When stroke strikes

In conjunction with World Stroke Day, we take a quick look at the facts about this fast-striking disease.

  • Every two seconds, someone in the world suffers a stroke.
  • Every six seconds, someone dies of a stroke.
  • Every six seconds, someone's quality of life will forever be changed - he will be physically disabled permanently due to a stroke.

As alarmingĀ as the statistics on the right are, what's more disturbing is the fact that there are real lives behind the numbers - someone's spouse, child, sibling, parent or a friend.

Life expectancy is rising in much of the world, but many people are also choosing lifestyles that contribute to an early death.

People are eating too much, consuming junk food, exercising too little, overindulging in alcohol and smoking. These habits increase the probability of getting a stroke, which may cause death or leave the person permanently disabled.

What is stroke?

A stroke is caused by an abnormality of the blood vessels, which stops the brain from working properly.

It occurs without warning and lasts for more than 24 hours, with or without causing death.

Sometimes called a "brain attack", a stroke happens when the flow of blood to part of the brain is interrupted for longer than a few seconds. Deprived of blood and oxygen, the affected brain cells die, resulting in permanent damage to the brain.

There are two major types of stroke: ischaemic and haemorrhagic.

An ischaemic stroke occurs when a vessel that supplies blood to the brain is blocked.

This may happen when a clot forms in an artery that is already very narrow (thrombotic stroke), or a clot breaks off from another place in the blood vessel and travels up to the brain (cerebral embolism or embolic stroke).

Ischaemic strokes may be caused by arteries clogged by plaques made up of fat, cholesterol, and other substances.

A transient ischaemic attack (TIA) is similar to an ischaemic stroke.

TIAs are caused by a blockage in the arteries supplying blood to the brain, or less frequently, by small bleeds. They are only temporary, and typically last less than two hours. TIAs are also referred to as a "mini stroke".

Meanwhile, a haemorrhagic stroke occurs when a blood vessel in the brain becomes weak and bursts, causing blood to leak into the brain.

Potential victims

Potential stroke victims

A stroke can happen to anyone, but the risk of getting one increases with age.

After the age of 55, the risk of suffering from a stroke doubles for every decade a person is alive. At 45 years of age, the chance of having a stroke in the next 20 years is approximately one in 30.

However, the lifetime risk of stroke is one in four for men, and one in five for women.

Here are some of the common risk factors to watch out for:

  • Hypertension - People with high blood pressure have a higher risk of having a stroke compared to those who consistently have an optimal blood pressure, (See A bit of pressure, a lot of risk)
  • Diabetes - People with diabetes are up to four times more likely to have a stroke, mainly because many people with diabetes have health problems that are also stroke risk factors.
  • Atrial fibrillation (AF) - AF is a condition where the upper chambers of the heart (atria) beat rapidly and unpredictably, producing an irregular heartbeat. AF patients are five times more likely to suffer from a stroke than individuals without AF. Strokes caused by AF are more severe than strokes from other causes.
  • High cholesterol - High cholesterol or plaque build-up in the arteries can block normal blood flow to the brain and cause a stroke. High cholesterol may also increase the risk of heart disease and atherosclerosis, which are both risk factors for stroke.
  • Heart disease and/or atherosclerosis - People who have heart disease or poor blood flow in their legs caused by narrowed arteries are more likely to have a stroke.
  • Family history of stroke - If a family member has had a stroke, everyone in the family has a higher risk of stroke.
  • Lifestyle factors - The chance of stroke is higher in people who lead a sedentary lifestyle and are overweight or obese, drink heavily, smoke or take illegal drugs.

Warning signs and what to do

Red flags

The signs and symptoms of stroke depend on what part of the brain is affected.

Symptoms often develop fast and without warning, which is why it is good to be aware of them, so that immediate medical attention can be sought.

Common warning signs include:

  • A sudden severe headache, which may be accompanied by vomiting, dizziness or altered consciousness.
  • Confusion or trouble speaking and understanding.
  • Paralysis or numbness on one side of the body.
  • Trouble with seeing in one or both eyes.
  • Difficulty in swallowing.
  • Difficulty walking, loss of coordination and balance.
  • Change in alertness, such as feeling drowsy or becoming unconscious.

Use FAST to remember the warning signs:

F for FACE: Ask the person to smile. Does one side of the face droop?

A for ARMS: Ask the person to raise both arms. Does one arm drift downward?

S for SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T for TIME: If you observe any of these signs, seek medical attention immediately.

Initial treatment for a stroke takes place in the hospital.

The sooner you get treatment, the better, as the worst damage from a stroke often occurs within the first few hours.

Your doctor will use a computed tomography (CT) scan or magnetic resonance imaging (MRI) of your head to diagnose the type of stroke you've had.

Treatment for an ischaemic stroke will focus on restoring blood flow, whilst in the case of a haemorrhagic stroke, it will be to control bleeding.

Global, personal burden

A global and personal burden

The World Health Organization (WHO) has identified stroke as having the fourth highest burden of disease worldwide. In Malaysia, stroke is the third largest cause of death.

Stroke is a disease of the elderly, and will affect an increasing number of people as the global population ages.

Of the individuals surviving stroke, around 70% will experience severe disability immediately after, and 30% will still be experiencing severe disability 12 months post-stroke.

Although a stroke takes just minutes or hours to occur, the effects can continue for years, with many stroke survivors left disabled and dependent.

Even with the best medical care, approximately two-thirds of stroke victims will die or be disabled and dependent on others for the rest of their lives.

Recovery from stroke is a lifelong process. While some stroke survivors are able to return to life as before, some others will continue to need specialist care in order to regain lost skills and reduce long-term disability.

Patience, perseverance and support from loved ones are crucial in the journey to recovery.

The devastation of a stroke is all the more disheartening when we know that many stroke cases are preventable.

One in six people are at risk for stroke, and it could be you or a loved one.

Help protect yourself and your loved ones from the assault of stroke - arm yourself with essential life-saving information, know your personal risk factors and the warning signs of stroke, and lead a healthy lifestyle.

I would like to leave you to ponder on a quote by Professor Hilton Hotema, a 20th century American alternative health writer:

"The consideration of man's body has not changed to meet the new conditions of this artificial environment that has replaced his natural one.

"The result is that of perceptual discord between man and his environment. The effect of this discord is a general deterioration of man's body, the symptoms of which are termed disease."

Let us all come together to acknowledge the very real and looming threat of stroke by take positive actions now.

Remember, the impact of stroke reaches beyond the patient - it includes the family, society and the nation.

The good news is that stroke is a preventable disease. Choose to prevent it today.