Health Tips

Stroke

What is stroke?  

In Malaysia, stroke was recorded as the second leading cause of death according to the Malaysian National Burden of Diseases Study and study on vital registry system in 2000.⁵ A stroke happens when there is a sudden interruption of continuous blood flow to the brain, caused by a clot or bursts of a blood vessel in the brain. When stroke happens, reduced oxygen and nutrients supply as well as sudden bleeding in the brain cause brain cells damage or death, and this can happen within minutes. Hence, stroke requires immediate medical attention.¹

Types  

Image adapted from source: Op2Lysis

There are two main types of stroke³ :

1. Ischemic stroke (accounts for approximately 80% of strokes)

   1. When the supply of blood to one or more regions of the brain is suddenly cut off or interrupted

   2. Caused by a clot within a blood vessel (thrombosis/embolism ) or arterial narrowing (stenosis)

2. Hemorrhagic stroke (accounts for approximately 20% of strokes)

   1. When an artery in the brain bursts and blood gushes into or around the brain

      1. Caused by conditions like hypertension and cerebral amyloid angiopathy or irregularities in the brain’s vascular system.

   2. Damage brain tissue by either

      1. Increased pressure inside the skull (intracranial pressure) or

      2. Brain tissue exposed to the toxic substances in the blood mass

Mini stroke  

A transient ischemic attack (TIA) occurs when the blood flow to part of brain is cut off temporarily, which then dissipates after a short amount of time. The stroke symptoms usually begin to fade in less than 20 minutes, and often disappear within an hour. Although the damage from a TIA is confined to a small region in brain, it is an important sign that a larger, more serious stroke could occur soon. It is noted that about 1 in 3 people who experience a TIA will have a stroke sometime in the future, with the majority happening within a year after the TIA.³

Therefore, never ignore an episode of TIA. Immediate action can make a difference in avoiding lifelong disabilities or potentially save a life.³

Signs and symptoms ⁸

It is important to know the signs and symptoms of stroke and call for medical help as soon as possible in order to save a relative, neighbour, friend, or even a stranger’s life. Timely treatment allows higher possibility of survival and to greatly reduce and reverse the damage to the brain.

Image adapted from source: American Stroke Association

Other symptoms:          

• Sudden numbness or weakness of face, arm, or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

Prevention to lower risk ^{4, 9}

• Keep your blood pressure and blood cholesterol in check (High blood pressure, a major risk factor for stroke, can increase your risk of stroke by 2-4 folds. High cholesterol also affects the blood flow to the brain as well. Check your blood pressure and cholesterol level regularly by visiting a doctor.)
• Choose heart-healthy food(Increase the intake of fruits and vegetables while limiting the consumption of food with saturated fats or transfat and added sugar)
• Aim for a healthy weight (Maintain your body mass index (BMI) within the range of 18.5 to 24.9. Being overweight can increase the risk of various cardiovascular disease. You can speak to your doctor about what BMI is right for you. You can also calculate your BMI here.)
• Stress management(Stress and agitation can contribute to higher blood pressure and higher risk of cardiovascular events. Learning to cope with stress using healthy ways can help to improve quality of life and health in general.)
• Exercise regularly(Increased physical activity has been proven to be beneficial in terms of heart health with physical inactivity being one of the risk factors of stroke⁶)
• Stay away from cigarettes and alcohol (Smoking and drinking alcohol have been widely known to result in detrimental effects to our own heart. Staying away from these harmful substances can save your life.)
• Get sufficient quality sleep (aim for around 7 to 9 hours of sleep every night. Many studies have proven the relationship between sleep duration and cardiovascular diseases⁷)

Complications²

A stroke can cause lasting brain damage, long-term disability, or even death, and this depends on how much brain tissue is damaged.

To learn more, please visit these websites:

https://www.myhealthmylife.com.my/                 https://www.menshealth.com.my/

References:

1. American Heart Association. About Stroke. Available at: https://www.stroke.org/en/about-stroke. Accessed on 19 October 2020.
2. National Heart, Lung, and Blood Institute. Stroke. Available at: https://www.nhlbi.nih.gov/healthtopics/stroke. Accessed on 19 October 2020.
3. National Heart, Lung, and Blood Institute. Stroke: Hope Through Research. Available at: https://www.ninds.nih.gov/disorders/patient-caregiver-education/hope-through-research/st roke-hopethrough-research#who. Accessed on 19 October 2020.
4. National Heart, Lung, and Blood Institute. Heart-Healthy Living. Available at: https://www.nhlbi.nih.gov/ healthtopics/heart-healthy-living. Accessed on 19 October 2020.
5. My Stroke Hospital. Stroke Prevalence and Epidemiology. Available at: https://mystrokehospital.my/ strokeprevalence-and-epidemiology/#:~:text=The%20prevale nce%20of%20stroke%20in,Survey% 20(NHMS)%20in%202006.&text=The%20same%20surv ey%20also%20illustrated,%25. Accessed on 19 October 2020.
6. Gordon NF, Gulanick M, Costa F, et al. Stroke. 2004; 35: 1230-1240.
7. Nagai M, Hoshide S, Kario K. Curr. Cardiol. Rev. 2010; 6(1): 54-61.
8. American Heart Association. Stroke Symptoms. Available at: https://www.stroke.org/en/about-stroke/ strokesymptoms. Accessed on 19 October 2020.
9. My Health My Life. Stroke. Available at: https://www.myhealthmylife.com.my/cardiovascular/stroke. Accessed on 30 October 2020.

Written by

Ms. Charlotte Lee