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Stroke: The Silent, Deadly Threat

January 18, 2007

Last year, more than 240,000 people in Thailand suffered a stroke an average of 27 people every hour. Around the world, 15 million people are suffering stroke and of these, 5 million die and 5 million are permanently disabled.

Last year, more than 240,000 people in Thailand suffered a stroke an average of 27 people every hour. Around the world, 15 million people are suffering stroke and of these, 5 million die and 5 million are permanently disabled.

The good news is, there are a number of ways to lower your stroke risk, while advances in stroke treatment are saving lives and reducing the severity of long-term health damage. Here’s a look at the important points you need to know about stroke, and how to lower your stroke risk.

WHAT IS A STROKE?

stroke, or cerebrovascular disease, is the interruption of the blood supply to the brain caused by a blood clot or the bursting of an artery or blood vessel. Blood is rich in oxygen, so when a stroke occurs, the brain is deprived of oxygen, leading to damaged brain tissue in a matter of minutes. At the onset of a stroke, a person may experience a painful headache, difficulty speaking or swallowing, and numbness or muscle weakness.

WHO’S AT RISK

Most of the factors that raise a person’s stroke risk are related to overall health and lifestyle. Most stroke victims are aged 50 and older, while smoking, high blood pressure, high cholesterol, diabetes, and heavy alcohol consumption significantly increase the risk of stroke (see the text box on p.17 for more details).

KNOW THE SYMPTOMS

A stroke is a serious, life-threatening condition, so recognizing stroke symptoms is extremely important. The most common symptoms include:
  • weakness or numbness in the arms, legs, face, or on one side of the body;
  • loss of normal speech or vision (usually in one eye);
  • sudden, severe headache;
  • dizziness or a sudden fall.
If you experience any stroke symptoms, you need to seek immediate medical attention.

DIFFERENT STROKES

There are two types of strokes, ischemic and hemorrhagic. Ischemic strokes result from a reduction in blood flow to the brain when an artery narrows or becomes blocked. Hemorrhagic strokes occur when an artery in the brain leaks or bursts, causing bleeding near the brain surface or within the brain tissue.

Transient ischemic attacks (TIAs) can happen prior to a stroke. These TIAs act like warning signals, and it’s not uncommon for more than one TIA to occur before the onset of a stroke.

A TIA may last for just a few seconds, after which normal blood flow usually resumes.

STROKE TREATMENT

A doctor will first determine the type and severity of the stroke, before recommending the best course of treatment. Tests such as CT and MRI scans are often used to locate the position of the blood clot and any bleeding, and to assess the extent of brain damage. Blood, ultrasound and electrocardiogram (ECG and EKG) tests help reveal specific heart problems and measure blood flow.

Restoring blood flow is the primary focus of treating an ischemic stroke, and doctors have a number of proven medications and treatment procedures at their disposal.

A clot-dissolving medicine called tissue plasinogen activator (t-PA) is sometimes used to treat ischemic strokes; research has shown that t-PA can greatly improve a patient’s recovery when given within three hours of the onset of symptoms.

When treating a hemorrhagic stroke, doctors first focus on controlling bleeding and stabilizing blood pressure. Mild bleeding inside the brain can be treated without surgery, while heavy bleeding may require surgery, as increased pressure can lead to serious complications.

MEDICATION AND REHABILITATION

After a patient’s condition has stabilized, treatment will focus on rehabilitation and reducing the risk of another attack. Your doctor may prescribe medications including aspirin, cholesterol-lowering statins, and medication to treat high blood pressure.

Rehabilitation helps restore a patient’s speech, balance and movement. Significant improvements are typically seen during the first three months, with more gradual improvements continuing over the course of about one year. Many stroke victims make full and successful recoveries, especially those who begin their rehabilitation program soon after the stroke, managed by a team of experienced medical professionals.

New Stenting Procedure Helps Stroke Patients

A relatively new endovascular (i.e. inside a blood vassel) procedure called Carotid Artery Stenting is now being used to prevent blocked carotid arteries and to treat patients who’ve suffered a stroke or transient ischemic attack (TIA).

Narrowing or blockage in one or both of the carotid arteries in the neck is a leading cause of strokes and TIAs. Carotid artery angioplasty and stenting is similar to angioplasty of the heart, a procedure commonly used to open blocked or narrowed arteries in the heart. During the stenting procedure, a catheter is inserted into the patient and threaded through the artery. The doctor then inserts a tiny metal tube called a ‘stent’ and guides it inside the carotid artery. The stent remains inside the artery to maintain healthy blood flow.

Dr. Roekchai Tulyapronchote, a stroke neurologist specializing in the stenting procedure, noted that “carotid artery stenting is fast becoming one of the main tools we use to prevent strokes in high-risk individuals who have severe stenosis (narrowing) of the cerebral vasculature.”

Healthier Living: The best way to lower your stroke risk

Watch Your Blood Pressure
High blood pressure is the greatest risk factor for stroke, so be sure to have yours checked regularly.

Don’t Smoke
Smoking doubles your stroke risk by damaging blood vessel walls and raising your blood pressure.

Limit Alcohol Consumption
Having more than two alcoholic drinks a day on average can increase your stroke risk by 3 times, so cutting down can make a huge difference.

Exercise Regularly
Exercising four to five times a week has benefits for both blood pressure and cholesterol, and makes it easier to maintain a healthy weight.

Eat Healthy
A high-fat, high-sugar diet can lead to high cholesterol and obesity, putting you at much greater risk of a stroke. Apples, strawberries, grapes, tomatoes, almonds, dark chocolate, fish, oatmeal, tea and cinnamon are all good stroke-fighting foods.
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