During a stroke, a staggering 1.9 million neurons are lost every minute. To add to the urgency, each passing minute of a stroke effectively ages the patient by an equivalent of 3.1 weeks.
Dr Vikas Gupta is a Senior Consultant (Neurology) at Fortis Hospital, Jaipur
As a neurologist, my commitment to raising awareness about strokes and their prevention is unwavering. On this World Stroke Day, let me share my insights about this critical topic, which affects millions of lives each year. Strokes are a global health concern, and I believe that through knowledge and proactive lifestyle changes, many of them can be prevented.
Demystifying Stroke
A stroke, often referred to as a "brain attack," strikes when there is a disruption in the blood supply to the brain. This disruption can be caused by a blood vessel that either bursts, ruptures, or is blocked by a clot. As a result, the brain doesn't receive the oxygen and nutrients it requires, leading to the death of brain cells.
The brain is responsible for controlling everything your body does, so a stroke will have a profound impact on how your body functions, affecting your movement, sensations, thoughts, and communication. A stroke is sudden, and its effects on the body are immediate. To put it into perspective, every six seconds, someone, regardless of age or gender, succumbs to a stroke.
One in Six: The Global Impact
One in six people worldwide will experience a stroke during their lifetime. This is a staggering statistic, underscoring the importance of stroke awareness and prevention.
Strokes don't discriminate by age or gender, and their consequences can be devastating. It is sobering to note that stroke is the second leading cause of death among those above 60 and the fifth leading cause for individuals aged 15 to 59. Stroke doesn't even spare children, including newborns.
Each year, nearly six million people lose their lives to stroke. Astonishingly, stroke is responsible for more deaths annually than those attributed to AIDS, tuberculosis, and malaria combined.
Know Your Enemy: Types of Stroke
There are two main types of stroke:
Ischemic Stroke: This type occurs when a clot or mass clogs a blood vessel, cutting off blood flow to brain cells. Remarkably, ischemic strokes account for a significant 87 percent of all stroke cases.
Hemorrhagic Stroke: In contrast, a hemorrhagic stroke is the result of a weakened blood vessel that ruptures and bleeds into the surrounding brain tissues, thereby compressing and causing the death of brain cells.
In addition to these, we must not overlook Transient Ischemic Attacks (TIAs), often referred to as "mini-strokes." TIAs produce stroke-like symptoms and are caused by a clot. Though temporary, they usually cause no permanent damage. However, it is crucial to emphasize that TIAs are a medical emergency, as approximately 15 percent of all strokes occur after a TIA.
Recognizing the Signs: Symptoms of Stroke
Being able to recognize the signs of a stroke is crucial for prompt intervention. The F.A.S.T. acronym is a valuable tool:
Face: Is one side of the face drooping?
Arms: Can the person raise both arms?
Speech: Is their speech slurred or strange?
Time: Time is critical
During a stroke, a staggering 1.9 million neurons are lost every minute. To add to the urgency, each passing minute of a stroke effectively ages the patient by an equivalent of 3.1 weeks. These sobering statistics underscore the critical importance of swift intervention in the event of a stroke. Acting swiftly and seeking medical attention within the first few hours can be life-saving. Treatments like clot-busting medications or surgical interventions are most effective when administered promptly.
Stroke Management
Stroke management is a critical aspect of providing effective care to individuals who have experienced a stroke. The management of stroke depends on the type of stroke – ischemic or hemorrhagic.
For ischemic strokes, time is of the essence, as prompt intervention with clot-busting medications like t-PA (tissue plasminogen activator) within the first 4.5 hours from symptom onset can be lifesaving. Beyond this timeframe, t-PA may not be administered. For select cases, endovascular treatments, such as thrombectomy, can be performed for for up to 6 hours and even up to 24 hours after the onset of symptoms.
Hemorrhagic strokes necessitate a different approach, focusing on controlling bleeding and managing blood pressure. In all cases, stroke management involves a multidisciplinary team of healthcare professionals, including neurologists, radiologists, nurses, and rehabilitation specialists.
Preventing Strokes
Prevention is the linchpin when it comes to strokes. Encouraging a healthy lifestyle is paramount which can reduce the risk of Modifiable Risk Factors of stroke. Below mentioned are some modifiable risk factors and tips to prevent them:
1.High blood pressure: The number one cause of strokes, linked to almost half of all cases. Regular blood pressure checks and management are imperative.
2.Weight issues: A well-balanced diet and regular exercise are key to stroke prevention.
3.Tobacco use: Smoking damages blood vessels and is a significant risk factor.
