Anatomy of a strokeA popular miscon

Anatomy of a stroke
A popular misconception is that a stroke strikes the heart. A stroke actually occurs when blood supply to the brain is affected. There are chiefly two types of strokes: ischemic and hemorrhagic. Ischemic strokes are the result of a clot that blocks blood flow in an artery supplying blood to the brain; hemorrhagic strokes are caused by the rupture of a wall of an artery that performs the same function, leading to bleeding in the brain.

Dr Kaseansom Viranuvatti, M.D., at the Samitivej Srinakarin Hospital, explains, “The symptoms depend on which part of the brain is affected. Usual symptoms are weakness on one side of the face, or one leg or arm. A drooping smile, slow and/or slurred speech, double vision, dizziness are all signs of a stroke.”

If someone is having a stroke, doctors recommend the FAST approach: Get them to smile and check their Face to see if part of their smile is drooping; get them to raise their Arms and check if one arm sags down; get them to answer a simple question and see if their Speech is slurred or they seem to be having trouble formulating responses. If these symptoms are identified, Telephone emergency services immediately.

“We cannot do anything for stroke patients but get them to the nearest hospital. The problem must be diagnosed and treated immediately,” Dr Kaseansom says. Time is of essence in such cases. “The best outcome in the case of a stroke can only be achieved if the patient receives medical attention within 4.5 hours, which is the golden period. The faster treatment is started, the better the patient’s chances for optimal recovery.”

Treatment and recovery
Once the cause of the stroke is diagnosed, it can be treated by either administering a drug to dissolve clots or by administering a blood thinner. In the case of a hemorrhagic stroke, surgery may be required to stem the bleeding causing the stroke, surgery can be carried out in any part of the brain, including the brain stem. In some cases, the doctors do not need to carry out surgery, they can inject a glue to stop the bleeding. Depending on the severity of the stroke and the speedy provision of medical care, it is possible for stroke patients to return to near-normal health.

“Our hospital offers occupational and physical therapy. Depending on what part of the brain the stroke has affected, patients receive walking, balancing, aqua therapy (swimming), fine-motor movement and self-care training,” Dr Kaseansom reveals.

However, some patients may have to deal with life-long problems such as weakness in one side of the body; speech difficulties; memory, sleep, or appetite related problems; and depression.

Prevention is better…

“Prevention is better than treatment. So lower your risk factors,” Dr Kaseansom advises. What are the risk factors? High blood pressure or high LDL or bad cholesterol, obesity, type 2 diabetes, smoking, excessive alcohol consumption, and heart disease or hereditary conditions that increase the risk of a stroke (To assess your vulnerability, use the Stroke Risk Scorecard on http://www.stroke.org/site/DocServer/scorecard_risk.pdf?docID=601).

“Strokes are more common in Bangkok than in villages because of the kind of food we eat here —unhealthy, fatty, rich food. Stress is another major factor,” Dr Kaseansom points out.