Stroke, a major non-communicable disease, occurs when the blood supply to a part of the brain stops, or a blood vessel in the brain bursts. It can cause brain damage, disability, or even death.
According to the Global Burden of Disease Study 2016, stroke is the second leading cause of death worldwide; 5·5 million deaths were attributed to stroke in 2016. According to the Ministry of Health and Family Welfare (MoHFW), stroke is responsible for 3.5% of disability adjusted life year (DALY) in India. It says the incidence of stroke is about 116-163 per 100,000 population, according to some studies.
“Stroke, the sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is lost by blockage or rupture of an artery to the brain, is a leading cause of dementia and depression,” says the World Health Organisation (WHO).
Here are some of the most important things everyone should know about stroke:
1. Risk factors
According to the American Stroke Association, high blood pressure, diabetes, smoking, a lack of physical activity, obesity, high blood cholesterol are all risk factors for stroke. However, these can be controlled; managing these conditions can lower your risk of stroke as well as heart disease in general.
The organisation also says that carotid artery disease, wherein the carotid arteries in the neck which supply blood to the brain, are narrowed by plaque buildup, can cause a stroke. Peripheral artery disease (PAD), which causes the blood vessels that carry blood to the arms and leg muscles to narrow because of fatty buildup, raises the risk of stroke as well.
Age, race, gender, family history are the risk factors that cannot be controlled. Women have a higher risk of stroke and are more likely to die from it. “Factors that may increase stroke risks for women include pregnancy, history of preeclampsia/eclampsia or gestational diabetes, oral contraceptive use (especially when combined with smoking) and post-menopausal hormone therapy. Be sure to discuss your risks with your doctor,” says the American Stroke Association.
Women have a higher risk of stroke and are more likely to die from it. “Factors that may increase stroke risks for women include pregnancy, history of preeclampsia/eclampsia or gestational diabetes, oral contraceptive use (especially when combined with smoking) and post-menopausal hormone therapy.
2. What happens during a stroke
When the flow of blood is blocked to the brain, brain cells start to die from a lack of oxygen. “It is important for you to know that every minute (after a stroke) 1.9 million neurons are lost in the brain. Patient with a stroke is to reach the hospital as soon as you can,” says Dr. Chandril Chugh, senior consultant and head, interventional neurology.
There are primarily two types of stroke: Ischemic and hemorrhagic. In an ischemic stroke, blood vessels are blocked by blood clots or other particles. It can also be caused by plaque buildup. In a hemorrhagic stroke, a blood vessel bursts in the brain. There is also Transient Ischemic Attack (TIA) or a mini stroke, which is caused by a temporary clot.
Dr. V. P. Singh, Chairman, Institue of Neurosciences, Medanta – The Medicity discusses the types, symptoms and treatment for stroke in this video.
3. Learn the F.A.S.T warning signs for stroke
F.A.S.T is the easiest way to remember the most important symptoms of stroke.
F: Face drooping (One side of the face drooping or numb, inability to smile, or a lopsided smile)
A: Arm Weakness (Numbness or weakness in arms)
S: Speech (Slurring in speech or inability to understand and speak)
T: Time (Time not to be wasted, should act fast for the treatment)
Additionally, patients may also present symptoms like sudden weakness in one side of the body, trouble in speech or understanding, sudden trouble in seeing, walking, loss of balance, or a sudden severe headache.
4. Time matters when it comes to stroke treatment
It is important to reach the hospital as quickly as possible when someone suffers a stroke. Ischemic and hemorrhagic stroke have different kinds of treatment, but the key is rapid diagnosis, so that brain damage can be reduced.
“In a patient with blocked blood vessels, they can be given intravenous medication to dissolve the clot, in some cases the same can be achieved by using catheters to go inside the brain and take the clot out, which will improve the outcome of the patient,” says Dr. Chugh.
Stroke also has long lasting physical and emotional changes. Some patients need speech, physical, and occupational therapy as part of their rehabilitation.
5. Stroke impacts more people in low- and middle-income countries
The WHO says that almost 70% of strokes are reported in low- and middle-income countries. The incidence of stroke in these countries has doubled in the last four decades, and declined by nearly a half in high-income countries. “On average, stroke occurs 15 years earlier in – and causes more deaths of – people living in low- and middle-income countries, when compared to those in high-income countries,” says WHO.
- The global burden of stroke: persistent and disabling. Philip B Gorelick.
- Centre for Disease Control and Prevention (CDC)
- Guidelines for Prevention and Management of Stroke. Directorate General of Health Services Ministry of Health and Family Welfare Government of India 2019.
- American Stroke Association.