WHY TALK ABOUT STROKE?

by Niyi Borire MBBS FRACP PhD

A useful acronym for recognising the earliest symptoms of stroke is:

“FAST.”

• Face:Thefacemaydrooponone side

• Arm:Thearmmaybeweakor numb.

• Speech:Thepersonmayhave troublespeaking cause of death and is also largely implicated in most disabilities. In the last half-century, the incidence of the disease has doubled, especially among low and middle-income countries. Stroke has no socioeconomic group; it affects the rich and poor; it does not matter whether you areinaruralorurbanarea.

• Time:Ifyounoticeanyofthese strokesigns,immediatelyvisit thenearesthospital.

Time is important because the effects of stroke depend on how quickly treatment is administered. The quicker treatment is administered, the better the chances of recovery.

WhatcausesStroke?

The risk factors for stroke are broadly divided into modifiable and non-modifiable risk factors. The modifiable risk factors are the ones you can control, while the nonmodifiable ones are beyond your control.

In fact, there is said to be 1 in every 1,000 people suffering from stroke in Nigeria, and the fatality rate is as high as 40%. It has also been shown that about 100,000 Nigerians suffer from Stroke yearly. Hospital-based studies in Nigeria state that stroke is the leading reason for neurological admissions, accounting for over 60% ofpresentingcases.

The economic and financial burden that stroke imposes on its victim has been noted to be a major challenge, especially in developing countries like Nigeria, as it has been shown that it requires an average of N95,100 ($600) and N767,900 ($4,860) in a government and a private hospital, respectively, to access care within the first 36 weeks of post-stroke affectation in Nigeria, rehabilitation even among survivors ofstroke.

WhatisStroke?

Stroke is an insult to the brain that results from the lack of adequate blood flow. It occurs when a part of the brain dies because it is deprived of blood for too long. Blood supply to the brain can be cut off because an artery in the brain gets clogged or closes off (ischaemic stroke) or an artery in the brain starts bleeding (Haemorrhagicstroke).

Riskfactorsthatyoucannotcontrol (non-modifiable)

• Age–yourriskofstroke increasesasyougetolder.

• Gender–menaremorelikelyto havestrokethanwomen.

• FamilyHistory–yourriskof strokeincreasesifoneofyour firstorsecond-degreerelatives hashadastroke.

Risk factors that you can control (Modifiable)

• Highbloodpressure (Hypertension)

• Highbloodsugar(diabetes)

• Cigarettesmoking

• Obesityorbeingoverweight.

• HighCholesterol

HowtohelpStrokepatients breathing is absent, start cardiopulmonary resuscitation (CPR – chest compressions with or without mouth -mouthbreathing)straightaway.

HowtorecogniseStroke?

The symptoms of a stroke depend on the part of the brain affected. Stroke may produce little or no permanent effects in some people and may affect important brain functions in others. For example, some people become partly paralysed or unable to speak.

Take them to the nearest hospital immediately, and ensure the person lies down on his or her side with their head slightly raised and supported if he or she is conscious. It is important not to give them anything to eat or drink. If there is a weak limb, support it and avoid pulling on it when moving the person.

HowisStroketreated?

Strokes caused by blocked arteries canbe treatedby:

• Drugsbreakupbloodclots.

• Drugs thatpreventnewblood clots.

• Treatmentsthatreducethe damagecausedbybleeding.

• Treatmentsthatreducethe damagecausedbybleeding.

• Stoppingmedicinesthat increasebleeding.

• Surgerytorepairthearteryor stopthebleeding(thoughnot always possible)

• Poordietandlackofexercise

• Drinkingtoomuchalcohol factors that you can control. The followingstrategiesareveryuseful:

1.Dietarychanges

• Eatplentyofvegetables, legumes,andfruits.

• Includeleanmeat,fish,poultry, oralternatives.

• Includemilk,yoghurt, cheeses and/oralternatives.

• Drinkplenty ofwater.

• Limitsaturatedfatandtotalfat intake.

• Limitsugarandfoods containing addedsugars.

2.Stopsmoking

3.Regularannualscreeningfor diabetesandhighcholesterol

• Men–startatage35.

• Women–startatage45.

4.Haveregularexercise

• Atleast30minutesadayon5or moredays perweek

• Ifyouaretoobusy tofindtime forexercise

 Take the stairs instead of the elevator.

 Park your car farther away from youroffice

Take a longer route when you walkfromoneplace toanother.