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Magazine
HEALTH
On a red alert
DR. V. GURUMOORTHY
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Immediate treatment can prevent much damage when a stroke strikes.
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A stroke occurs when a blood clot or a fatty plaque blocks an artery (ischaemic stroke) or when a blood vessel leaks or ruptures, interrupting blood flow (haemorrhagic stroke) to an area of the brain. Ischaemic strokes are more common. About 60 per cent of blocks in the brain are caused by emboli or blood clots that travel to the brain after forming elsewhere, typically in the heart or great vessels.
Impending stroke
A Transient Ischaemic Attack (TIA), a miniature stroke, is similar to a major stroke in every way. Both are caused by ischaema or blocked or severely restricted blood flow. TIAs last for a few seconds, minutes or hours, mostly disappearing spontaneously. TIAs, by definition, disappear within 24 hours; in contrast, symptoms of a major stroke last longer and are often permanent.
TIAs are not to be brushed aside lightly and forgotten. Of course, they fade away; yet, trouble still lurks. These mini strokes should be treated with the same sense of urgency and emergency, as imminent signs of a heart attack.
TIA may herald an impending stroke. One in three, who have TIA, goes on to have a full-blown stroke sometimes within the next day or two. Up to one in five sustain slight but permanent brain damage. An episode of TIA should prompt a detailed search as to what caused the block and plan to prevent its recurrence.
One of the most feared complications of high blood pressure is a stroke. Blood pressure tends to rise with age. About 10 per cent of 30-year-olds have high blood pressure, whereas around 75 per cent of 75-year-olds have it.
A healthy blood pressure is 120/80 mm Hg or below. The chances of having a stroke or heart attack doubles with each increase of 20/10. Even with a seemingly normal BP of 135/85, the risk increases twice. Controlling blood pressure is the number one way to severely limit stroke incidence and to maintain arterial health.
“A man is as old as his arteries.” This 17th century axiom still runs true. A man’s health is only as good as his arteries. Advancing age takes a toll on arteries and, as years pile on, the arteries become stiffer, stickier and narrower. The all important innermost layer of the blood vessels, the endothelium, undergoes changes in its nature, structure and function.
Prevention tips
To arrest and reverse this relentless march, the essentials rules are: Physical activity through the day; exercising regularly; no smoking; normalizing blood sugar and lipid profile; limiting alcohol intake to responsible levels; avoiding excess stress and intense anger; a diet, low in salt and fats but rich in fruits, vegetables and whole grains; avoiding being overweight, obese and increased waist circumference; above all, keeping blood pressure in the normal zone.
In an ideally equipped stroke care centre with expert personnel, the chances of recovery increase tremendously with early detection and intervention. Availing of treatment at the earliest is vital.
“Newer drugs to dissolve clots and arrest bleeding, innovative brain imaging, effective interventional procedures to flatten the obstructing plaques and to open the infarct-related vessels and to pinch the bleeding vessel with clips and coils, uncorking a blocked artery with a mechanical clot retriever, neuro-protective strategies …”
Golden hour
Despite all these advances, the outcome of a completed stroke is rather gloomy, due to delay in recognition and reporting.
Only 10 per cent of ischaemic stroke patients receive the clot-busting drug, called tissue plasminogen activator (tPA) in time. This all-important drug is most effective when given within three hours after the onset of an episode. With delay, this window of opportunity closes.
Given the dismal treatment outcome of completed full-blown strokes, prevention proves the best form of therapy. Nearly 80 per cent of strokes can be effectively prevented by healthy lifestyle changes and periodic health checkups.
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Warning signs
Weakness or loss of strength
Heaviness, clumsiness; inability to move arm or leg,
Loss of sensation or numbness especially on one side
Slurred speech or other difficulties in speaking or difficulty in understanding others’ speech
Difficulty in seeing, impaired vision or double vision
Difficulty in hearing
Difficulty in walking, unsteadiness, loss of balance or co-ordination
Inattention, confusion, fainting, dizziness, loss of memory and orientation
Severe headache
Brief loss of consciousness or a spell of decreased consciousness
Convulsions
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Easy ways to identify the onset of a stroke.
On smiling, one side does not move as much as the other, resulting in a droop or a crooked smile.
When arms are extended straight out in front, one arm starts drifting down within a few seconds.
Even with simple familiar statements, the words begin slurring, some words are wrong or there is an inability to speak.
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