The incidence, prevalence, and mortality rate of strokes have increased globally, with most of the burden being in low and middle-income countries. Worldwide, it is ranked as the second leading cause of death with an annual mortality rate of 5.5 million. It is now the leading cause of physical disability in people aged 65 years and above.
The burden of stroke lies in high mortality and high morbidity, resulting in up to half of the survivors being chronically disabled. Nearly one-fifth of people globally will have a stroke in their lifetime. Developing countries, like Bangladesh, have a higher burden of non-communicable diseases than the rest of the world. More than two-third of strokes occur in low-and middle-income countries.
Stroke is the third leading cause of death in Bangladesh. The majority of cases occur in individuals over the age of 40. Hypertension was found to be the leading risk factor for stroke, followed by heart disease and diabetes. A lack of information and poor control and management of risk factors have contributed to stroke’s growing incidences.
According to a study published by icddr,b, only about one-third of patients who have died of a stroke in the same community were brought to a health facility, which may be attributable to inadequate knowledge about stroke severity.
Thus, let us enhance our knowledge about stroke and its treatment.
Stroke is a disease that affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is blocked, either by a clot or burst (or ruptures). When that happens, part of the brain cannot get the blood and oxygen it needs, and the brain cells die.
There are three main types of stroke -- ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA). The type of stroke you have affects your treatment and recovery.
Most strokes are ischemic strokes. An ischemic stroke happens when blood flow through the artery that supplies oxygen-rich blood to the brain becomes blocked. Blood clots often cause the blockages that lead to ischemic strokes.
A hemorrhagic stroke happens when an artery in the brain leaks blood or ruptures (breaks open). The leaked blood puts too much pressure on brain cells, which damages them. High blood pressure and aneurysms -- balloon-like bulges in an artery that can stretch and burst -- are examples of conditions that can cause a hemorrhagic stroke.
Every minute counts during a stroke. Thus, fast treatment can lessen the brain damage that a stroke can cause. The symptoms of stroke that are important to remember are sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. People might experience sudden confusion, trouble speaking, or difficulty of understanding speech. Other signs include sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance, or lack of coordination, and sudden severe headaches with no known cause. Individuals should seek immediate medical help if any of the symptoms occur.
Treatment depends on the type of stroke. For ischemic stroke, doctors use a thin and flexible tube (catheter) and a tiny cage to remove the blood clot that caused the stroke.
The procedure is called a thrombectomy. If the bleeding occurred because of a ruptured brain aneurysm for hemorrhagic stroke, surgery is done to repair it. In some cases, medicines are prescribed to control blood pressure, brain swelling, blood sugar levels, fever, and seizures.
Today is World Stroke Day, observed annually to raise awareness and organize campaigns to highlight the importance of reducing death from stroke. This year advocates the slogan of “Join the Movement” -- its emphasis on the fact that 1 in 4 adults have a stroke but being active can decrease the risk.
Remember, 80% of strokes can be preventable. As the leading cause of strokes, hypertension can be managed by being active -- just do 30 minutes of exercise five days a week, and it can prevent 1 in 20 cases. Moreover, the damage caused by smoking and tobacco usage cannot be ignored as smokers have a much higher fatality rate from stroke than non-smokers. Thus, maintain a healthy lifestyle to prevent stroke, and in case of an emergency, seek immediate medical help.
Dr Md Badrul Alam is Joint Director & Professor of Neurology, National Institute of Neurosciences & Hospital (NINS). Any and all the Information provided in the article are independent views expressed by Dr Md Badrul Alam for general overview and educational purposes only.
