World Stroke Day: Dr Chandril Chugh Answers Your Questions
On World Stroke Day, Dr Chandril Chugh answers frequently asked questions on stroke or brain attack.
For ages we have known that prevention is better than cure, it holds true even for stroke. Stroke or brain attack is preventable and is a lifestyle associated disease like most other diseases that we suffer from nowadays. So in a way Stroke is a matter of choice and you can choose to prevent it.
In majority of cases stroke is the end result of years of wrong diet and an unhealthy life style. If we can change our diet and lifestyle majority of strokes can be prevented. Some of us are prone to having a stroke due to genetic causes and that is a totally different topic altogether. Preventing a stroke is not rocket science it’s simple and can be done easily.
Dr. Chandril Chugh, Senior Consultant & Head, Interventional Neurology, Max Super Speciality Hospital, Saket answers frequently asked questions on stroke.
What is Brain Attack or Stroke?
Sudden loss of brain function is known as brain attack or stroke. Brain attack can be due to a blocked vessel (medically known as an ischemic stroke) or due to ruptured blood vessel (medically known as a hemorrhagic stroke or a subarachnoid haemorrhage).
Is it an emergency?
What does it cause and what happens it brain attack or stroke is not treated?
Stroke may cause one or more of the following symptoms: weakness and numbness on one side of the body, difficulty in speaking and understanding words, drowsiness, loss of vision, severe headaches and sometimes even death. Symptoms depend on which part of the brain is affected. If not treated in time the weakness and other neurological deficits may become permanent and extremely disabling.
How do you recognise stroke?
Remember the 7s method to diagnose stroke:
1. SUDDEN (symptoms usually start suddenly)
2. SLURRED SPEECH (speech is not clear, as if drunk)
3. SIDE WEAK (face, arm or leg or all three can get weak)
4. SPINNING (vertigo)
5. SEVERE HEADACHE
6. SIGHT (loss of vision)
7. SECONDS (note the time when the symptoms start and rush to the hospital)
How bad is stroke?
If I were to say stroke is really bad, you will probably not believe me. Luckily, some studies have made my job easier. According to a study done by researchers in 2006 in USA, a patient with ischemic stroke loses 190,0000 brain cells every minute, about 14000,000,000 nerve connections are destroyed every minute and 12 km (7.5 miles) of nerve fibers are lost every minute. The end result is the patient is paralyzed for life and becomes dependent. That’s pretty scary.
Is there any treatment for stroke?
Yes. The treatment depends on which kind of stroke the patient has. Up to 85 % of all strokes are ischemic (blocked blood vessel). For ischemic brain attack, there is an option of intravenous medication called TPA (recombinant tissue plasminogen activator) available which can be given to the patient within first 3 to 4.5 hours of the symptom onset. The patients who have a blockage in a large blood vessel can be offered a procedure called mechanical thrombectomy (can be done up to 24 hours, but sooner the better!), which involves removing the blockage in the blood vessel and restoring the blood supply. This procedure is done through a small nick in the groin and there is no open surgery involved. Recent trials have shown that patients do exceedingly well post mechanical thrombectomy and have a greater chance to live life independently.
What is the single most important factor in stroke care?
The most important part of stroke care is not the doctor or the hospital, it’s the patient! As most of the strokes are painless, patients tend to ignore their symptoms and hence delay the treatment. If the patient and the family are aware of stroke symptoms they can reach the hospital in time and can get treated.
How many patients are able to get stroke care in India?
There is about 1.2 million to 1.5 million strokes in India every year. If you consider the entire population of patients who suffer from stroke then less than <1% patients are able to get stroke treatment in our country. For the patients who are able to reach the hospital in time less than 10 % are able to receive the treatment.
What is the stroke mortality rate?
Worldwide, stroke is the 2nd leading cause of death. More than 2/3rd of the patients with large stroke don’t survive beyond the first year.
What are some ways to prevent stroke?
1. High Blood pressure: The single most important thing that anyone can do to prevent stroke is to control their blood pressure. The easiest way to control blood pressure is through exercise and diet and if needed medications. Normal blood pressure is less than 120/80 mm hg anything higher should not be ignored.
2. High Cholesterol: Second amongst the usual suspects is cholesterol. One easy way to manage cholesterol is to increase fruits and vegetables in the diet andavoid fried foods. Consuming healthy fats from nuts (almonds or walnuts), fish oils and oils like olive oils and flax seed oil is also beneficial. If diet doesn’t work then medications can come to rescue.
3. High Sugar: Sugar beyond the normal values is not good for the body not just the brain. It is important to realize that, and eliminate or at least limit the intake of sugary foods like cold drinks, juices, cookies, biscuits, chocolates,sweets etc. One 500 ml bottle of cold drink contains about 55 gm of sugar which is equivalent to 11 teaspoons of sugar. You can aptly call it the Devil’s drink, it’s not going to do any good to you.
4. Smoking: The smoke that travels through the lungs into the blood and then circulated throughout the body mixed with blood is known to make the blood sticky and cause strokes. Stay away from smoking and keep your blood flowing. There are two kinds of people who don’t smoke, the healthy ones and the ones who are paralyzed due to stroke.
5. Diet: My advice for diet is simple, you can eat anything that comes out of the ground( fruits, vegetables) is white (low fat milk) or sometimes pink( fresh fish or lean chicken) stay away from anything that comes out of a box, plastic packet or a bottle.
6. Exercise: A good diet with regular physical exercise is the secret to good health. If you follow this routine you will not have to worry about the first three points of the discussion.
7. Doctor: The last piece of stroke prevention puzzle is the doctor. “Your brain is the Ferrari of your body, and you don’t take your Ferrari to a road side mechanic” Choose wisely.
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