Stroke happens to be one of the top-most killers in the world and India is no exception. The country suffers from a leaping burden of stroke. The stroke prevalence in various parts of India ranged from 44.29 to 559/100,000 persons over the last two decades. In the same duration, the cumulative incidence of stroke in India ranged from 105 to 152/100,000 persons per year, affecting a hundred thousand lives. 

When a stroke occurs, the brain stops getting the blood it needs. As a result, the risk of brain damage increases leading to disability or even death. To avoid fatal consequences, one must be aware of the ways by which stroke can be identified easily. 

Since stroke can happen to anyone at any time, awareness and prevention are the best ways to minimize the risk and damage of a stroke. The FAST test can be very helpful in checking for the most common symptoms of a stroke. 

F: Face Drooping 

A: Arm Weakening

S: Speech Difficulties 

T: Time 

One can easily identify these signs if one notices a side of the face drooping while smiling, it is indicative of a stroke. Next, when you raise both arms and one arm drop down, it is time to do a stroke check. When you speak and experience a slurred or strange speech, it may hint at an upcoming stroke attack. And, time plays a pivotal role in treating strokes. If you are facing any of the above symptoms, you must not delay and immediately get in touch with a doctor or rush to your nearest stroke ready hospital. It is ideal to get an ambulance as it is equipped to give the basic first aid treatment you need as early as possible. 

In times of stroke, it is important to seek immediate medical attention. It is vital to identify hospitals with a well-equipped emergency stroke-ready infrastructure and facility and reach as soon as possible and within the golden hour (0 to 3/4.5 hours). Also, it is important to create awareness by putting sharing proper educative materials on the signs of stroke and people going for native and unscientific treatment, the alternative method of treatment of stroke is important. 

Warning signs to watch out

Apart from the FAST technique, it is also important to be aware of the warning signs of the stroke to detect it at the earliest and get it treated. The stroke may happen but one is likely to experience one or more than one symptom like:

• Numbness or weakness in your face, arm, or leg, especially on one side
• Confusion or trouble understanding other people
• Difficulty speaking
• Trouble seeing with one or both eyes
• Problems walking or staying balanced or coordinated
• Dizziness
• Severe headache that comes on for no reason

In case you are having the above symptoms, it is wise to get in touch with the doctor even if you are not sure whether you are having a stroke. 

Risk factors of stroke

The various risk factors of stroke include high blood pressure, diabetes, heart and blood vessel diseases, high LDL cholesterol levels, infections or conditions that cause inflammation like rheumatoid arthritis and smoking. Age and gender also play a crucial role. The risk of stroke is higher among babies who are less than a year old and for adults the risk increases with growing age. At younger age, men are more prone to stroke. Women who use birth control pills or hormone replacement therapy are at a greater risk of stroke. Women may also suffer from stroke during pregnancy or immediately after giving birth. The other risk factors are race, ethnicity and family history. 

Preventing Stroke  (Prevention is better!!)

Lifestyle modification plays an important role in stroke prevention. Eating a healthy diet, stress management, regular exercise, giving up smoking and avoiding excessive alcohol consumption are some of the ways by which strokes can be prevented. 

Case Study: 64-yr-old Mr Khan (name changed) from Oman presented at Sakra World Hospital with complaints of having multiple episodes of Transient Ischemic Attack (warning sign of stroke) and left-sided weakness for the past one month. He was brought on a wheel chair and incontinent. Upon investigation, he was diagnosed with Right Internal Carotid Artery Severe Stenosis or narrowing of the large artery on the side of the neck that carries blood to the head, face and brain due to atherosclerosis (a condition where plaque build-up within the arteries). Mr Khan suddenly developed weakness on one side of his body which caused him to lose balance and fall most of the time. He also had multiple episodes of giddiness as warning signs previously. He consulted doctors and sought medical help at his native but his condition could not be improved. 

At Sakra World Hospital, he consulted Dr Swaroop Gopal, Director – Neuro Sciences, who upon examination and evaluation found severe calcified blockages in the neck artery and after counselling the family conducted Right Carotid Micro Endarterectomy (surgery used to treat carotid stenosis. Following the surgery, Mr Khan’s condition improved considerably. He became ambulant and content and in a few days has flown back to his home country to continue medical management and rehabilitation. 

By Dr Swaroop Gopal

Director – Neuro Sciences, Sakra World Hospital