A brain stroke or a brain attack is a medical emergency and one of the most disabling diseases that are preventable in many forms. It is said that 1 in every 6 or more Indians is at risk of brain stroke.
Earlier, we used to see strokes to be more common in the elderly but unfortunately, now, it is not the same as it used to be and we are seeing more younger people also being affected by it.
A stroke occurs because of stoppage of blood flow to a certain region of the brain which may be due to:
Since constant blood flow is needed for brain cells (neurons) to function, even a few minutes, as less as 3-5 minutes without adequate blood and oxygen to neurons can kill them. Due to neuronal death, the function they are responsible for also gets lost.
Brain Stroke can affect parts of the brain responsible for essential functions like breathing and blood pressure control besides other vital control centers and thus, if they are involved, it can cause death.
Stroke is the second leading cause of death worldwide. While the number of people affected by stroke is increasing, the deaths are reducing in places with good medical care facilities.
Various factors increase the risk of having a stroke:
Above: Pictorial representation of a brain stroke
The effects of stroke are wide depending upon the area of the brain affected and the severity of the stroke. It may impair your ability to:
Other less common symptoms of stroke may include:
Unfortunately, life and optimum function can be saved in this catastrophic event only by early recognition followed by rapid and adequate treatment, at a centre equipped for stroke with a well-trained stroke team.
The patients do not seek medical attention on their own because they lose the appreciation that something is wrong with them or they lack the knowledge of how acute treatment can be beneficial for them.
It is often a family member or a bystander who calls for help. Therefore, please recognize early signs, as it may help a victim in your known circle, or even a bystander. Remember, A stroke can happen to anyone at any time.
Above: Steps to identify a brain stroke
A brain stroke requires proper medical evaluation and timely treatment. Taking a prompt treatment action for a stroke is vital for recovering from it. As per the American Heart Association, “Time lost is brain lost.”
Dr. Vikas Gupta is one of the first neurosurgeons in the country with 20 years of experience in leading a stroke team to adapt new scientific methods after worldwide trials* to successfully treat stroke which involves opening up blocked artery in a neurovascular cath lab to open the blocked artery in an ischemic stroke (clot in an artery) called mechanical thrombectomy or block the ruptured brain artery by filling it and blocking it with coils, flow diverters and flow disruptors.
Dr. Gupta says that when a victim of acute stroke reaches in the window period, he/she is rapidly evaluated and various imaging and brain scans were done using different modalities are employed to decide the appropriate therapy depending on the type of stroke (ischemic or hemorrhagic). The exact site affected is identified along with the blood vessel involved and the severity of the stroke. According to these factors and the standard scientific treatment guidelines, the patient is given intravenous thrombolytic (a clot-busting drug given via veins) or mechanical thrombectomy is done by an endovascular surgeon in the Neurovascular Cath lab.
Along with specific treatment, utmost care is taken by the specialized and dedicated team to prevent further damage to the brain by giving neuroprotective medicines, decreasing the increased pressure in brain and brain swelling, preventing seizures and taking care of vital functions like breathing (with help of a ventilator), blood flow across the body, blood pressure, fluid and nutritional needs of the patient.
Dr. Gupta truly believes that timely treatment is a game-changer in this disease with grave outcomes of probably a life of physical dependence or even death, to very gratifying outcomes.
Time being the key, the patient should reach the right hospital at earliest for the treatment to show optimum results. With every minute of delay, outcomes become worse.
*(to read more refer to N Engl J Med 2015; 372:11-20 “A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke” popularly called MR clean trial and many similar trials)
Above: CT scan of brain damaged by a brain stroke
The impact of a stroke depends on part of the brain affected and the amount of damage occurred. A team of different specialists including physiotherapists, psychologists, psychiatrists, speech and language therapists, dieticians helps the patient rehabilitate after the stroke.
Many people who have a stroke are left with paralysis of one of their limbs or improper speech.
Other problems can include having trouble with:
Some people may need lifelong assistance to carry out their daily activities and take care of their hygiene.