4. Diabetes: Diabetes affects the health of blood vessels in the brain, making proper management with your healthcare provider is essential.
5.High blood cholesterol: High levels of 'bad' (LDL) cholesterol increase stroke risk, but dietary choices can mitigate this. Eating low-saturated, non-hydrogenated fats instead of saturated fats can reduce the stroke risk.
6. Minimum physical activity and obesity: Being inactive, obese, or both elevates the risk, making exercise crucial for stroke prevention.
7. Achieving a healthy BMI or waist-to-hip ratio: Obesity is linked to stroke risk; calculating your ratio can provide valuable insights. A good way to know if you need to lose weight is to divide your waist measurement by your hip measurement. If the number is over 0.9 (man) and 0.85 (woman), your weight is putting you at a higher risk of stroke and you benefit from losing weight.
8. Carotid and other artery diseases: Carotid arteries in the neck supply most of the blood to the brain. A diseased carotid artery can lead to stroke if blocked by a blood clot.
9. TIAs: Prompt action after experiencing TIA symptoms can reduce the risk of a major stroke.
10. Heart conditions: Conditions like atrial fibrillation (disturbed heart rhythm) or other heart issues can raise stroke risk, so they require appropriate management.
11. Certain blood disorders: A high red blood cell count makes clots more likely, raising the risk of stroke. Conditions like sickle cell anemia increase stroke risk.
12. Limiting excessive alcohol intake: Alcohol consumption should be moderate, as excessive drinking can lead to high blood pressure and stroke risk.
Non-Modifiable Risk Factors:
While many stroke risk factors are modifiable through lifestyle changes and medical management, some are beyond our control. It's crucial to be aware of these non-modifiable risk factors and focus on mitigating the modifiable ones to reduce the overall risk of stroke.
1. Increasing Age: Age is an unchangeable risk factor for strokes. While strokes can affect people of all ages, the likelihood of experiencing a stroke increases as we grow older. This is partly due to natural wear and tear on blood vessels, the cumulative effect of risk factors over time, and other age-related factors.
2. Gender: Gender plays a role in stroke risk. In most age groups, more men than women have strokes. However, it's important to note that more women tend to die from strokes.
3. Heredity and Race: Family history and genetic factors can also contribute to stroke risk. People with close blood relatives who have had a stroke are at a higher risk of experiencing a stroke themselves. Additionally, race can play a role, as certain racial and ethnic groups may have a higher risk of stroke. For example, African Americans have a higher risk of death and disability from strokes compared to white individuals, and Hispanic Americans are also at a higher risk.
4. Prior Stroke: Having previously experienced a stroke is a strong predictor of future stroke risk. However, secondary prevention strategies, such as the use of blood thinners and cholesterol-lowering drugs, can help manage this risk. Regular medical follow-ups and adherence to prescribed medications are essential in reducing the risk of recurrent strokes.
While we cannot change these non-modifiable risk factors, it's important to remember that the majority of stroke risk factors are modifiable. By managing conditions such as high blood pressure, diabetes, high cholesterol, and obesity, as well as adopting a heart-healthy lifestyle, individuals can significantly reduce their overall risk of stroke. Regular medical check-ups and discussions with healthcare providers are invaluable in assessing and managing individual risk factors.
Stroke Recovery
Stroke Recovery varies widely among individuals, and these statistics offer valuable insights into the diverse outcomes following a stroke:
1. Approximately 10% of stroke survivors achieve near-complete recovery, regaining a high level of independence in their daily lives.
2. Another 25% recover with minor impairments, which may include some lingering weakness or cognitive challenges but do not significantly impact their overall functionality.
3. 40% of stroke survivors experience moderate to severe impairments requiring special care.
4. For 10% of stroke survivors, the challenges are substantial, and they may need care within a skilled-care facility or another long-term care setting
5.Tragically, about 15% of stroke patients do not survive the stroke, highlighting the importance of timely intervention and stroke prevention efforts.
These figures underscore the significance of early recognition, prompt treatment, and ongoing rehabilitation for stroke survivors. Stroke remains preventable, treatable, and, in many cases, beatable, emphasizing the importance of awareness, proactive risk reduction, and timely medical care.
Ultimately, awareness, education, and early intervention remain our most powerful tools in the fight against stroke. World Stroke Day serves as a reminder of our collective responsibility to raise awareness about strokes and promote preventive measures. As a neurologist, I encourage everyone to take their health seriously, make informed choices, and seek regular medical check-ups. Knowledge is the first step towards stroke prevention, and by spreading awareness, we can significantly reduce the burden of strokes on individuals and their families.