Overview

A stroke is a medical emergency that happens when the blood supply to a brain part is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells start to perish quickly.

Prompt treatment is crucial to reduce brain damage, and other complications and effective treatments help prevent disability.

Symptoms

Some treatment options are most effective when given promptly following a stroke.

Symptoms of stroke involve:

• Trouble speaking and understanding what is told - confusion or slur in words.
• Paralysis or insensitivity of the face, arm or leg. 
• Problems seeing in one or both eyes. 
• Abrupt, severe headache, followed by vomiting, dizziness or altered consciousness.
• Stumbling or losing balance while walking - sudden dizziness or a loss of coordination.

Seeking immediate medical attention is vital if any of the above signs are noticed, even if they seem to come and go or they disappear entirely. 

Practice the "FAST" rule and perform the following:

• Face. Ask the individual to smile and check if one side of the face droops.
• Arms. Ask the individual to raise both arms and check if one arm drifts downwards or cannot raise an arm.
• Speech. Ask the individual to repeat a simple phrase to check if speech is slurred or strange.
• Time. If any of these signs are observed, seek immediate emergency medical help. Every minute counts.

Delay in treating a stroke can cause potential damage to the brain, even leading to disability.

Treatment

Proper medical evaluation and immediate treatment are vital to recovering from a stroke. Immediate intervention is necessary for the stroke. Treatments are based on the stroke type:

Ischemic stroke and TIA

Ischemic stroke is caused by a blood clot or additional blockage in the brain that is primarily treated with:

• Antiplatelet and anticoagulants

Aspirin is often the first line of defence against stroke damage. Anticoagulant and antiplatelet drugs need to be administered within 24 to 48 hours after symptoms begin.

• Clot-breaking drugs

Thrombolytic drugs can break up blood clots in the brain's arteries, stopping the stroke and reducing brain damage.

• Mechanical thrombectomy

This procedure involves inserting a catheter into a large blood vessel inside the head and using a device to pull the clot out of the vessel. This surgery is most successful if performed 6 to 24 hours after the stroke begins.

• Stents

If the location where the artery walls have weakened are found, a procedure to inflate the narrowed artery and support the artery walls with a stent may be performed.

• Surgery

If other treatments don't work, surgery may remove a blood clot and plaques from the arteries. This may be done with a catheter, or if the clot is vast, the artery may be opened to remove the blockage.

Hemorrhagic stroke

Strokes due to bleeding or leaking in the brain need another set of treatment strategies, including:

• Medications

For a hemorrhagic stroke, the treatment goal is to make the blood clot. Therefore, medication may be given to counteract any blood thinners one takes. Also, prescribed drugs can reduce blood pressure, lower the pressure in the brain, prevent seizures, and prevent blood vessel constriction.

• Coiling

During this procedure, a long tube is guided to the haemorrhage area or weakened blood vessel. Then coil-like equipment is installed where the artery wall is weak, blocking blood flow and reducing bleeding.

• Clamping

A tiny clamp at the base of the aneurysm is placed to prevent additional bleeding, which cuts off blood supply and prevents a possible broken blood vessel or new bleeding.

• Surgery

If an aneurysm has burst, surgery may be done to clip the aneurysm and prevent additional bleeding.

Fact sheet

Frequency: Around 1.8 million people in India suffer from a stroke every year, and only early treatment can reduce morbidity and mortality. 

PGC Resolution: Providing information and creating awareness about strokes and the importance of treating patients on time to save many lives.