Stroke, also called ” Brain Attack” is the commonest devastating disease of the brain. It is the leading cause of adult disability and second cause of death worldwide. It affects most people before 60 yrs of age in Indian population, when compared with western data.
The Global Burden of the Disease study (GBD) revealed that of the 9.4 million deaths in India, 619000 were from “stroke” and the DALY (Disability Adjusted Life Years) that were lost, almost accounted to 20.5 million.
Asians die more from stroke than coronary heart disease. It appears that high incidence of stroke in the east is due to increased incidence of hypertension -undiagnosed and /or inadequately treated. Risk factors of stroke include high blood pressure (Hypertension), smoking, high cholesterol and sugar(Diabetes) level in blood, heart disease – ischaemic or arrhythmia, obesity , lack of exercise, increasing age and genetic factors. Unhealthy lifestyle and food habits predispose to hypertension, diabetes, hyper-cholesterolaemia, obesity etc. which in turn precipitate stroke. High incidence of haemorrhagic stroke is directly related to high blood pressure (Hypertension), which is so common in our population..
Stroke results mainly from diseases of the arteries or blood vessels supplying the brain. A stroke occurs when such a blood vessel that carries oxygen and nutrients to the brain is blocked by a clot (Ishaemic stroke), or when it ruptures(Haemorrhagic Stroke) resulting in blood coming out of vessels in the brain tissue .
Warning Signs of Stroke (Symptoms)
Stroke symptoms may have different manifestations. Two stroke cases may present in absolutely dissimilar ways.
The manifestations may be as follows:
- Sudden numbness or weakness of face, arm or leg or all, especially on one side of the body
- Sudden development of trouble speaking or of comprehension.
- Sudden change of mood, personality or behaviour
Sudden loss of vision on one side.
- Sudden vertigo, double vision, dizziness, lack of balance or coordination on walking
- Sudden unexplained headache, vomiting and impairment of consciousness.
If these symptoms are seen in an individual, the patient should be shifted to a hospital, where stroke care facilities are available. It is to be remembered that “Time is Brain”, as millions of cell die each moment after stroke. Delay in initiation in management will adversely affect the outcome in terms of mortality and disability. So unnecessary delay should be avoided.
Stroke disability is frustrating to the victims, to the family members and the physicians.
Disabilities include paralysis of limbs, problems of locomotion, feeding, toileting, loss or impairment of speech, vision memory, ability to read or write(i.e Activity of daily leaving); there may also be disturbance of psychological and intellectual functions.
As the outcome of stroke is unpredictable in majority of cases, the emphasis is given mostly on its prevention ( Prevention is better than cure) and rehabilitation.
Though devastating, stroke can be prevented in more than 70% cases by controlling the risk factors especially high blood pressure.
Stroke is neglected because of extreme lack of awareness among the public, professionals and policy makers.
- Stroke or “Brain Attack” is devastating.
- Stroke is the leading cause of adult disability.
- Stroke is the second leading cause of death after heart attack worldwide.
- Stroke is preventable easily in more than 70% of cases by the control of risk factors, most important of which is high Blood Pressure (Hypertension). Its prevention is better than cure.
- Stroke is treatable in most cases, but patients must seek immediate medical care.
- Post-stroke disability needs proper rehabilitation to bring the patient back to his normal life
- All persons should be aware of the signs and symptoms of stroke.