Each year, 15 million people worldwide suffer a stroke. Approximately six million of these die and another five million remain permanently disabled in the aftermath of the sickness. Those who survive without challenges would be lucky because when disability strikes, damage is gross. Globally, stroke is labelled the leading cause of disability, after dementia but is there any chances of surviving?

"With an attack from a stroke, chances are that you may die instantly and if you don’t there is a likelihood of impairment in movement, speech, vision among others,” says Dr Ruhamya Nathan, a cardiologist at King Faisal Hospital.

A stroke occurs when blood supply to the brain is blocked or when a blood vessel in the brain bursts. The result is a loss in blood flow to the brain and consequentially there would be a loss of oxygen supply too. It is this drop in oxygen supply to the brain that causes injury to brain cells that eventually die.

Dr Ruhamya, who is a senior consultant in cardiovascular diseases, equates stroke to heart attacks because the two conditions are caused by similar reasons.

"Don’t be surprised every time a stroke is referred to as a brain attack. A heart attack occurs when there is limited supply of blood to the heart, and in the event of a stroke, supply of blood is limited to the brain,” he explains.

Types of stroke

According to experts, there are two types of strokes that include; transient ischemic attack (TIA) and hemorrhagic.

In a transient ischemic attack there is a temporary interruption in the blood flow to a part of the brain. While, most TIAs last only a few minutes, they account for 80 per cent of all strokes and warning signs of a TIA are the same as the warning signs of a stroke. Sometimes TIAs are referred to as "warning strokes” as they may be an indication that a full, far more serious stroke is about to happen.

On the other hand, during a hemorrhagic stroke, an artery in the brain bursts.

Hemorrhagic strokes could be intracerebral hemorrhage, which happens when a blood vessel in the brain leaks blood into the brain or subarachnoid where bleeding occurs under the outer membranes of the brain and into the thin fluid–filled space that surrounds the brain. Such a hemorrhage can cause extensive damage to the brain and is the most lethal of all strokes.

Currently, stroke is the second leading cause of death in ages above 60 and fifth in people aged 15 to 59 years.

Especially in the developing world, incidence of stroke is soaring but most countries in the developed world are not in the green zone either. Close to 1.3 million people in China have a stroke each year and 75 per cent live with varying degrees of disability as a result of stroke, according to the World Heart Federation.

Warning signs

Knowing the warning signs of stroke and seeking immediate medical help can improve the outcome of the stroke, however most care-takers and victims are unlikely to distinguish such symptoms from ordinary ailments.

Jacqueline Uwase’s family has suffered the tragedy of a stroke. While her sister constantly complained about headache, the whole family blamed it on fatigue

"It was always hard to determine whether it was just minor headache or a serious condition. All we always said was that she was tired and advised her to take rest. Now she is in a comma,” says Uwase.

Symptoms of stroke appear suddenly and often there is more than one at the same time, but all strokes happen fast.

According to the World Health Organisation, the most common symptom of a stroke is sudden weakness or numbness of the face, arm or leg, most often on one side of the body.

Other symptoms would include confusion, difficulty speaking or understanding speech; difficulty seeing with one or both eyes; difficulty walking, dizziness, loss of balance or coordination; severe headache with no known cause; fainting or unconsciousness.

Causes

Dr Harold R Golberg, a specialist in cardiology in US, told Health Times in an interview that risk factors towards strokes in sub-Saharan Africa are many but hypertension remains the commonest.

"Hypertension is often silent, meaning there are no obvious signs that the blood pressure is elevated. On some occasions elevated blood pressure can manifest itself with headaches as a warning that the blood pressure is elevated, but certainly not always,” says Golberg.

He also adds that a set of other non-communicable diseases are responsible for predisposing people to stroke in the developing world.

"Focus of attention of health organizations should include non communicable diseases such diabetes, obesity among others,” adds Goldberg.

Likewise, stroke is a risk factor for coronary heart disease and strokes are assumed to be common in women than men.

Dr Evariste Ntaganda, the head of cardiovascular diseases at the Ministry of Health, explains that since coronary heart diseases and stroke share many factors resulting form life style habits, the public ought to avoid such habits.

Factors such as "bad” cholesterol levels, low HDL "good” cholesterol levels, high blood pressure, smoking, diabetes, physical inactivity, and being overweight or obese are predisposing factors to these lifestyle diseases,” says Dr Ntaganda.

Unfortunately, studies published in the Journal of Neurology and Psychiatry, suggest that use of anti-retroviral agents is associated with an increased risk of cardiovascular disease, particularly myocardial infarction.

According to the journal, anti-retroviral drugs can lead to premature atherosclerosis by inducing elevations in cholesterol and triglyceride levels, insulin resistance although experts believe further studies are needed to evaluate the effect of anti-retroviral agents on the risk of stroke.

In the event of stroke, however, medics advise that patients seek immediate medical attention. A particular type of stroke can only be identified through a CT scan or an MRI that provides images of the state of the brain.

Recovery during stroke is also possible, but in the event of an attack, experts also advise for close monitoring of patients because patients with depression may be less complaint with treatment.

*************************************

Things you can do to prevent a stroke

Regardless of your age or family history, a stroke doesn’t have to be inevitable. Here are some ways to protect yourself starting today.

- Lower blood pressure: High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. High blood pressure is the biggest contributor to the risk of stroke in both men and women. Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference women can make to their vascular health.”

- Lose weight: Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk.

- Exercise more: Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer. One 2012 study found that women who walked three hours a week were less likely to have a stroke than women who didn’t walk.

- Drink—in moderation: What you’ve heard is true. Drinking can make you less likely to have a stroke—up to a point. Studies show that if you have about one drink per day, your risk may be lower. Once you start drinking more than two drinks per day, your risk goes up very sharply.”

- Take a baby aspirin: The landmark Women’s Health Initiative study found that women over age 65 who take a daily baby aspirin lower their stroke risk. Aspirin helps by preventing blood clots from forming.

- Treat atrial fibrillation: Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart.

Those clots can then travel to the brain, producing a stroke. Atrial fibrillation carries almost a fivefold risk of stroke, and should be taken seriously.

- Treat diabetes: Having high blood sugar over time damages blood vessels, making clots more likely to form inside them. Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

- Quit smoking: Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly.

Don’t give up. Most smokers take several tries to quit. See each failed attempt as bringing you one step closer to successfully beating the habit.

Agencies