Quick action is crucial
ACCORDING to the National Stroke Association of Malaysia, stroke is the third largest cause of death among Malaysians.
It is a clinical syndrome or sign of global loss of cerebral function caused by a blocked blood vessel or a blood vessel that is experiencing a haemorrhage.
Symptoms include functional limb weakness, numbness, difficulty speaking, affected memory and loss of higher mental function. In severe cases, stroke can lead to the loss of mobility and muscle function.
Besides physical disability, stroke presents a host of psychological, behavioural and emotional disorders such as disturbance of sleep, anxiety disorder, depression, denial and even erectile dysfunction.
Stroke can be divided into two types – ischaemic stroke, which occurs as a result of obstruction within a blood vessel supplying blood to the brain, and haemorrhagic stroke, which occurs when a weakened blood vessel in the brain ruptures.
Cause and effect
Age is a significant nonmodifiable factor in the incidence of stroke. Men who are 55 years old and above and women aged 65 and above are at a higher risk of getting a stroke.
However, modifiable factors contribute to higher incidences of stroke especially among younger individuals.
“High blood pressure due to hypertension is the largest contributing factor of stroke among Malaysians while patients with diabetes have two to five times higher chance of getting a stroke in their lifetime,” says Dr Mooi Chin Leong, neurologist from Mahkota Medical Centre, Malacca.
Other modifiable factors for stroke include cardiovascular disease, diabetes, obesity, lack of exercise, and excessive smoking, alcohol and salt intake.
“The key to reducing morbidity and mortality in a stroke is to act fast. Hence, it is important for people to recognise the symptoms of a stroke when it is happening so that they can seek immediate medical attention,” he adds.
One of the typical signs of a stroke is sudden numbness of the face and limbs. This is followed by confusion and difficulty in speaking or seeing.
Individuals who are having a stroke may also experience difficulty walking, loss of coordination and a combination of severe headache and vomiting.
Stroke diagnosis differs on a case-to-case basis. After going through a patient’s medical history, a neurologist will prescribe a diagnostic brain scan such as a computerised tomography or a magnetic resonance imaging scan.
“Images produced from these scans will be able to confirm if a patient has experienced an ischaemic or haemorrhagic stroke. A blood test is also conducted to identify the prothrombotic state or coagulation in the blood,” says Dr Mooi.
As cardiovascular disease is a risk factor for stroke, cardiovascular diagnostics such as an electrocardiogram is used to identify any abnormality in the heart.
Time is key
Treatment for stroke patients depends on the type and severity of the stroke. The most important aspect is to make necessary lifestyle modifications once the patient has been discharged from the hospital.
Stroke patients should consume a diet low in sugar and salt as well as completely quit smoking and alcohol consumption.
In terms of physical rehabilitation, stroke patients are required to undergo multiple sessions of physiotherapy, speech therapy and occupational health therapy.
Lifestyle modifications and therapy can be challenging but the right encouragement from friends and family can go a long way on a patient’s road to recovery.
“It is important to give patients milestones during their recovery period so that they are motivated to recover without giving up,” says Dr Mooi.
Oral medication may also be prescribed to patients. In addition, surgery may be considered if the patient’s condition is life-threatening.
It is crucial to treat stroke patients rapidly to minimise physical disability and avoid mortality.
“About 70 to 80% of stroke cases can be treated if patients come to us early. In Malaysia, stroke symptoms tend to become severe due to delay in treatment. Time is of importance and rapid treatment provides better recovery outcomes,” says
Dr Mooi.
For more information, call 06-285 2999.