Moses Gakuba, 44, a former local league basketballer, was once the real definition of the word ‘giant’, he was not only tall, but also physically  well built.

The resident of Kicuciro sector, Kigali, however started experiencing strange body changes in 2008; he started getting numbness in the face, arm, or leg, especially on one side of the body, confusion, trouble speaking, trouble seeing in one or both eyes and lack of body balance.

A few months after getting the first symptoms, doctors confirmed he had a stroke, after various examinations.

What is a stroke?

A stroke is an acute, dramatic loss of function of one or more parts of the body, which occurs due to sudden cessation of the blood supply of specific part/parts of brain resulting in tissue destruction.

Damage to any portion of the brain results in paralysis of a body part it represents.

The severity of the paralysis and subsequent recovery depends on the blood vessel affected and opening of collateral circulation from adjacent blood vessels.

"In the commonest form, there is paralysis of limbs on one side along with face on the same or opposite side. In other forms, one can have visual defects, convulsions, paralysis of only one limb, among others. If the frontal or parietal lobe of the brain is affected, there may be no paralysis but the person suddenly becomes apathetic to his surroundings. The speech area if involved, results in mutism,” says Dr Rachna Pande, a specialist in internal medicine at Ruhengeri Hospital.

Research

Sleeping more than eight hours a day is associated with a higher risk for stroke, a new study done by researchers at the University of Cambridge , U.K, has found.

Researchers studied 9,692 people, age 42 to 81, who had never had a stroke. The study tracked how many hours a night the people slept at the beginning of the study and how much nightly sleep they were getting four years later. Over the 10-year study, 346 of the study subjects suffered strokes.

After controlling for more than a dozen other health and behavioral variables, the researchers found that people who slept more than eight hours a day were 46 percent more likely to have had a stroke than those who slept six to eight hours.

The study, published online about a week ago, also found that the risk of stroke was higher among people who reported that their need for sleep had increased over the study period.

The authors caution that the data on sleep duration depended on self-reports, which can be unreliable. In addition, the study identified an association between sleep and stroke risk, rather than cause and effect. Sleeping more may be an early symptom of disease that leads to stroke, rather than a cause.

"It could be that there’s already something happening in the brain that precedes the stroke risk and of which excessive sleep is an early sign,” said the lead author, Yue Leng, a doctoral candidate at the University of Cambridge.

In any case, she added, "we don’t have enough evidence to apply this in clinical settings. We don’t want people to think if they sleep longer it will necessarily lead to stroke.”

Demystifying myths

Dr Pande says that due to ignorance, many myths prevail, regarding stroke.  When somebody has a stroke it is very frightening for the onlooker. The innocent often consider it to be witchcraft and spend resources going to witch-doctors.

In case of paralysis of one or more limbs, it is considered by some to be a form of "rheumatism.” Rheumatism is a condition of pain and inflammation of the joints. Here, an individual is unable to move their limbs due to severe pain but strength of limbs is maintained.

"Many people gather half knowledge about it on the internet  and form their own impressions. Recently, the spouse of a patient was arguing with me, that though her husband was given aspirin and other anti clotting drugs, she wondered why within an hour, the paralysed limbs did not recover,” Pande says.

According David Gahamanyi, a neurologist with Medplus Clinic, Remera, a stroke is identified only when it manifests in the form of paralysis. Drugs like aspirin, are given immediately to break the clot already formed and prevent its further extension. But the damage incurred remains, unless blood circulation to that part is restored.

"Stroke occurs due to a clot occluding a blood vessel or bleeding from one of the vessels. Hypertension, diabetes, obesity, fat rich diet, lack of exercise, stress, are risk factors for stroke, along with alcohol  and smoking,” he says.

Diagnosis

Diagnosis is made clinically and by scans of the brain.  Treatment is initiated which is to prevent further injury. One has to wait patiently for normal strength to return in paralysed limbs. This may take any time from weeks to months or years, depending on size of brain damage.

"Physiotherapy is useful in improving the muscle tone and strength. If the family cannot avail professional help, a family member can also do some physiotherapy at home. All that is needed is slow and smooth movements of the paralysed limb in all directions,” Gahamanyi says.

The number should be increased gradually. Good nursing care is important to prevent bed sores and other infections in a physically helpless person.

He adds that it is vital for one to know about the true facts regarding stroke. As soon as a person develops any signs he should be taken to nearest health centre.