Dr. Madan Bajagain, PhD-Resident Neurosurgery, Kagoshima University, Japan

How does a stroke occur?

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked or ruptures which causes the death of brain cells and leads to a stroke.

What are the types of strokes?

There are 5 types of stroke:

1. Ischemic stroke: It occurs when a blood vessel supplying blood to the brain is blocked by a clot.
2. Hemorrhagic strokes: It occurs when a weakened blood vessel ruptures or gets blocked. The two blood vessels that are usually responsible for stroke are aneurysms and arteriovenous malformations (AVMs).
3. Transient Ischemic Attack (TIA): It is also called a “mini-stroke” caused by a serious temporary clot. This attack is a warning stroke and should be taken seriously.
4. Cryptogenic Stroke: A stroke with an unknown cause is called a cryptogenic stroke.
5. Brain Stem Stroke: A brain stem stroke can affect both sides of the body and may leave someone in a ‘locked-in’ state. In this state, the patient is generally unable to speak or move below the neck.

What are the Symptoms of a Strokes?

Following are the most common symptoms of a stroke:

• Numbness of the face, arm, or leg on the side of the body
• Loss of vision in one or both eyes
• Loss of speech, difficulty in talking
• Sudden, severe headache with no known cause
• Loss of balance or unstable walking

What should one do if they experience stroke symptoms?

Immediately contact the nearest hospital if you experience symptoms of a stroke. immediate treatment can save your life and also increase the chances of a full and fast recovery.

How do you prevent a strokes?

Stroke is becoming the leading cause of disability, after a road traffic accident in our country. Every year hundreds of people are developing strokes which produce serious morbidity in them and affect their activity of daily living. So it is very important to prevent such a disease so that after-effects are stopped.

Steps involved in the Prevention of stroke

a) Primordial prevention

Adopting a healthy lifestyle, i.e regular exercise, good food habits i.e food containing less salt, food containing less amount of cholesterol. Avoid smoking, maintaining adequate/correct body weight, and body mass index.

b) Primary prevention

This step is employed by the people who are having risk factors for the disease.

1. Diabetes & Hypertension: All patients should have their blood sugar adequately controlled,
2. Blood pressure needs to be monitored and maintained at the appropriate level because high blood pressure can produce brain hemorrhage and thrombotic stroke.
3. People who are having heart problems especially related to valvular problems, Heart failure i.e. with low pumping functions should be started on blood thinning agents (Anticoagulants) because it can prevent the clot which is formed in the heart reaching the brain.
4. Persons who are having a family history of brain hemorrhage should get themselves screened with a CT scan brain with CT angiogram of intracranial vessels. To Rule out aneurysm of the vessels and A.V malformations of vessels.
5. People who are having a strong family history of Ischemic stroke should undergo screening for diabetes and hypertension, also have patients should undergo Doppler, the scan of neck vessels to look for blocks in the main vessels supplying the brain (i.e carotid & vertebral arteries).
6. People who are having altered lipid levels should get their lipids checked every 3 months & adequate medication. So as to reduce both cholesterol and triglycerides to less than recommended for a particular problem as advised by their neuro physician.

c) Secondary prevention

Just before the large storm in the ocean, a few high tides are seen. Similar way if the patient gets Premonitory symptoms in the form of TIA (transient Ischaemic attack) that are taken as warning symptoms of a stroke. Those patients should immediately consult a neuro physician and get an evaluation with brain imaging and scanning of heart and neck vessels. So by modalities of primordial, primary, and secondary prevention, you have several opportunities to intervene before the development of stroke. It is up to us to take the necessary measures to prevent getting stroke and reducing productivity, burden, and disability to the community.

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