What is a Stroke?

A stroke is a neurological emergency that occurs when the blood and oxygen supply to the brain is reduced or interrupted. Due to a lack of oxygen, brain cells begin to die which results in brain damage leading to neurological deficits

Quick treatment is vital when someone is having a stroke. It is important to recognise the signs and symptoms of a stroke so the individual can receive medical attention at the earliest. Here are some common symptoms:

• Trouble speaking such as slurred speech, garbled speech or no speech or difficulty understanding others’ speech.
• Sudden numbness or paralysis in the face, arm or leg. This may involve one arm or leg along with face drooping or both arms and legs.
• Vision problems, or field cuts involving one section of the visual field
• Headache accompanied by nausea, vomiting
• Dizziness or vertigo
• Trouble walking or loss of coordination.

To easily remember the symptoms of a stroke, experts recommend using the acronym “FAST.”

Face: Is one side of their face drooping when they smile?

Arms: Can they raise both arms and keep them raised? Is one arm drifting downwards?

Speech: Is the person’s speech strange or slurred?

Time: It is time to call for ambulance if you notice any of the above symptoms.

What are the causes of a Stroke?

The two main causes of stroke are a blocked artery or a ruptured blood vessel in the brain. These are known as ischemic stroke and haemorrhagic stroke respectively. In some cases, there may only be a temporary disruption of blood and oxygen flow to the brain. This is known as a transient ischemic attack (TIA) and its symptoms last few minutes usually.

There are some risk factors that make one more prone to developing a stroke. These include:

• Smoking
• High blood pressure
• Cardiovascular disease
• Obstructive sleep apnea
• Diabetes
• Family history of stroke
• Leading a sedentary or physically inactive lifestyle
• Heavy consumption of alcohol or drugs like methamphetamine and cocaine
• Being obese or overweight
• Heart rhythm abnormality called atrial fibrillation

How is a Stroke treated?

If a person has had a stroke, they need to be immediately taken to a stroke ready hospital. This is a hospital which has MRI/CT facility, a Neurologist, Neurosurgeon, Radiologist availability round the clock. A CT Head/ MRI brain is done to distinguish between clot and bleed in the brain. If the patient presents within IV window period of 4.5 hours, once BP is brought to acceptable limits, IV clotbuster is administered if CT rules out a bleed (in case of clot) Subsequently if CT Angio or MR Angio shows a blockage of large artery (MCA/ICA/Basilar artery), mechanical clot extraction can be done via a stent retriever introduced through a groin puncture. This can be performed within 6 hours of onset of symptoms. Rarely, in few carefully selected patients, this procedure can be done upto 24 hours.

In case of bleed in the brain, the blood pressure needs to be aggressively controlled. If there is increased pressure in the brain, surgical evacuation of hematoma or decompression (where skull bone flap is opened, allowing for brain to expand outwards, which can be a life saving measure.