Are you likely to have a Stroke?

He looked elderly and weak. He couldn’t walk on his own. He entered the consulting room supported by a young man I later learnt was his last born son. He limped with the limb he could use and was supported on the side he couldn’t move. His son helped him settle into the chair across my desk. “Good morning baba” I greeted with a smile. He tried to reply, but I couldn’t make out the words that escaped his lips. He turned towards his son, a frustrated countenance taking over his face. His son said some things to him in their native tongue, it must have been some words of comfort because his countenance became more relaxed again. His son took it from there and told me all about what had happened. Baba had been hypertensive for some years and recently hadn’t been consistent with his medications because of financial difficulties. Yesterday, baba had finished watching the evening news on the national television network and was walking towards his bedroom to retire for the night, when he fell down suddenly. Since then he hadn’t been able to speak properly or use his left limb, so he was brought to the hospital. Apparently, baba had had a stroke.

WHAT IS STROKE?

Stroke is a damage to the brain caused by the interruption of its blood supply. 

Blood is supplied to all the organs of the body (including the brain), by blood vessels called arteries, and any interruption in the blood supply to any organ of the body can cause damage to the organ. This is what happens to the brain during a stroke.

TYPES OF STROKE

According to the Centre for Disease Control(CDC), there are 3 types of stroke:

1. Hemorrhagic stroke: Coined from the word “Hemorrhage”, which means bleeding. A hemorrhagic stroke happens when an artery in the brain leaks blood or breaks open (ruptures). Baba most likely had a hemorrhagic stroke because these types of stroke are more common in people with poorly treated hypertension. The high pressure of the blood in the blood vessels can easily cause their arteries to break open.

2. Ischemic stroke: Most strokes (87%) are ischemic strokes. An ischemic stroke happens when blood flow through the artery that supplies oxygen-rich blood to the brain becomes blocked. Blood clots often cause the blockages that lead to ischemic strokes.

3. Transient Ischemic attack: A transient ischemic attack (TIA) is sometimes called a “mini-stroke.” It is different from the major types of stroke above, because blood flow to the brain is blocked for only a short time (usually not more than 5 minutes). It is important to know that:

1. A TIA is a warning sign of a future stroke.
2. A TIA is a medical emergency, just like a major stroke.
3. Strokes and TIAs require emergency care.
4. People who have a TIA and don’t get treatment have a major stroke within 1 year. 

HOW COMMON IS STROKE

According to the CDC  2018, 1 in every 6 deaths from cardiovascular disease was due to stroke. Someone in the United States has a stroke every 40 seconds and every 4 minutes, someone dies of a stroke. Every year, more than 795,000 people in the United States have a stroke. Stroke is a leading cause of serious long-term disability. The current prevalence of stroke in Nigeria is 1.14 per 1000 persons.

WHO IS LIKELY TO HAVE A STROKE?

A stroke, as we already have highlighted, is caused by rupture of a blood vessel or a blockage of a blood vessel to the brain. However, there are some factors that make a person likely to have a stroke. They include:

1. High blood pressure
2. Diabetes
3. Smoking
4. Heart and blood vessel diseases: these can cause blood clots or other blockages,
5. Brain aneurysms or arteriovenous malformations (AVMs). AVMs are tangles of poorly formed arteries and veins that can break open in the brain.
6. Viral Infections or conditions that cause inflammation.
7. Age: A stroke can happen at any age, but the risk is higher for babies under the age of 1 and for adults. In adults, the risk increases with age.
8. Sex: At younger ages, men are more likely than women to have a stroke. But women tend to live longer, so their lifetime risk of having a stroke is higher. 
9. Race and ethnicity. It occurs more often in blacks, Alaska Natives, American Indian, and Hispanic adults than in whites. 
10. Family history and genetics. Your risk of having a stroke is higher if a parent or other family member has had a stroke, particularly at a younger age. 

Others include: Anxiety, depression, high-stress levels, medical conditions, like bleeding disorders, kidney disease, migraine headaches, and sickle cell disease, unhealthy habits, including eating unhealthy foods, lack of exercise, drinking alcohol, getting too much sleep (more than 9 hours), and using illegal drugs such as cocaine.

SIGNS AND SYMPTOMS

These include:

1. Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
2. Sudden confusion, trouble speaking, or difficulty understanding speech.
3. Sudden trouble seeing in one or both eyes.
4. Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
5. Sudden severe headache with no known cause.

WHAT TO DO

If you think someone may be having a stroke, act F.A.S.T., and do the following simple test:

F— Face: Ask the person to smile. Does one side of the face droop?

A— Arms: Ask the person to raise both arms. Does one arm drift downward?

S— Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?

T— Time: If you see any of these signs, call a doctor right away or get the person to the hospital immediately.

You can speak with a doctor for free on the flexicare HMO plan by initiating a message via the AI health messenger here or via your dashboard on the website. Being on a Health insurance plan helps tackle medical emergencies quickly. 

PREVENTION

Stroke is preventable. Up to 80% of strokes could be prevented through healthy lifestyle changes and working with your doctor to control health conditions that raise your risk for stroke. You can prevent stroke by making healthy lifestyle choices. The CDC recommends:

1. Healthy Diet:

Choosing healthy meals and snack options. Be sure to eat plenty of fresh fruits and vegetables. Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol.
Limiting salt (sodium) in your diet can also lower your blood pressure.

2. Healthy Weight:
   Being overweight or obese increases your risk of stroke.

3. Physical Activity:
   This can help you stay at a healthy weight and lower your cholesterol and blood pressure levels.

4. No Smoking:
   Cigarette smoking greatly increases your chances of having a stroke. If you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for stroke. 

5. Limited Alcohol:
   Avoid drinking too much alcohol, which can raise your blood pressure. Men should have no more than two drinks per day, and women only one. 

Now you know what to do if you or someone else has a stroke. Spread the word, and don’t forget to act FAST!