Only 50pc of stroke victims ‘recover partially’
Doha, December 9, 2009
Of those who experience a stroke, about 50 percent will make a partial recovery and may live the rest of their lives with significant neurological problems that affect their movement and speech, said a professor of neurology.
The World Health Organisation says stroke is a leading cause of disability around the world, and it’s a condition that evades notice until it’s upon you, said Dr Leopold Streletz, associate professor of neurology at WCMC-Q, established in partnership with Qatar Foundation and part of Weill Cornell Medical College of Cornell University of the US.
Dr Streletz was speaking at a public lecture entitled “Strokes of Insight.”
“One minute, you are normal. The next minute, you are paralyzed or numb on one side of your face or body, you cannot speak or have difficulty walking or any combination of these symptoms,” Dr Streletz said.
How strokes happen
Dr Streletz explained that there are two types of stroke – hemorrhagic, caused when arteries that serve the brain become weak and rupture; and ischemic, caused by blockages in arteries serving the brain.
Hemorrhagic strokes are usually caused by untreated high blood pressure against weak vessel walls in the brain, Dr Streletz said. But these are less common than ischemic strokes, which account for 80 per cent of all incidents.
The most common cause of ischemic strokes is hardening of the arteries or what the medical community terms atherosclerosis, Dr Streletz said. This situation results in narrowing of the arteries, which leads to clot formation.
“It’s important to note that 50 per cent of all strokes are caused by hardening of the arteries and many of these can be prevented,” Dr. Streletz said.
“About 30 per cent of strokes are caused directly by heart problems, where blood clots form on the valve surface or in a chamber of the organ and break loose, travelling to the brain and blocking blood flow there.”
When the arteries serving the brain become blocked, the cells affected die within minutes and cannot be replaced.
The result is a loss of function in the part of the nervous system associated with the place in the brain where the stroke occurred—usually producing paralysis, loss of feeling, problems with speech, loss of vision or difficulty walking.
Hardening and narrowing of the arteries happens naturally as we age, Dr Streletz explained, but it’s accelerated by habits and medical conditions such as high blood pressure, smoking, high cholesterol levels, obesity and lack of exercise.
“High blood pressure is the biggest risk factor for heart attacks and stroke,” Dr Streletz said, “but you can’t know what your blood pressure is unless it is measured by a doctor or nurse so it is often termed ‘the silent killer.’”
Dr Streletz urged everyone in the audience to have their blood pressure measured to make sure the numbers are below 140/90. Anything above that for either number signals a need for the patient to start a blood pressure reduction program.
Additionally, diabetes affects one out of every four people in the region over the age of 65, Dr Streletz said, and one out of every 10 people older than 75 has a heart problem known as atrial fibrillation, which is the most common cardiac cause of stroke.
“An examination by your doctor and a simple blood test can reveal any of these conditions that are major causes of stroke,” Dr Streletz said. “If you have any of these conditions, it’s important to listen to your doctor’s advice and see them regularly to ensure that these conditions are treated and properly controlled.”
Warning signs and symptoms
Major warning signs of a stroke include:
• Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
• Sudden confusion or difficulty speaking or understanding
• Sudden trouble with vision in one or both eyes
• Sudden onset of the worst headache of your life
Dr Streletz said that these symptoms might linger or they may last for only a brief time, in which case they are part of a transient ischemia attack or TIA. Caused by the same process that produces most strokes, TIAs block arteries in the brain and are a critical warning sign that you could be headed for a larger stroke.
Evaluation and treatment
Proper evaluation usually requires immediate hospitalisation. After a thorough medical examination—including an EKG, CT scan of the head and basic clinical laboratory blood tests—the treatment focuses on either relieving the blood clot or arterial block that caused the ischemic stroke, or on stopping the bleeding of the hemorrhagic stroke.
In some cases new clot-busting drugs may be used, in others carotid surgery or other intracranial surgery may be in order.
Even if you do not have any of these troubling health conditions, it’s important to note that a number of health and lifestyle factors can increase the risk for stroke, Dr. Streletz said. Smoking and excess weight are a couple of the major causes of heart attacks and strokes. – TradeArabia News Service