World Stroke Day 2022: Be prepared by learning about risk factors and ways to rebuild strength after a stroke.

According to a survey by the Indian Stroke Association, there are over 18 lakh documented stroke cases in India each year. In India, stroke is now the sixth major cause of disability-adjusted life years and the third leading cause of mortality. World Stroke Day is marked annually on October 29 in an effort to raise public awareness of the illness and identify strategies for lessening its burden. The focus of this year's World Stroke Day theme, #precioustime, is on the value of prompt medical attention and why each second counts when a patient has a stroke.

What is stroke?

According to Dr. Amit Kulkarni, Senior Consultant Neurologist and Stroke Specialist at SS SPARSH Hospital, a stroke is an abrupt neurological impairment caused by a momentary blockage of blood flow or transient seepage of blood into the brain. It may cause speech difficulties, abrupt disorientation, visual issues, numbness, giddiness, unbalance, and sudden weakness. The word "sudden" is crucial to pay attention to since stroke symptoms appear suddenly and without warning, according to Dr. Kulkarni.

Hemorrhagic stroke, which happens when there is a seepage of blood in the brain caused by a burst blood vessel, and ischemic stroke, which occurs when the blood supply to the brain is blocked, are the two primary types of strokes, as was previously discussed.

Risk factors for stroke

Although it is widely believed that stroke mainly affects the elderly, Dr. Kulkarni pointed out that younger people can also get stroke. "Therefore, showing that there is no age restriction for stroke. The most prevalent age group for stroke victims is those who are 60 years of age or older. Children also experience between 10 to 15 percent of strokes among persons under the age of 45, according to him.

the below are typical risk elements

Diabetes, hypertension, and atherosclerosis, which causes carotid stenosis and cerebral stenosis due to cholesterol buildup in blood vessels, are all conditions that impair blood flow (blockage of brain arteries)
LV dysfunction (poor ability of the heart to pump blood) *Smoking, sedentary lifestyles, and heavy alcohol use *Obesity and obstructive sleep apnea *Genetics and some environmental variables *Atrial fibrillation (irregular heart rhythm) *Obesity and obstructive sleep apnea *

Similar to how cholesterol buildup in the coronary arteries of the heart may result in a heart attack, buildup in the arteries of the neck or brain can likewise result in a stroke through a process of plaque rupture that results in additional artery obstruction. In comparison to the Western population, Indians and Asians have a larger percentage of stroke patients with intracranial atherosclerosis-blockage of brain arteries (ICAD), according to Dr. Kulkarni.

BE FAST to identify stroke symptoms:

The term BE FAST should be used when recognising a stroke. Observe the warning indicators listed below.

B - Balance: Unexpected loss of balance or trouble walking straight
E- Eyes: Sudden loss of vision or squinting of the eyes.
F-Facial: One-sided facial drooping or a skewed angle of the mouth
A-Arm weakness: The inability to raise or grasp objects with the arm
Speech loss that occurs suddenly. The guy is unable to utter even a single syllable. Loss of linguistic ability, slurred speech, or both may occur
T - Timely action: As soon as you notice these signs, dial 911 and move the patient.

"Symptoms like a sudden severe headache, loss of consciousness, or seizures may also be present in individuals with hemorrhagic stroke (leakage of blood inside brain matter or subarachnoid space). According to Dr. Kulkarni, excessive blood pressure, abnormalities in the arterial wall, or inappropriate connection between an artery and vein are the typical causes in such circumstances.

Ischemic Stroke Treatment

The patient's chances of recovery might be considerably increased with prompt therapy. A clot buster is given to the patient after transfer to a stroke-ready hospital in order to dissolve the clot that is obstructing blood flow. "Up to 4.5 hours after the beginning of symptoms, it may be administered. The outcomes are better the earlier the clot buster is used, according to the specialist.

It is less probable that IV clot busters alone will free the artery if any of the main arteries are blocked—LVOs (Large vascular occlusions)—MCA, ICA, Basilar artery, which are diagnosed by CT Angiogram or MR Angiogram. "In such circumstances, a DSA (Digital Subtraction Angiogram) is performed, and a guiding catheter is followed by a stent retrieval, which 

engages the clot, which then dissolves. In major vessel strokes, this surgery can significantly lower disability and death. According to Dr. Kulkarni, this can be done in LVOs for up to 6-7 hours and in a small number of patients for up to 24 hours based on CT/MR perfusion studies.

Rehabilitation after a stroke: regaining strength

The damage is minimised, according to Dr. Kulkarni, if the medical professionals can break the clot promptly and restore blood circulation. If the patient does not receive quick medical attention, it might result in total loss of speech, weakness on the right side of the body, or neglect of one side of the body, which would result in a more severe impairment and a greater death rate, according to Dr. Kulkarni.

The stroke's severity affects the recovery procedure and timetable. A person who has had a stroke is affected physically and emotionally. A person who has always been active may suffer anxiety and, in rare situations, depression in addition to their physical disability if they suddenly find themselves restricted to a wheelchair. In order to assist the patient regain lost talents, skills, and confidence in general, rehabilitation is crucial.

- Physical therapy: increasing muscular coordination, strengthening muscles, and recovering range of motion.
- Speech, language, and swallowing treatment - Walking balance and gait training
- Occupational therapy - Support and counselling for psychosocial issues

Rehab can start as soon as 48 hours after the stroke has started (as soon as stroke symptoms stabilise, not necessarily until symptoms start improving). According to the specialist, it lasts for a few weeks depending on the location and severity of the stroke.

SPOT Stroke, STOP Stroke

According to the adage "time is brain," when a stroke advances, a patient loses 1.9 million neurons per minute. Time is therefore of the essence in the treatment of stroke. You have to get to a hospital equipped for strokes as soon as the symptoms appear. Hence, detect stroke, halt stroke, according to Dr. Kulkarni.