Treatment and prevention of stroke through awareness

If you had to do all your daily works without using your one hand, one leg, and one portion of the face, you might be able to imagine how critically stroke-affected patients have to live their lives.

A brain stroke causes a severe medical condition due to complications in the brain's blood vessels. The cells in our brains are extremely sensitive. Even a little lack in the supply of oxygen and carbohydrate causes the cells to start to decay. If blood flow to any part of the brain is hampered (except due to injuries) and continues to sustain for twenty-four hours or the patient dies by twenty-four hours, then it might be a case of a stroke.

A stroke could be detected from severe symptoms like paralysis; in some cases, it might even lead to death. In most cases, one particular side of the patient's body, including hand, leg, and face gets paralysed. If the left side of the brain is affected by a stroke, then the right side of the body will be paralysed, and vice-versa. It indicates that the limbs controlled by the affected portion of the brain will suffer the impact. The type and severity of the stroke determine the type and severity of the paralysis.

Many of us have misconception that stroke and heart attack are the same. We have to remember that stroke is not heart disease; it is mainly related to our brain. Hospitals have separate specialised units for both cardiac and stroke treatments, and different specialist doctors for each unit. If a stroke patient is diagnosed early and taken to the hospital on time, chances of recovery increases to quite some extent.

STROKE SYMPTOMS: Symptoms include sudden weakness or unresponsiveness of one side of the body, headache, vomiting, sudden fainting, difficulty or inability to speak. A stroke-patient might feel dizzy and have severe pain in head, neck, face, and even between the eyes. The patients might face difficulty to walk or keep balance, their words may sound mumbled. Blurry eyesight and nausea can also indicate the same. Remembering the acronym 'FAST' is recommended to diagnose and care for a stroke-patient, where F is for 'facial deformation' or droopiness, A is for 'arm weakness', S is for 'speech impediment.' and T is for 'Time to seek emergency healthcare'.

When a patient is found to show these symptoms, we must not panic. Instead, we have to quickly reach the nearest hospital emergency and avail medical attention within the shortest possible time. Patients suffered by a stroke could be cured with timely medical attention.

Stroke can be of two types, depending on how it affects the brain. These are 1. Ischemic stroke, and 2. Hemorrhagic stroke. If blood is clotted inside the brain vessels or clotted-blood is circulated from the heart or any other limb to the brain, then there are high chances of an ischemic stroke. Although the rate of fatality from ischemic stroke is comparatively low, the recovery phase for the sufferer is longer, and in many cases, patients have to live with permanent paralysis.

In the case of a hemorrhagic stroke, blood vessels are broken followed by bleeding inside the brain. Signs and symptoms in such cases depend on the location and severity of the impact on the brain. In most cases, patients arrive at hospitals in an unconscious state or with high blood pressure. The chances of death are higher in hemorrhagic strokes. Patients who overcome the primary strain have lower chances of facing a second hemorrhage. They face a lesser risk of permanent paralysis, and the initial paralysis is also cured within a comparatively lesser duration.

TREATMENT FOR STROKE: Whichever type of stroke a patient suffers from, his/her recovery depends mainly on how quickly, efficiently, and properly primary treatment and rehabilitation process is provided.

Certain patients can be treated by thrombolysis (melting blood-clots using injections) and thrombectomy (taking out blood-clots using stents), if brought to the hospital within 3-4 hours of attack from an ischemic stroke. In other cases, the doctor needs to conduct extensive investigation and advise medicines and rehabilitation accordingly. Besides primary treatments, hemorrhagic strokes can be treated by surgery, surgical clipping, or coiling.

Few more remedies are recommended; for example: if there is shortness of breathing or no breathing, then the patient needs to be artificially respirated by mouth-to-mouth breathing. If the patient is vomiting, then the head needs to be placed sideways. Those looking after should remember to not feed the patient anything solid or liquid. The respiration, respiratory channel, and blood circulation need to be constantly monitored for unconscious patients. The patient needs to be laid sideways. At least two persons shall be at the hospital along with the patient. This will ensure smoother progress of the diagnosis and treatment.

CAUSES OF STROKE: People over 55 years of age have higher risks of stroke. Men are more vulnerable to stroke compared to women. High blood pressure, diabetes, cardiac diseases and obesity are some of the underlying causes of stroke. Previous cases of stroke or heart attack in the family, smoking or alcohol consumption, heart diseases like irregular heartbeat, heart failure, heart infection, hormone therapy or birth-control medicines, previous history of one or more strokes or Transient Ischemic Attack (TIA) can also increase the chances of stroke.

PREVENTIVES: Stroke is mostly preventable. But it is required to raise awareness to prevent it, which is why all should know about the risks of stroke and abide by the rules for a healthy lifestyle. To maintain a healthy lifestyle, one should regularly check blood pressure and take necessary steps to keep it under control, avoid high-fat foods, control cholesterol levels, check diabetes regularly, maintain physical exercise, and control weight. Vegetables, small fish, sea-fish, dried fish, and milk should be included in the diet.

Patients could face paralysis, coma, or even death due to stroke. But a little awareness and timely treatments can result in up to 50 per ent improvement of the patients' condition. A healthy lifestyle can lessen the risks of stroke by a large margin.

Stroke Day is celebrated around the world on October 29 every year. Stroke-related illness and mortality are a matter of concern for people all over the world. It is great that stroke awareness among the people in our country is now slowly increasing. We want to move forward with modern medical management of stroke and public awareness about stroke.

Dr. Mohammad Shah Jahirul Hoque Chowdhury is Professor (Clinical Neurology), National Institute of Neurosciences & Hospital (NINS). Sher-e-Bangla Nagar, Dhaka

[email protected]

Disclaimer: Any and all the Information provided in the article are independent views expressed by the writer for general overview and educational purposes only.