stroke information for OCTOBER stroke awareness month

Stroke
Stroke is the acute and dramatic interruption of the blood supply to the brain or hemorrhage into brain tissue. Stroke is now an important and a leading cause of death in most countries. In America, approximately 500,000 strokes occur each year. The estimate for Nigeria is around 200,000. Of these about 70% die within a year and the rest are often disabled. Stroke causes significant disability and death in many countries and places a huge financial burden on health services. This is estimated at £2.318 billion costs to the National Health Service in the United Kingdom for 1995-6 alone. In Nigeria, the impact on the local economy and the financial burden of stroke has not been estimated. The costs are both physical and material; the social effects often devastating. Costs are often borne by individuals and families.
Can you afford to have a stroke?
Stroke is a major life changing event. It is sudden, happens out of the blue and brings about unexpected changes. It can lead immediately to death or permanent disability. The effect on the individual and the family can be long lasting. Many stroke patients die or suffer untold misery. Stroke can blight even the most resourceful family and bring untold misery with possible financial ruin. Many families are decimated due to stroke with the loss of a bread winner. Even if a breadwinner still exists within the family unit, the resources are expended on the sick relative.
No two strokes are the same and the experience is individual. Nobody else can understand the impact on an individual or a family. For the individual nobody else knows what it is like for YOU to have had a stroke. The effects can be mild, minor or devastating. The disability can range from or be a combination of different deformities and disabilities. These could include blindness, confusion and mental incapability, loss of speech and use of language, depression, loss of identity, anxiety, helplessness, loss of a limb with functional disability, dependency, sleeplessness, loss of control and dignity. The high social and economic burden of stroke, on individuals, families, societies and the nation, calls for effective strategies for prevention, treatment, and rehabilitation. Currently, in Nigeria, there is little or no support for stroke victims and the poor medical infrastructure is unable to provide effective rehabilitation. Prevention is therefore very important.
What you need to know about stroke?
Remember the symptoms of a stroke are sudden weakness of an arm or a leg, difficulty with speech, problems with walking, sudden blindness in one eye, confusion and headache. The symptoms can be short lived, they can come and go: each episode lasting for minutes to hours or a day (transient ischemic attack: called T.I.A. or mini stroke). If you or a relative has any of these symptoms, you need to react FAST. Do not hesitate. Do not ignore this type of symptoms as they may herald a bigger stroke which could become permanent and devastating. "Brain attack!" is a term used to describe the acute presentation of stroke, which emphasizes the need for urgent action. The concept of "brain attack" is very important to sensitize physicians and the public to the need for rapid mobilization and early treatment of stroke patients. This approach of treating stroke as an emergency requires educational programs directed at the general public, general practitioners, and primary and emergency department physicians. It helps to teach the early recognition of stroke symptoms and the importance of treating stroke with the same urgency as for heart attack. The longer the delay before active and effective therapy, the more brain tissue is lost by the patient. Remember the saying, 'time is brain'. If you waste time and delay in getting effective help, you lose brain. It has been estimated that someone whose brain is starved of oxygen for an hour ages by 3.5 years.
Most basic studies show that to be effective, acute intervention to restore blood to the brain must take place within a few hours. Damaged brain and the surrounding 'at risk' brain need to be protected as soon as possible. Doctors have a duty to evaluate a stroke patient rapidly, investigate astutely and prescribe effective medication within 1-3 hours of the event or within the first hour of arrival in hospital. Most people do not present to the doctor in time and this delay could be very costly. Many ignore the early warning signs of stroke. Do not go to bed and hope it will go away by the time you wake up. You may not wake up. Act FAST, if you think someone may be suffering a stroke.
What is FAST?
FAST requires an assessment of three specific symptoms of stroke:
Facial weakness - can the person smile? Has their mouth or eye drooped?
Arm weakness - can the person raise both arms? Is one arm or leg weak?
Speech problems - can the person speak clearly and understand what you say?
Time to call or go straight to the hospital. If the person has failed any one of these 3 tests written above, you must act fast. Stroke is a medical emergency. Do not delay. Ensure that it is investigated by a competent doctor. This is vital information. Do not ignore it even if the symptoms resolve. This can happen and it's called Transient Ischemic Attack or TIA for short. This is actually a warning sign of an impending major stroke. This is the time to take action to prevent stroke. Getting help early may prevent a further stroke or lessen brain damage thereby limiting its effects on the person. About a third of patients with a TIA suffer a major stroke in the near future. Note that the symptoms are similar to a stroke but wear off within 24 hours and sometimes in minutes. Temporary blind spots or a curtain covering the vision, difficulty in talking, numbness, tingling or weakness of the face or down one side of the body are all signs of TIA. Many strokes can be prevented by heeding the warning signs and treating underlying risk factors.

The types of stroke
There are three types of stroke and hundreds of different underlying causes. The three types are called ischemic stroke, haemorrhagic stroke and subarachnoid haemorrhage. Strokes are either due to obstruction of the blood supply to a part of the brain or rupture of the blood vessel leading to a blood clot forming within the brain. It can be devastating as discussed earlier.
What can you do to prevent a stroke?
Life style modification is the key preventive strategy to prevent stroke. Be aware of the various risk behaviours that can lead to someone developing a stroke. These are bad habits such as smoking and indulging in too much alcohol. Bad diets lead to high blood pressure and obesity. High blood pressure and high blood cholesterol are closely related to excessive consumption of fatty, sugary and salty foods. They become an even more lethal combination when combined with tobacco and excessive alcohol consumption. Be careful with having too much of a good life! It might become very short lived.
Cigarette smoking should be avoided by all and especially by patients following a stroke or TIA. Excessive alcohol should also be eliminated. Eating fruits and vegetables can help prevent cardiovascular diseases. Reduction of salt intake is an important message for the population at risk of a stroke. Salt reduction leads to reduction in high blood pressure and risk of stroke.
Physical inactivity causes about 15% of diabetes and heart disease. The American Heart Association recommends 30-60 minutes of exercise 3-4 times per week.
Walk, run, jog, exercise, play, dance, just do something! Stay alive.
Stroke is preventable and this article sets to tell you how. Dr. Ajayi (Federal Medical Center, Ido-Ekiti, Nigeria) found that patients who recognize their increased risk of stroke are more likely to engage in stroke prevention practices than those who do not. Perception about stroke among the 'at risk' population in the study indicates that more health education both at the community and the hospital is very vital to reducing the prevalence, recurrence, disability and mortality of stroke.
Knowledge is power. This is true and more so with stroke. The emphasis is on primary prevention and empowerment. We implore you to become an avid reader of stroke articles in newspapers, books and online. We beg you to discover a knowledgeable doctor or nurse who can help you unravel the medical mysteries and myths surrounding stroke. We beseech you to identify a doctor close to you who can provide effective and timely care for you when and if needed. Please discuss stroke with your local health provider and identify ways you can improve stroke care within your particular community. They should share accurate and current information on stroke care with you and empower you with tools to support you in your daily activities: to prevent you or your loved ones from having a stroke. Health providers are enjoined to communicate information about stroke risk to their patients.
October has been designated stroke awareness month by the World Stroke Organisation. We are using this forum to promote stroke awareness in Nigeria.
Learn about stroke. Teach someone else about stroke. Save lives.