Lets talk about Stoke

After heart disease, stokes are the second leading cause of death worldwide and the third leading cause of disability (WHO). There are not as many reported cases in Africa as in the developed world however, cases of stroke are on the rise due to urbanisation .Over the last four decades, the cases of stroke in low and middle income countries have more than doubled while new cases in high income countries decreases. It has been shown that strokes do affect people at the peak of their productive life.

 

Stoke is the leading cause of dementia, depression and many other complications that lower ones quality of life. The importance of understanding and preventing strokes can therefore not be understated. Modification of lifestyle to reduce risks goes a long way in the prevention of stroke. Early medical consultation and proper follow-up in the days and months immediately following a stroke have shown benefit in reducing the disability caused by stroke. 

WHAT IS A STROKE

A stroke is the sudden death of some brain cells due to lack of oxygen supply. This happens when there is sudden loss of blood flow to a particular area in the brain. Blood supply can be cut off due to either a clot in the blood vessel or when a blood vessel ruptures as in high blood pressure or from narrowing or spasm of a blood vessel. The damage to the brain cells leads loss of their function and these manifests physically as a sudden loss of a body function.

The duration of the disability or dysfunction caused by a stroke can last seconds, minutes, hours, days, months or sometimes  for  life. This highly depends on what caused the stroke and the duration before blood supply is restored.  When the disability or dysfunction caused by the disruption of blood flow lasts over 24 hours without resolving, then a diagnosis of a stroke is made. If the disability resolves within 24 hours and one is able to go back to their normal functioning, then this is referred to as a TIA (transient ischaemic attack). Some people after experiencing a stroke recover fully with no residual disability while some end up with moderate to severe physical and mental disability. Its key that one gets to consult with a qualified doctor despite of the duration of presentation.

Blood is what supplies all our body organs and cells with nutrients, removes waste and delivers oxygen. If blood is stopped from reaching the brain cells, this leads to injury to some cells and death of some brain cells. There are a couple of mechanisms that can lead to interruption of blood flow. A blood vessel can burst and in the process spill blood into the brain and interrupt blood supply. Also, a clot my form and block blood flow. Blood vessels may get narrowed  or develop spasms too.  If a major blood vessel that supplies a larger part of the brain is affected, then a larger ar5rea is affected. If it’s a terminal blood vessel that supplies a small area of the brain, then the area affected will be small.  Note that the size of the area affected is not proportional to the disability caused.  Sometimes  a small area of the brain affected is very essential for basic functioning and can cause serious complications as compared to if a largely dormant part of the  brain is affected.

 

The good news is blood supply to the brain is quite extensive and it forms collaterals. Think of a major river flowing backwards. The main river would flow into the tributaries and the tributaries would form collaterals that feed into each other so that if one tributary was to be affected then another could still deliver water to a given area. The blood supply to the brain is more like that. This is a protective mechanism that limits damage to the brain by ensuring some blood supply is maintained as efforts are taken to restore the original blood supply. Its essential that early medical care is sort so as maximum efforts to restore good supply are made. This prevents further brain damage, decreases disability and death from stokes.

SOME RISK FACTORS TO STOKE

As with most medical conditions, there are some things we can do to reduce our risk of getting a stroke(modifiable risk factors) and there are some things we do not have control over(non-modifiable  risk factors) that have been associated with increased risk of developing a stroke. By modifying one’s lifestyle, one reduces their chances of getting a stroke and also prevents many other non-communicable diseases. Here are some of the risk factors

Aging is the greatest non-modifiable factor that is associated with increased risk of getting a stroke. Older people are more prone to developing a stroke as compared to younger people. The other risk factors that one cannot change include race and gender.

Heart disease puts one at risk of getting a stroke. Some other medical conditions also increase the risk of one developing a stroke. For instance sickle cell disease, cancers, HIV and many others

Cigarette smoking has shown an association with increased risk of experiencing a stroke

Physical inactivity, high lipid levels and obesity (abdominal obesity) have also been shown to increase ones risk of developing a stroke

HOW DOES A STOKE PRESENT

Someone experiencing a stroke or who has had a stroke will mostly present with weakness or paralysis of one side of the body. This can be also associated with loss of sensation on the affected side. Most of the time, if the left side of the brain is affected then the weakness will be on the right, and if the right side of the brain is affected, then one will experience the weakness on the left. It all depends on the part of the brain affected.  Sometimes convulsions can be experienced, inability to swallow, sometimes incontinent to urine and stool (loss of control), abnormal speech, loss of memory, decreased consciousness. 

Taking care of a stroke patient

After experiencing a stroke, one needs a lot of support from their loved ones. This support might range from physical support due to weakness, help feeding, support with bathroom routines while some may need a fulltime care giver.

While taking care of a person recovering from a stroke or living with its complications, a lot of patience is required. You will have to adjust their schedules so as to provide the best care as sometimes this includes helping them relearn some basic skills. It’s important to seek help where possible to avoid being overwhelmed. Also involving the relevant professionals in the care of stoke patients goes a long way in hastening recovery where possible and lessening the work load for those taking care of the patient. Here is a list of some things that can help you give the best care for a stroke patient.