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Can you get a brain stroke?

By Ehtasham Khan
Last updated on: June 24, 2005 19:46 IST
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D id you know that brain stroke, the most common life-threatening neurological disease, is the third largest killer after heart attacks and cancer?

Get these facts:

illustration Fact I: According to an independent study in India, between 100 and 268 persons in a population of 100,000 are struck by brain strokes. About 20 percent of heart patients are susceptible to it.

Fact II: A World Health Organisation study has quoted the incidence of stroke in India to be 73 of 100,000 persons per year.

Fact III: It is also the most common cause of disability and dependence, with more than 70 percent of stroke survivors remaining vocationally impaired and more than 30 percent requiring assistance with activities for daily living.

June 24 is observed every year as the World Brain Stroke Day. Dr Harsh Rastogi, Senior Consultant, Interventional Neuro-Radiology at New Delhi's Apollo Hospital, tell us more.

He has some good news too: brain stroke can now be treated without surgery.

Recognising brain stroke

As compared to a heart attack, the awareness about a brain stroke, which is even more debilitating, is very limited.

People are either not aware of the symptoms of a brain stroke and, if they are, they do not know how to cope with the illness. At one time, it was believed little could be done to treat a stroke.

If a stroke victim receives emergency care within the first three to six hours of the first symptom, the disabling, long-term effects of a stroke may be avoided or greatly reduced.

Unfortunately, many people do not recognise the warning signs of a stroke or do not know that immediate emergency care can greatly improve their chance of recovery.

Studies show that the average person waits 13 hours after experiencing the first symptoms of a stroke before seeking medical care, and 42 percent of patients wait as long as 24 hours.

It is critical to recognise the symptoms of a stroke and seek immediate emergency attention.

What causes a brain stroke?

A stroke occurs when a blood vessel carrying oxygen and nutrients to the brain is blocked by a clot or bursts, causing the brain to starve.

If deprived of oxygen for even a short period of time, the brain nerve cells will start to die.

Once the brain cells die from lack of oxygen, the part of the body controlled by that section of the brain is affected through paralysis, loss of language, motor skills or vision.

2 types of stroke

i. Ischemic Strokes

Ischemic strokes -- which are basically blood clots that block the artery -- are the most common type, causing between 70 to 80 percent of all strokes.

When a blood vessel ruptures, it causes a bleeding or hemorrhagic stroke.

Such strokes are usually the result of a ruptured blood vessel or an aneurysm -- a weakened area of a blood vessel that bulges or balloons out.

Approximately 20 percent of strokes are hemorrhagic. This is the most common type of stroke in young people. Using the latest technology, coils as small as 2 mm can cure strokes without undergoing any surgery.

iiTransient Ischemic Attacks

'Mini-strokes' are known as transient ischemic attacks. People who have one TIA are likely to have another one.

TIAs cause brief stroke symptoms that go away after a few minutes or hours.

People often ignore these symptoms, but they are an early warning sign and 35 percent of those who experience a TIA will have a full blown stroke if left untreated.

TIAs should be taken as seriously as a stroke.

Watch out for these symptoms

The most common symptoms of stroke are:

i. Sudden numbness or weakness in the face, arm and/ or leg, especially on one side of the body.

ii. Sudden confusion, trouble speaking or understanding speech.

iii. Sudden trouble in seeing, including double vision, blurred vision or partial blindness, in one or both eyes.

iv. Trouble in walking, dizziness, loss of balance or coordination.

v. Sudden severe, headache with no known cause.

What are the risk factors for stroke?

If you have the following conditions/ habits you may be at a higher-than-average risk level as far as a brain stroke is concerned.

i. High blood pressure

High blood pressure, or hypertension, puts stress on the walls of blood vessels and can lead to strokes from blood clots or hemorrhage. Half or more of all stroke victims have uncontrolled high blood pressure.

Fortunately, this risk factor can be controlled.

Eating a balanced diet, maintaining a healthy weight and exercising regularly can help control high blood pressure.

Medications that lower blood pressure may also be prescribed.

ii. High cholesterol

High cholesterol can lead to blockage in the carotid artery that takes blood from the neck to the brain. A piece of this plaque can break off and travel to the brain causing a stroke.

iii. Heart disease

Approximately 15 percent of all stroke victims have a common heart rhythm disorder called atrial fibrillation, that causes the upper chambers of the heart (the atria) to quiver instead of beating which allows the blood to pool and clot. If a clot breaks off and enters the blood stream to the brain, a stroke will occur.

iv. Personal history of stroke or TIA

People who have already suffered a stroke or TIA face an increased risk of having another.

Modifying risk factors for stroke, including lifestyle changes (eg exercise, stop smoking), medications and/ or other treatments can reduce this risk.

v. Lifestyle risk factors

Smoking, excessive alcohol consumption and being overweight are all significant risk factors for stroke. 

vi. Age, gender and race

The risk of stroke goes up with age, with two-thirds of all strokes occurring in individuals 65 years or older. Twenty-eight percent of strokes occur in people under the age of 65. Men have a slightly higher risk than women although more women die from strokes.

vii. Family history of stroke or TIA

If others in your family have suffered aa stroke, you may be at higher risk. Regular physical exams, lifestyle changes and medical treatments may reduce this risk.

viii. Diabetes

People with diabetes are at increased risk, although keeping diabetes under control with diet and/ or medication may help to decrease the risk.

ix. Sickle cell anemia

Sickle cell anemia makes red blood cells less able to carry blood to the body's tissues and organs. They also stick to the walls of the blood vessels which can block the arteries to the brain, causing a stroke.

x. Hyper-homocysteinemia

Elevated homocysteine levels in the blood have been identified as a risk factor for heart attack and stroke that may be as important as high cholesterol.

Homocysteine is a by-product of the process that metabolides methionine, an amino acid essential for human nutrition.

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Ehtasham Khan