STROKE – A KILLER, MINI-STROKE – A WARNING

 

 

I usually buy fish from a fish-seller whom I have known since my childhood. You can say that we grew up together and my father used to buy fish from his father. One morning I noticed that there was something unusual about him, he was not speaking clearly and when I noticed carefully he had a paralysis of the right side of face. When I asked his son he said that this occurred on the previous night. I prevailed upon him to take his father to the hospital immediately as he was having a stroke and his life is in danger. He immediately arranged for the transport and we admitted him to our hospital. Sure enough a CT scan revealed the cause of stroke and he remained in hospital for 2 weeks. He is now recovering at home and is still not completely normal, and we do not know whether he will ever be again, but what we know is we could have helped him better if he was admitted the evening he had his symptoms.

A stroke is a disruption in the blood flow to the brain that causes rapid cell death, ending in death, coma, or physical and mental disability. Around 75% of stroke survivors are disabled to some degree, as the damage to the brain during the stroke hampered their ability to move or communicate.

 

Types of Stroke: There are two types of stroke - ischemic and hemorrhagic.

1.      By far the most common type of stroke, an ischemic stroke is caused by loss of blood flow to the brain, typically due to a clot in the arteries.

2.      Hemorrhagic strokes are far less prevalent at only 15% of strokes, but they are far deadlier, accounting for around 40% of stroke deaths. They are caused by damage to a blood vessel in the skull, resulting in internal bleeding in the brain or the meninges, the coverings that envelop and protect the brain.

 

What is a Mini-stroke or TIA?

Transient ischemic attack (or simply TIA): it occurs when the blood flow is temporarily cut off to a part of the brain.  It usually resolves within a day and does not inflict lasting damage to the brain. If you or someone you know is experiencing symptoms of TIA, never turn a blind eye and get urgent medical help.

During a mini-stroke, the blockage of the blood vessel in the brain is brief enough and it doesn’t cause lasting damage to the brain tissue. In a stroke, blood flow is cut off long enough for such damage to occur. Due to this causal similarity, the signs and symptoms of TIA are identical to that of stroke. However, the duration of symptoms is different. In a mini-stroke, the neurological symptoms last anywhere from a few minutes and up to 24 hours. The symptoms and complications of a stroke last for a day or more and may never clear up.

All things considered, a mini-stroke should always be treated as a stroke because only a doctor can distinguish between the two and administer proper treatment. If you or someone you know is experiencing any of these symptoms, seek immediate medical attention. If the symptoms go away by the time the doctor arrives, describe your symptoms and ask for a more thorough evaluation. Those diagnosed with a mini-stroke in the past should never disregard it because TIA can signal an imminent stroke. More than a third of people who have a TIA and don’t get treatment have a major stroke within 1 year. It is estimated that as many as 10% to 15% of people will have a major stroke within 3 months of experiencing a TIA.

 

The causes of TIA

TIAs and stroke have the same root cause — a blood clot blocking a blood vessel in the brain. This usually occurs as a result of:

Embolism - a blood clot travels from another part of the body (e.g. the heart) to the brain.

Atherosclerosis - fatty plaque builds up in a blood vessel, obstructing blood flow.

 

 

What puts you at risk of TIA?

A number of factors increase the risk of stroke and mini-stroke, and not all of them are under our control.

Not in our control

1.      Age : the risk of TIA and stroke increases with age

2.      Sex: Women are also more likely to experience a mini-stroke and stroke than men

3.      Diabetes sufferers are more likely to experience TIA and stroke than non-diabetics.

4.      Those suffering from high blood pressure are at a high risk of atherosclerosis and therefore mini-stroke and stroke too.

 

In our control:

1.      Not enough physical activity can contribute to TIA and stroke.

2.      Smoking - cigarette smoke damages the cardiovascular system, which raises the risk of mini-stroke and stroke.

3.      High cholesterol - a diet high in trans fat and saturated fat (fatty cuts of red meat, fast food, and anything fried) makes your levels of LDL “bad” cholesterol surge, which then raises the risk of ministroke and stroke.

4.      Poor control of Diabetes and high blood pressure

 

What can you do if someone nearby is having a stroke?

Symptoms of mini-stroke and stroke tend to arise suddenly and unexpectedly, and you need to act fast and call an ambulance as soon as possible. The word “FAST” also helps you remember the things you should pay attention to if you suspect a stroke:

Face - look at the person and ask them to smile. If one of the sides of the face droops, that points to a stroke.

Arms - ask the person to raise their arms. If the arms are uneven and one arm drifts downward, that is a sign of a stroke.

Speech - make the person repeat any simple phrase. Unorganized, strange, or slurred speech is a symptom of stroke.

Time - If you notice any of these symptoms, call your local emergency service immediately.

 

Common symptoms include:  

•    Feeling numbness in the face or limbs, particularly on one side of the body

•    Sudden trouble seeing with one or both eyes

•    Problems associating language (either written or spoken) with meaning

•    Difficulty speaking or forming meaningful words

•    Losing balance and coordination

•    Dizziness

•    A severe, inexplicable headache  

 

Additionally, these symptoms are specific to women:

•    Nausea and vomiting

•    Seizures

•    Hiccups

•    Labored breathing

•    General weakness and pain

•    Loss of consciousness

All stroke symptoms tend to appear suddenly and in full force.

Treatment and Prevention of TIA

A patient who has experienced TIA will undergo a thorough medical examination with the goal to identify the root cause of the issue and prevent a future stroke. A neurological examination, brain imaging, and blood tests will most likely be required to diagnose the issue.

The treatment will depend on the results of the medical examinations, but it nearly always involves changing your lifestyle to manage atherosclerosis and prevent a future mini-stroke and stroke. You can follow the same tips to prevent TIA:

1. Seek medical help to manage high blood pressure, diabetes, or high cholesterol if you suffer from any of these conditions.

2. If you smoke, it’s necessary to stop. If someone in your household smokes, avoid secondhand smoke.

3. Consume antioxidant-rich fruits, vegetables, and whole grains and avoid foods high in trans fats and saturated fats.

4. Be physically active and exercise on a regular basis.

5. Limit your alcohol consumption as much as you can.

Promptness in the management of Stroke is non-negotiable. If you forget everything that I have mentioned just remember FAST - Face, Arms, Speech and Call for help!