluation also involves detailed cardiac evaluation in the form of a 2D Echocardiography to look for structural cardiac abnormalities and a Holter recording (continuous ambulatory ECG recording) to look for changes in heart rhythm which could cause clots to form inside the heart, which then gets thrown to the brain via the blood vessels.
In addition to the steps Dr. Stany outlined, other diagnostic measures include:
Initial Assessment: Doctors take a medical history and conduct a physical exam to evaluate neurological function.
Neurological Examination: A detailed neurological exam checks motor skills, speech, and cognitive abilities, often using the NIHSS to assess severity.
Additional Tests:
Carotid Ultrasound: This test evaluates the carotid arteries for any blockages or narrowing.
CT or MR Angiography: These imaging techniques create detailed visuals of the brain’s blood vessels to detect any irregularities or obstructions.
ECG and Blood Tests: Assess heart rhythm and other health factors.
Immediate treatment is crucial and differs depending on the type of stroke.
Thrombolytics (Clot Busters): Given within 3 to 4.5 hours to dissolve clots.
Antiplatelet Agents: Such as aspirin, to prevent future clots.
Mechanical Thrombectomy: Removal of large clots via catheter.
Antihypertensives: To manage blood pressure.
Aneurysm Repair: Surgical clipping or coiling to prevent bleeding.
Involves a combination of physical, occupational, and speech therapies to enhance recovery.
Control risk factors and promote a healthy lifestyle to prevent future strokes.
Understanding what increases the chances of having a stroke is key to prevention. Here are some major risk factors:
• High Blood Pressure: This condition is the leading factor behind strokes. Consistently elevated blood pressure can weaken blood vessels, leading to a higher risk of breakage or blockage.
• Cardiac Conditions: Heart-related issues, including atrial fibrillation and heart disease, can result in blood clots that heighten the risk of stroke.
• Diabetes: High blood sugar levels can damage blood vessels over time, making strokes more likely.
•Unhealthy Habits: Smoking, drinking too much alcohol, and not being physically active can all heighten stroke risk.
• Unhealthy Diet: Consuming a diet rich in salt, unhealthy fats, and cholesterol can raise blood pressure and contribute to heart disease, both of which greatly heighten the risk of having a stroke.
• Age: The chances of experiencing a stroke rise as you get older, especially beyond the age of 55.
• Genetic Factors: If strokes or heart conditions are common in your family, your risk may be greater because of hereditary influences.
• Eat a Balanced Diet: Focus on consuming fruits, vegetables, whole grains, and lean proteins while reducing salt, sugar, and unhealthy fats.
• Exercise Regularly: Aim for at least 150 minutes of moderate physical activity each week to support heart health.
• Quit Smoking: Stopping smoking can significantly lower your chances of experiencing a stroke.
• Monitor Health Conditions: Regular health check-ups can help manage high blood pressure and diabetes effectively.
• Limit Alcohol Use: Follow guidelines for alcohol consumption to help decrease stroke risk.
• Manage Stress: Participate in activities like meditation or yoga to help keep stress levels low.
Blood Pressure Management: A study published in The Lancet found that lowering systolic blood pressure to below 130 mmHg can significantly reduce the risk of stroke in older adults, suggesting that aggressive treatment for hypertension is beneficial.
Diet and Stroke Risk: Research in the American Journal of Clinical Nutrition indicates that a diet rich in fruits, vegetables, and whole grains can lower the risk of ischemic stroke. The study highlighted that individuals who consume a Mediterranean diet have a notably lower stroke incidence.
Physical Activity and Stroke Prevention: A study in Stroke, a journal of the American Heart Association, showed that regular physical activity reduces the risk of stroke by up to 25%. The findings emphasized that even moderate exercise, such as brisk walking, can have protective effects
Common Occurrence: Stroke is a major health issue, impacting one in four people during their lives. It’s more common than many realize.
Younger Adults at Risk: Surprisingly, around 10% of strokes occur in people under 50, showing that age isn’t the only factor.
Higher Risk for Women: Women face a greater risk of strokes, partly due to hormonal changes throughout their lives.
Silent Strokes: Some strokes can happen without obvious symptoms, yet they can still lead to significant brain damage.
The Stroke Belt refers to a region in the southeastern United States where stroke rates are significantly higher than the national average. This area includes states like Alabama, Mississippi, Louisiana, and Tennessee.
Factors contributing to the high incidence of stroke in this region include:
Risk Factors: Higher rates of high blood pressure, diabetes, and obesity are prevalent in this area
Socioeconomic Barriers: Inadequate access to healthcare and healthy food alternatives.
Cultural Influences: Dietary habits high in fat and sodium, along with lower levels of physical activity.
World Stroke Day is an important chance for us to come together and raise awareness about strokes and how to prevent them. A stroke can change a person’s life in an instant, but the encouraging news is that many strokes can be avoided. By recognizing risk factors like high blood pressure and diabetes, and by making simple changes to our lifestyles—such as eating better and staying active—we can protect ourselves. Let’s take this opportunity to talk openly about strokes, share helpful information, and encourage our friends and family to take care of their health.
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. If you or someone you know is experiencing symptoms of a stroke, such as sudden numbness, confusion, difficulty speaking, or loss of coordination, seek immediate medical attention.
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