Stroke What is it? Stroke or Cerebrovascular Accident (CVA) - is a major cause of death and disability in Singapore. A stroke happens when blood flow to part of the brain is cut off. This stops the supply of oxygen and nutrients, causing the brain cells to die. When this happens, the body parts controlled by that injured portion of the brain will be affected.
Who does it commonly affect? • Men and women of all ages, but usually those 40 years old and above. •
People with risk factors are at higher risk. These include: - High blood pressure, - High cholesterol - Diabetes mellitus - Smokers - Excessive alcohol intake - Obesity
How does a stroke happen? There are two types of stroke:
Haemorrhagic stroke • An artery bursts causing bleeding in the brain. • This is less common but more deadly.
Ischaemic Stroke • A clot blocks an artery stopping blood flow to a part of the brain. • This is the most common type of stroke in Singapore.
What are the signs? • Weakness or numbness on one side of the body.
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Giddiness together with one of the above symptoms.
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Slurred speech.
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Severe headache.
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Sudden difficulty in talking.
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Loss of consciousness, coma.
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Sudden difficulty in seeing.
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Difficulty in walking or lack of coordination in movement.
The quicker you get treatment in hospital, the less likely your brain tissue will be permanently damaged. Does your relative look unwell? Act FAST to check for signs of STROKE
Face
Ask them to smile. Is the smile uneven?
Arms
Ask them to lift up both arms. Does one arm drift down?
Speech
Ask them to speak. Are the words mixed up or slurred?
Time
If you answer YES to any of the above... Time to call 995 for an ambulance.
What tests are done? Several tests will be done to find out the amount of damage to the brain and whether the stroke was caused by a clot or bleeding in the brain. Common tests include: • Scans of the brain such as Computerized Tomography (CT) or Magnetic Resonance Imaging (MRI). • Blood tests. • Checking the rhythm of the heart and ultrasound scan of the heart (2D Echocardiography). • Ultrasound scan of the main artery in the neck (carotid artery). • X-rays of the veins and arteries (angiogram). What else is monitored? • Blood pressure. • Heart rhythm. • Alertness and conscious level. • Muscle strength. • Walking and sitting balance. • Functional activities. • Swallowing – to see if you can eat and drink safely.
How is it treated? The treatment needed depends on the type of stroke. Medication There are different kinds of medications that the doctor may prescribe. • Recombinant tissue plasminogen activator (rtPA) may be given within the first 4 ½ hours after stroke symptoms start to break up a blood clot and stop the stroke. • Blood thinners, such as Aspirin, to prevent more blood clots and reduce the risk of another stroke. • Other medications that control risk factors. Many of them are long-term treatments to reduce your chances of another stroke. This protection only lasts while you are taking them, so make sure you follow your doctor’s instructions and take your medications! Surgery An operation is sometimes needed for patients with severely narrowed blood vessels and severe brain swelling, to allow adequate blood supply or to relieve pressure on the brain.
Rehabilitation Rehabilitation is important. It helps you to regain independence and improve your quality of life. Recovery take time and effort, you need to persevere and continue with your rehabilitation programme.
Useful link Singapore National Stroke Association Tel : (65) 6358 4138 Website : www.snsa.org.sg
Support from family and friends is important during this period.
Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group. Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.
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