Times of India
8 December 2008
Umesh Isalkar
Pune, India
TNN

The symptoms of a stroke are often deceptive, but when ignored, the patient’s life can be at risk. quick hospitalisation and treatment are the only way to guard against irreparable brain damage or even death
When 50–year–old Vishwas Sodi experienced sudden numbness in one side of his head, difficulty in lifting his right hand, heaviness in his legs and blurred speech, his wife dismissed it initially as something minor. As the symptoms refused to subside, they called their family physician and he prescribed blood pressure pills. But the symptoms lingered. It was only after the diagnostic tests that the doctors found that he had suffered a brain stroke.

Doctors warn that the deceptively simple symptoms of brain stroke which are often ignored result in high mortality rates. “While 80 per cent of brain strokes are preventable, low awareness about the disease only makes it fatal,” said senior neurologist Sudhir Kothari, who heads the department of neurology at the Poona Hospital and Research Centre.

Patients need to reach the hospital ideally within one hour of being afflicted by stroke so that investigations can be undertaken rapidly and clot buster drug tissue plasminogen activator (TPA) can be administered. The TPA can not be given more than three hours after the onset of stroke, said Kothari.

“Every single minute is crucial for saving the life of a stroke victim. In fact, every second after a stroke, the patient permanently lose more than 30,000 neurons ( brain cells),”said Kothari. Also nearly 14 billion synapses (connections between nerve cells) and myelinated fibres (nerve fibres), approximately 7.5 miles, are lost in just a single minute following the attack, he added.

In the study carried out by the Poona Hospital’s department of neurology, it was found out that 387 stroke cases were admitted in the hospital between May ’07 and May ’08 which means at least one case per day.

“Of all these cases, only 28 reached the hospital within three hours following the attack,” said Kothari. And only 4 per cent patients were eligible and actually thrombolysed (breakdown of blood clots) with the clot buster drug TPA, he added.

Senior neurologist Nasli Ichaporia of Jehanigir hospital said, “The incidence of brain stroke is as common as heart attack, but people are unaware about its symptoms and causes.”

“Unlike heart attack, people fail to understand the symptoms of stroke. And instead of consulting a neurologist, they waste precious time in consulting other doctors and in the process the patient’s chances of survival reduces,” said Iachaporia.

Explaining the disease’s impact, Kothari said that when brain cells die during a stroke, abilities controlled by that area of the brain are lost. “These abilities include speech, movement and memory. How a stroke patient is affected depends on where the stroke occurs in the brain and how much the brain is damaged,” said Kothari.

What is brain stroke?
A stroke or ‘Brain attack’ occurs when a blood clot blocks an artery (a blood vessel that carries blood from the heart to the body) or a blood vessel (a tube through which the blood moves through the body) breaks, interrupting blood flow to an area of the brain. When either of these things happen, brain cells begin to die and brain damage occurs.

Warning signs
Sudden numbness or weakness of face, arm or leg, especially in one side of the body Sudden trouble in vision in one eye or both Sudden confusion, trouble speaking and understanding Sudden difficulty in walking, dizziness, loss of balance and co–ordination Sudden onset of severe headache with no known causes.

How to prevent
Know your blood pressure. Have it checked at least annually Check if you have atrial fibrillation (abnormal heart beats). If you have AF, consult a doctor on how to manage it Avoid smoking If you consume alcohol, do so only in moderation Keep a check on your cholesterol levels If you are diabetic, follow a proper lifestyle regime Include exercise in your daily routine Eat a low sodium (salt) and low fat diet.

Changing perception Myths
Stroke is not preventable It can not be treated Brain attack only strike the elderly The disease occurs in the heart Recovery occurs after a few months following the attack.

Reality
Almost 80 per cent strokes are preventable It requires emergency treatment Brain attack can happen to anyone, irrespective of age It occurs in the brain Recovery may be a life–long process