Ten things you need to know about STROKE
Stroke has massive global impact
Stroke is the second leading cause of death and the third leading cause of death and disability combined in the world (Feigin VL et al ; Lancet Neurol 2021 ; 20 : 795–820). In every country throughout the whole world, there are many people who are suffering due to the physical and mental disability caused by Stroke.
Stroke is much more disabling than heart or kidney failure
When Stroke is severe, patients can’t eat, speak and walk. Many are wheelchair-ridden or bed-ridden. In contrast, patients who have heart or kidney failure can eat, speak and walk – most of them can continue working, driving and even go for holiday overseas.
What distinguishes Stroke patients from others is the severe impact of the illness on the patients’ quality of life.
You are never too young to get Stroke
10% of Stroke patients are young patients i.e. < 50. (Krishnamurthi RV et al : Neuroepidemiology 2015;45:190–202). This is an important finding as the impact of Stroke is definitely much greater in young patients who are still in the most productive stage in their life. Moreover, the young Stroke patients have significant financial stress as they are working hard to make ends meet and save money for their children’s university education.
Beware of Silent Stroke
Silent Stroke refers to the MRI evidence of Stroke in patients who have no symptoms of Stroke. Silent Stroke occurs during the early stage of Stroke, especially the first 3-5 years. The most accurate way to diagnose Silent Stroke is by performing MRI brain scan. Silent Stroke is a time-bomb – it leads to higher risk of Stroke, Dementia (memory loss) and death. Silent Stroke is common, being reported in 10-30% of the population. The treatment of Silent Stroke is vital as it is a potentially effective way to prevent Stroke.
Stroke is preceded by early warning symptoms
Prior to the onset of Stroke, many patients experience numbness, weakness, slurring of speech which last for about 5-15 minutes. These symptoms subside without any specific treatment, and are known as Transient Ischemic Attack {TIA). Knowing the symptoms of TIA can help in early diagnosis and treatment of Stroke. Unfortunately, most Stroke patients present late to the hospital due to lack of awareness of symptoms of TIA among the general public.
Stroke is diagnosed based on history, physical examination and brain scan
The doctor needs to enquire whether patients have symptoms such as weakness, numbness, blurring of vision and difficulty in speaking. The next step is a thorough physical examination to determine whether the patient has any neurological abnormality.
Subsequently, the patient has to undergo CT brain scan and / or MRI brain scan.
Clot-buster medicine is available
This refers to a “blood-thinner”, a medication which is administered intravenously to “unblock” the blocked blood vessel in the brain. Clot-buster medication helps in improving recovery after Stroke. It is important to know that the clot-buster medication is only effective if given early (less than 4 hours after the onset of symptoms) after the diagnosis of Stroke.
Rehabilitation, physiotherapy and TCM treatment (Acupuncture) are crucial for recovery from Stroke
Rehabilitation, physiotherapy and TCM treatment (Acupuncture) are crucial for recovery from Stroke Rehabilitation refers to the process of helping a Stroke patient to regain the physical, functional and occupational function. Physiotherapy refers to the physical exercise program that helps a Stroke patient to improve the muscle strength, physical mobility and co-ordination of body movement. Acupuncture is now a well-recognized treatment for Stroke which helps in speeding up the recovery process of the brain after Stroke.
Stroke patients need the highest level of empathy
It is obvious that due to their physical and mental disabilities, Stroke patients have a lot of mental and physical stress. Almost all Stroke patients are depressed – which is not entirely their fault.
The best treatment for Stroke is prevention
If we could do our best to prevent Stroke, the Stroke patients would not have to suffer. Prevention is definitely better than cure. Health education is crucial - lifestyle modification to prevent Hypertension, Diabetes and Hyperlipidemia. We can diagnose Silent Stroke and treat them with blood-thinners to prevent Stroke. In addition, MRI brain scan for population screening should be our best way in preventing Stroke.
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