KUALA LUMPUR, Oct 31 – Stroke is known to be a leading cause of death and disability worldwide, and its prevalence continues to rise.
This sudden killer usually occurs when blood supply to a part of the brain is interrupted, causing damage to brain cells.
What makes this even scarier is that it can strike anyone at any age, but it is usually more common in people over the age of 60.
The World Health Organization (WHO) has stated that stroke patients are getting younger, and in fact, one in four strokes now occur in people under the age of 50.
Sunway Medical Centre assistant medical director and consultant emergency
physician Dr Lee Tuan Cheong shares that in Malaysia, stroke is the third leading cause of death.
“According to the National Stroke Registry, there were 47,911 stroke incidences in 2019, which means that about 130 people suffer from stroke every day in Malaysia,” he said.
Furthermore, the country also records almost 32 deaths per day due to stroke and patients are almost always burdened with various morbidities, where seven out of 10 stroke patients will need to depend on others to survive.
Known Risk Factors
According to the Global Burden of Disease Stroke Statistics Worldwide survey in 2016, it is estimated that one in four Malaysians will suffer a stroke by 2040 if no preventive action is taken.
“However, it is understood that up to 90 per cent of strokes can be prevented and attributable to a few modifiable risk factors,” said Dr Lee.
“Knowing these risk factors and taking the necessary steps to reduce them, you can lower your chances of having a stroke.”
The most common risk factors include:
- High blood pressure, diabetes, and high cholesterol.
- Smoking: can damage the lining of blood vessels, making them more likely to narrow or clot
- Obesity and physical inactivity can increase the risk of high blood pressure, heart disease, and diabetes, all of which are risk factors for stroke.
- Heart disease/ Irregular heartbeat (atrial fibrillation) can cause blood clots to form, which can travel to the brain and cause a stroke.
- If you have a family history of stroke, you are more likely to have a stroke yourself.
“The most significant contributor to a stroke attack is high blood pressure as
it can damage the walls of arteries, making them more likely to narrow or form a clot, which leads to a stroke,” added Dr Lee.
In addition to all these, here are some other risk factors for stroke:
- History of transient ischemic attacks (TIA), a temporary, stroke-like event that is caused by a blood clot that blocks a blood vessel in the brain.
- Drug abuse.
- Heavy lifting.
- Extreme emotional stress.
How Do You Know When A Stroke Attacks?
When a stroke attacks, the signs and symptoms may vary depending on the part of the brain that is affected.
However, there are some common signs in which you can determine a stroke attack:
- Sudden numbness or weakness on one side of the body.
- Sudden confusion or trouble speaking.
- Sudden trouble seeing in one or both eyes.
- Sudden difficulty walking or balancing.
- Sudden severe headache with no known cause.
There is also a simpler way to keep in mind these signs. Just remember to B.E.F.A.S.T.:
- B – Balance: Loss of balance, headache or dizziness.
- E – Eyes: Blurred vision.
- F – Face: One side of the face droops.
- A – Arms: Arm or leg weakness.
- S – Speech: Difficulty in speaking.
- T – Time: Immediately call for an ambulance or the nearest accident and emergency department.
“It is important to act quickly and seek medical treatment FAST during a stroke attack.
“TIME is BRAIN, and early treatment can help to reduce the damage caused by the stroke as well as improve the chances of a full recovery.
“It is best to head to the hospital immediately after the onset of symptoms, preferably within 4.5 hours because reperfusion therapy (re-establishing blood supply), such as thrombolysis and thrombectomy in ischemic stroke have been proven to minimise disability,” Dr Lee added.
Recuperating After A Stroke
Sunway Medical Centre consultant rehabilitation medicine specialist Dr Foong Chee
Chong shares vital knowledge on what can be done after the initial acute stroke management.
“I recommend a comprehensive stroke rehabilitation programme, which usually begins when the stroke survivor is still in the hospital, but it can be carried out in an outpatient setting or at home.
“With medical advancements, there are many rehabilitation processes fit for stroke survivors, such as robotic technology, non-invasive brain stimulation, and virtual reality, to name a few, that can help stroke survivors achieve better functional improvement,” he said.
One such advanced technology is an exoskeleton gait trainer, which helps to increase the chances of stroke survivors in improving their mobility, that would generally take between one to three months.
This is due to the fact that such robotic technology not only provides intensive training with accurate feedback, it also offers various levels of assistance depending on the severity of the patient.
For stroke survivors, rehabilitation is an imperative part of the journey to recovery. Therefore, choosing a health care facility that is well-equipped with the right expertise and tools to support the process leads to significant improvements.
Aside from that, there are also a few types of exercises a stroke survivor can perform at home, which can be broadly categorised into:
- Flexibility exercises.
- Strengthening exercises.
- Balance exercises.
- Functional task training.
- Aerobic exercises.
“All recommended exercises have to be individualised depending on the severity of the stroke,” according to Dr Foong.
Furthermore, the doctor reveals that there is actually a golden period where the injured brain is more ‘plastic’, and it is usually within the first three months.
“During this period, intensive therapy can produce more gain,” he said.
It takes lots of patience when a loved one suffers from a stroke attack. It is crucial for families and partners to understand the severity of the stroke and the impairments they suffer from.
This is so that they know what type of therapy and treatment the patient needs.
“More importantly, be there to support your loved ones throughout their long recovery journey. Be patient and persevere.
“Although they may not be able to regain their health and function completely,
do understand that they can still have a meaningful life, albeit in other ways,” advised Dr Foong.