Stroke

About

'Stroke' is a moniker that strikes fear in the mighty and the meek alike.

Many of us have seen or heard about people whose lives have been devastated by a 'Stroke'! Maimed for life, these individuals exist in a twilight zone, suspended between life and death. What is Stroke? Its early warning signs, risk factors and how to rehab and treat these patients.

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Stroke is a cerebrovascular accident that occurs when blood supply to a part of the brain is disrupted leading to brain cell death. When blood supply to the brain is compromised, it experiences a shortage of oxygen and glucose.

Typically there are two types of stroke-Ischemic and Hemorrhagic. The former is the most prevalent type (88%) and occurs due to a clot in an artery supplying blood to the brain. The latter (12%) is caused by a leak in a blood vessel supplying the brain. This results in profuse bleeding inside the brain.

Early warning signs of stroke are important to recognize as they are often missed. These include -

1. Sudden weakness of -

• facial muscles
• Arm
• Legs

2. Sudden difficulty with speech

3. Sudden loss of vision

4. Loss of co-ordination

5. Sudden, severe headache for no apparent reason

6. Unexplained dizziness

Every second is important and seeking help early can prevent permanent damage from occurring.

Transient Ischemic Attack (TIA) also known as "mini stroke" results from a temporary cessation of blood supply to a limited part of the brain. This results in a short -term neurologic dysfunction that lasts for, approximately, less than 24 hours. If the symptoms exceed the cut- off time the episode is classified as a stroke.

In the United States, stroke is the third largest cause of death after cardiovascular diseases and cancer. There is a lot of money being spent in taking care of stroke patients.

Indian Council of Medical Research estimates that by 2015, India will report 1.6 million cases of stroke every year and WHO warns that by 2050, 80% stroke cases in the world would come mainly from India and China and will occur among lower and middle income groups. An estimates in 2004 showed that there were 9.3 lakh cases of stroke and 6.4 lakh deaths due to stroke in India and most belonged to age group below 45 years. It was also estimated that if deaths and disability were counted together, then India lost 63 lakh of disability-adjusted life years in 2004.

If the stroke patient is 50 years or above, age-related factors such as hypertension, increased cholesterol and diabetes are suspected to be the triggers. If the patient is young, a genetic predisposition to the condition may be considered.

Typically the early signs of stroke are weakness, tingling sensation, slurred speech, abnormal gait, an inability to balance and difficulty in swallowing. The ultimate blow is the paralysis that sets in on one side of the body.

A person who has suffered a suspected stroke must get emergency medical aid. Administering clot-busting drugs, like the TPA, can minimize complications, but it requires that the drug be administered without delay.

Stroke often debilitates the sufferer, if they have succeeded in surviving it. The quality of life is often compromised in these patients. Some escape with minor abnormalities, like slurred speech or mild facial deformity. It is not surprising that many of them suffer from depression. Rehabilitation of the stroke patients may not be at its best in home surroundings and may require specialized attention.

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