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Business News/ News / Business Of Life/  Fast facts about a stroke

Fast facts about a stroke

Many people do not know the difference between a stroke and a heart attack. Experts explain how they differand the symptoms you should look out for

India has about 1.5 million new stroke cases every year.Premium
India has about 1.5 million new stroke cases every year.


Swaroop Ghosh, a Bangalore-based information technology professional, had the usual packed day at work last year, with back-to-back meetings and a team lunch. After the first couple of meetings, he had a “spongy" feeling in his left leg and saw black spots in front of his right eye. He brushed it aside, thinking he had just been sitting for too long. By evening, he was overcome with exhaustion, could barely walk without support, had lost functionality in the fingers of his left hand and couldn’t control his leg movements.

Ghosh, 43, was having a stroke. But he wasn’t aware of it until he was diagnosed later that night by a doctor who made an emergency home visit. He was admitted to hospital the very next day and made a fast recovery.

Jeyaraj Pandian, professor and head of neurology at the Christian Medical College and Hospital in Ludhiana, Punjab, says: “There is lack of awareness about stroke in India. Most people do not know the difference between a stroke and a heart attack. The simple way to remember stroke symptoms is ‘FAST’. F—sudden drooping or paralysis on one side of Face; A—sudden weakness in one Arm; S—Speech difficulty, in speaking or understanding; T— Time is crucial, act FAST."

The mechanism behind a heart attack and stroke are similar, says Raghunandan Nadig, assistant professor, neurology, St John’s Medical College and Hospital, Bangalore. He explains: “Stroke is the loss of brain function due to disturbance in the supply of blood to the brain, while heart attack is due to the disturbance (blockage of a blood vessel) of blood supply to the heart. But the distinguishing factors are the symptoms. Chest pain, sweating , dizziness and pain in the left arm are some of the symptoms of a heart attack. In addition to FAST, sudden numbness, loss of consciousness, vision impairment and imbalance are some of the other symptoms of stroke."

There are mainly two types of strokes. “If the stroke is due to a block in one of the brain arteries, it causes ischemic stroke. Disturbance due to bleeding caused by rupturing of a blood vessel leads to haemorrhagic stroke. The cardinal risk factors of stroke are diabetes, hypertension, high cholesterol levels, smoking, existing heart disease, obesity, family history of stroke, age," adds Dr Nadig.

In recent years, the incidence of “stroke in the young", that is in people below 45, has increased. Dr Pandian says, “Changes in lifestyle such as less physical activity, eating unhealthy food, stress, undetected high blood sugar and high BP (blood pressure) have led to an increase in stroke cases in young people."

According to Dr Pandian: “All over the world, one in six persons will have a stroke in his/her lifetime. The stroke deaths in India have increased from 350,000 in 1990 to 605,000 in 2010. In India, about 1.5 million new stroke cases occur every year. More than one-third of the patients are left with permanent disability."

Dealing with it

A stroke is caused by disturbance in blood supply to the brain; a heart attack is caused by disturbance in blood supply to the heart

Dr Pandian adds, “Acute care involves management of stroke patients in dedicated stroke units. There are about 55 stroke units in India, most of them in the private sector hospitals in big cities. If the patient reaches within 4 hours of the onset of the stroke, a clot-bursting injection is given (if the stroke is ischemic). This improves the patient’s functional capability and he/she can recover completely."

The most important part of care is rehabilitation. This includes physiotherapy, occupational therapy and, if required, speech therapy. Rehabilitation should be started as early as possible and is primarily done at the patient’s home.

Ghosh, who had a physiotherapist come home regularly for a month, says: “Physiotherapy was the key factor that helped me gain control, strength, balance to become self-sufficient. Since I had lost functionality in my left fingers, simple exercises like picking up matchsticks, rotating the doorknob were prescribed to regain strength and function. I have now regained 95% of my functionalities and am leading a normal life."

“Recovery depends on the severity of the stroke. Strokes can be fatal or cause severe disability. But many recover fully and lead normal lives, although the mental age of a person who has had a stroke advances by five years," says Dr Nadig.

The main focus in the secondary care of a stroke patient is prevention of a second stroke. Dr Nadig says, “Depending on the case history, aspirin, blood thinners, anticoagulants may be prescribed. Some people experience a transient ischemic attack, also called a mini-stroke, where the symptoms last for a short period, usually five to several minutes, and the patient recovers completely. This could a warning sign of an impending major stroke. Such people need to make lifestyle changes and take relevant precautions to prevent a major episode."

Primary prevention

Considering the incidence and severity of the disease, primary prevention is an important public health concern. Recently, the American Stroke Association introduced guidelines for the primary care of acute strokes and for lowering the risk of strokes in women. The guidelines include quitting smoking, undergoing frequent health checks, and taking aspirin as a preventive measure if recommended.

In India, there are no specific guidelines, but one can prevent stoke by following basic health advice. Dr Pandian says: “People above 40 years of age should undergo regular blood pressure and blood sugar checks. A healthy lifestyle, such as eating healthy food, and regular exercise, should be maintained. Smoking and excess alcohol should be avoided. People with diabetes, hypertension or high cholesterol are at high risk and should take respective treatment and ensure the blood levels are under control."

Ghosh sums it up: “It’s important to pace your life, exercise, lead a healthy life and not ignore any warning signs of illness."

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Updated: 05 May 2014, 08:00 PM IST
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