Brain attack or stroke

Dr S K Gupta
Today is World Stroke Day which calls for the attention to prevent and treat the brain attack as early as possible. The people are much aware about ‘Heart attacks” but are less informed about “Strokes”. To know about brain attack or stroke is very important since it is 3rd major cause of death and is leading cause of serious long term disability in the world as well as in India.
It is defined as rapidly developing clinical symptoms and signs of focal disturbance of Cerebral Function with symptoms lasting more than 24 hours or leading to death with no apparent cause other than that of Vascular Origin.
Considering the seriousness of the disease the World Stroke Organisation (WHO) and Indian Stroke Association (ISA) are calling for immediate attention to address the epidemic of stroke. WSO and ISA are advocating for a comprehensive continuum approach from prevention to  treatment and towards rehabilitation and long term support.
There are two types of major strokes.
1. Ischaemic Stroke
2. Haemorrhagic Stroke
In the first type blood clots and blocks the blood to a particular area of brain- known as Ischaemic Stroke which contributes to 80 percent . In the second type there is rupture of blood vessel and blood leaks in to the brain called as Haemorrhagic Stroke which contributes about 20 percent of all strokes.
Here are six steps any one can take to reduce the risk and danger of stroke.
1. Know your personnel risk factors- high blood pressure, diabetes and high blood cholesterol.
2. Be physically active and exercise regularly.
3. Avoid obesity by keeping  to a healthy diet.
4. Avoid cigarette smoking.
5. Limit alcohol consumption.
6. Learn to recognize the warning signs of stroke.
Stroke warning signs
* Sudden numbness or weakness of face, arm or leg on one side of body.
* Sudden confusion or difficulty in speech or understanding language.
* Sudden trouble in seeing in one or both eyes or having double vision.
* Sudden vertigo.
* Sudden trouble in walking and loss of balance.
* Sudden severe headache with no cause.
If one notice of these warning signs act fast. Stroke is a medical emergency and get to a hospital immediately. Don’t loose time.
Even if the symptoms disappears in a few minutes still consult the neurologist immediately, because it may be your last opportunity to prevent a potentially forthcoming major stroke. Since stroke is a medical emergency. Every minute counts when someone is having a stroke. The  longer flow is cut off to the brain, the greater the damage; immediate treatment can save people’s lives and enhance their chances for successful recovery.
Ischaemic strokes, the most common type of strokes can be treated with a drug rt-PA which dissolves blood clots. The time is very important and the window of opportunity to start treating stroke is 3 to 4.5 hours so one has to get into the hospital with in shortest time. Haemorrhagic stroke is usually treated conservatively with decongestive therapy.
The best treatment for stroke is prevention
There are several risk factors that increase your chances of having a stroke.
* High Blood Pressure
* Diabetes.
* Heart Disease
* High Cholesterol.
* Smoking and Obesity
Preventing or keeping them under control will greatly reduce your chances of having a stroke.
Stroke is a leading cause of adult diability worldwide.
Stroke survivors need appropriate long term care and support.
Physical and occupational therapy
Most persons that survive a stroke have some degree of post-stroke disabilities. Although rehabilitation does not reverse brain damage, it can substantially improve functions leading to better qualities of life. Persons who have had a stroke are in need of long term follow up for preventive strategies, risk factor control and regular check up for disabilities.
Mental health support
Stroke survivors may experience depression. To improve the quality of life and to facilitate rehabilitation, it is essential that they have access to professional help as well as receive sustained emotional support from their families and friends.
It is strongly suggested to recognize the stroke and act fast to prevent disability and loss of life. This is a slogan of WSO and ISA, which is to be fulfilled.
Precaution is better than cure,  so by taking care of risk factors one can prevent brain attack in their life time. Regular exercise, good food habits, eating plenty of vegetables and fruits controlling the blood pressure and blood sugar totally avoiding excess of alcohol and smoking, follow the instruction of Neurologists on blood thinning drugs which are essential to prevent potentially disabiling strokes.
(The author is a Neurologist)


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