Stroke

What is a stroke?

A stroke occurs when blood flow to the brain is interrupted, either because the arteries leading to your brain are blocked or burst. As a result, oxygen supply to the brain is cut off, causing brain damage as cells in part of your brain die. When this happens, bodily functions controlled by damaged parts of your brain are lost.

Stroke is the fourth leading cause of death in Singapore [1], with 3.65 percent of the population having experienced a stroke in the past, and an average of 26 new stroke cases every day [2].

There are two categories of strokes – ischemic and hemorrhagic stroke. Ischemic strokes are more common, and take place due to blockages in arteries in the form of blood clots or fat deposits leading to your brain, causing an obstruction of blood flow. On the other hand, hemorrhagic strokes occur when a blood vessel bursts within the brain, resulting in bleeding in the brain.

A stroke is considered a serious medical emergency. Thus, recognising the signs of a stroke and seeking treatment early is essential to minimising brain damage and potential complications.

Image depicting the two types of stroke.

Taken from: https://content.blog.neofect.com/2019/10/stroke-1.jpg

How will having a stroke affect me?

Following a stroke, you may experience several long-term implications that may affect you in your daily life. According to the American Stroke Association, 10 percent of stroke survivors recover almost completely, 25 percent recover with minor impairments, and 40 percent experience moderate to severe impairments. 

Long-term effects vary from person-to-person, and are dependent on the severity of the stroke and location of the brain which is affected. 

After a stroke, you may experience a full or partial loss of memory and ability to speak. You may also find yourself more fatigued than before, accompanied by muscle weakness, tremors, difficulty swallowing, or in serious cases, paralysis. All of this may take a toll on your mental health, increasing your risk of anxiety disorders and depression. 

Recovery after a stroke may be a long and difficult process, but with the support of your family, friends and doctors, you’ll be able to live an equally fulfilling life.

What does having a stroke feel like?

During a stroke, every second counts. Knowing the signs of a stroke and responding quickly may very well help you save your own life, and even someone else’s. 

Stroke symptoms vary depending on the part of the brain that has been affected. However, the classic sign that someone may be having a stroke is the sudden numbness or weakness on one side of your body, extending from your face all the way to your legs. You may also experience a sudden wave of confusion, and have difficulties speaking or understanding speech. Your vision may become impaired on one or both eyes, and you may have trouble walking or standing up straight. Lasty, you may feel a sudden severe headache out of the blue. 

To remember the signs of a stroke, use the acronym, BE FAST: 

  • B – Balance (Is the person having trouble balancing?)
  • E – Eyes (Is the person suddenly experiencing blurred or double vision?)
  • F – Facial drooping (Is one side of a person’s face drooping, and his/ her smile lopsided?)
  • A – Arm weakness (When raising both arms, does one arm fall downwards?)
  • S – Speech (Is the person’s speech slurred? Can he/ she understand what you are saying?)
  • T – Time (If the person shows any of these symptoms, it is time to call an ambulance and seek medical attention immediately.) 

If you have experienced a Transient Ischemic Stroke (TIA) recently or in the past, consult a doctor and seek medical treatment immediately as TIAs often foreshadow the occurrence of a full-blown stroke. A TIA usually presents as a minor stroke that lasts only for a few minutes.

What are the causes and risk factors of stroke?

There are several risk factors that can increase your risk for stroke. Some of these risk factors such as age and family history cannot be controlled, but others like lifestyle most definitely can. Everyone can take efforts to reduce their risk of stroke, and you should too! 

If you are obese, do not regularly exercise, do not eat healthily, smoke, are diabetic, drink heavily, and have high blood cholestrol levels you are at a higher risk of stroke. The most significant risk factor of stroke is high blood pressure, also known as hypertension. When someone has this condition, their blood exerts more pressure than is normal and healthy on the walls of their blood vessels. 

How are strokes diagnosed?

A prompt medical examination and assessment is key to diagnosing and treating a stroke. When visiting a doctor, your doctor will most likely make use of neuroimaging, such as MRI and CT scans to diagnose your stroke. This will allow him or her to detect damaged brain tissue resulting from a stroke, as well as its location in the brain. 

To determine the type and cause of your stroke, your doctor may also make use of other tests such as blood tests, an electrocardiogram (EKG) – a simple, painless test that measures your heart’s electrical activity, an ultrasound of your carotid artery, or a cerebral angiography – a test that uses X-ray to form images of the blood vessels in and around the brain. 

How do I prevent myself from getting a stroke?

If you feel that you have any of these risk factors and are at risk of a stroke, do not worry. By making key lifestyle changes, you are still able reduce your risk of stroke. 

Firstly, it is important to swap a diet that is high in salt and fat to a one that is high in fibre, fruits, and vegetables. Try following a meal plan or doing this together with a friend or family member to keep yourself accountable. 

Being physically active is equally important in reducing your risk for stroke. If you have never exercised before, it is a good idea to start building up your endurance and muscle by walking everyday. Eventually, it is recommended that you carry out 150 minutes of moderate to vigorous physical activity per week. It may sound daunting if exercise is not already part of your weekly routine but it is important to start somewhere. Remember it is okay if you cannot yet meet the recommended amount of exercise, some exercise is already better than no exercise.

How are strokes treated?

A stroke requires urgent diagnosis and treatment to restore blood flow to your brain. We offer a range of treatment options for strokes. 

Firstly, your doctor may make use of intravenous (IV) medications to help break up clots in your body. Your doctor may then prescribe blood thinners, also known as anticoagulant drugs, in order to help prevent more blood clots from forming and reducing the risk of a stroke recurring. 

In addition, we offer stroke neurointerventions, a minimally invasive approach to treat conditions that occur within the vessels of the brain and spinal cord, and to remove blockages that are obstructing blood flow to the brain. We also offer neurosurgery, surgery performed on the brain and spinal cord, to drain blood from the brain resulting from a hemorrhage or repair damaged blood vessels. 

Alternatively, we offer clot retrieval to treat acute, ischemic strokes. Firstly, your doctor will insert soft, hollow tubes known as catheters into the blocked artery with the help of X-ray. Tiny mesh tubes known as stent retrievers are then used to grab and remove any clots present in the artery. 

If you think that you may have experienced a stroke or a TIA recently, visit a doctor and seek medical attention immediately.

References
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  1. Stroke. (2018, December 12). Www.Singhealth.com.Sg. https://www.singhealth.com.sg/patient-care/patient-education/stroke
  2. Venketasubramanian, N., & Chen, C. L. H. (2008). Burden of Stroke in Singapore. International Journal of Stroke, 3(1), 51–54. https://doi.org/10.1111/j.1747-4949.2008.00181.x 
  3. Types of Stroke. (2020, January 31). Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/types_of_stroke.htm