Stroke is one of the leading causes of deaths in the world. Globally, it is the 5th and 3rd most common cause of death in men and women, respectively. In India, stroke cases have risen over time. The most troubling aspect is that stroke, which was earlier considered to be a disease of the elderly, is impacting younger people more.
“Young” stroke cases, where the victim is younger than 45 years, have risen in India. Various Indian studies have estimated stroke prevalence and stroke incidence of 100 to 300 and 27 to 34 cases per lakh people, respectively, in the young age group. It is therefore imperative that more education and awareness is spread about Stroke.
What happens during a stroke?
Often confused with heart attack, stroke impacts the brain of a person. It happens when the blood supply to the brain is compromised, interrupting the oxygen supply to the brain. This causes the brain tissues to die. If not attended promptly, it can cause brain damage, temporary or permanent paralysis, and other disabilities.
A stroke is majorly of two types, ischemic and haemorrhagic stroke. In ischemic stroke, the blood flow to brain is disrupted due to the formation of clot or blockages in the blood carrying vessels. Around 80% of stroke are ischemic in nature, which means that the blockages often are because of fat deposition. Haemorrhagic stroke is caused due to the rupturing of blood vessels, which prevents blood flow and causes tissue damage.
Symptoms of Stroke
Timely identification of a stroke case and prompt medical attention is critical to save life and to prevent life crippling condition. It is very important that a stroke patient is taken to a stroke ready healthcare facility within the golden period of 4.5 hours, beyond which the chances of severe damages and fatalities are higher.
To identify a stroke case and initiate immediate action, people need to be aware about the mnemonic or acronym F.A.S.T.
· F stands for whether the person suddenly develops a Fallen or drooping face from a side.
· A for whether the person is able to raise both Arms and keep them up.
· S stands for whether the person is showing signs of slurred Speech.
· T stands for Time to call emergency or take the person to a stroke ready healthcare facility if any of the three signs appear.
Other symptoms include weakness or numbness of the face, arm, or leg; difficulty in speaking or understanding; blurred vision or loss of vision in one or both eyes; dizziness or difficulty in balance or coordination; fainting or seizure; and so on. These patients should immediately referred to a hospital with an active stroke prevention unit and neuro -radiology department with other laboratory facilities.
Diagnosis, Risk Factors, and Prevention of Stroke
A stroke patient has to undergo complete physical examination and may undergo several tests which include CT scan of the brain, MRI, CT angiography; MR angiography, Doppler sonography, ECG and electrocardiogram (ECG).
However diagnostics has an important role to play in reducing the chances of stroke by alerting people of several lifestyle related risk factors which rapidly increases the chances of a future stroke incident. High cholesterol levels, obesity, diabetes, hypertension, alcoholism, smoking and cardiac ailments are the commonest modifiable risk factors causing stroke.
High cholesterol levels not only cause fat deposition in arteries of hearts but also in blood vessels to brain. It also causes heart diseases. In fact in many cases, stroke is preceded by a heart attack or cardiac arrest. Therefore, it is important that people undergo regular preventive diagnostic tests especially of blood pressure, cholesterol, and diabetes to be aware of their health conditions and take required measures.
All these risk factors can be prevented from developing or becoming severe by avoiding smoking and alcohol intake, leading an active lifestyle, practicing yoga and meditation for stress management, and consuming balanced healthy diet with low sugar, salt and saturated fat.
Predicting Stroke - A Future Possibility
With advancing medical technology it may be possible in the future to predict a possible stroke incident. Today, extensive research has indicated a promising candidate biomarker lipoprotein-associated phospholipase A2 (LpPLA2) for risk prediction of a stroke or heart attack. High levels of Lp-PLA2 signify atherosclerotic plaque, which creates blockage in arteries, has higher chances of rupturing arteries and entering into bloodstream.
This can cause blood to clot, resulting in stroke. Therefore, in future Lp-PLA2 levels can help us ascertain if patient would suffer a hemorrhagic stroke, and therefore take proactive measures to put such patients under aggressive treatment, including lipid-lowering therapy.