Stroke is an acute, dramatic loss of function of one or more parts of the body. This occurs due to sudden cessation of the blood supply to 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 most common form of stroke, there is paralysis of limbs of 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, e.t.c. 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. Due to ignorance, many myths prevail regarding stroke. For the onlooker, stroke is very frightening. The innocent often consider it to be witchcraft done by somebody and spend their time going to, “witch doctors”. The paralysis of one or more limbs is considered by some to be a form of, “rheumatism.,” which is not true. Rheumatism is a condition of pain and inflammation of the joints. Here an individual is unable to move his limbs due to severe pain but strength of limbs is maintained. Many people gather half knowledge about it from the internet and form their own impressions. Once the spouse of a stroke patient was arguing with me, that though her husband was given aspirin and other anti clotting drugs, within an hour, why the paralysed limbs did not recover. Actually, 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. Use of alcohol and smoking are also risk factors. Diagnosis is made clinically. Scans of the brain can show whether a blood vessel is occluded or has bled and part of brain affected. Treatment is initiated immediately to prevent further injury. This includes drugs to prevent clot. Surgical interventions are done where possible to open the occluded vessel. 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 learn from a professional and do passive exercises of paralyzed limbs of patient at home. All is needed is slow and smooth movements of the paralysed limb in all directions. The number should be increased gradually. Good nursing care is important to prevent bed sores and other infections in a physically helpless person. It is vital for people to know about the true facts regarding stroke. As soon as a person develops any signs he should be taken to nearest medical centre. Dr Rachna Pande is a specialist in internal medicine.
