Stroke is not the end of the story – it’s just the beginning:
Part of the brain can become paralyzed after a sudden interruption in blood supply, sometimes with loss of the ability to move specific parts of the body. [Face, arm, leg], Seeing or speaking failure and sudden change of balance. There are three types of stroke that need to be identified immediately. (1) Ischemic stroke: Blood clots form and block the arteries in the brain. (2) Hemorrhagic Stroke: This occurs when the blood vessels in the brain rupture. (3) Temporary ischemic attack. [TIA]This is a warning that an ischemic stroke is imminent because the narrowing of the blood vessels disrupts the flow.
Globally, stroke affects 33 million people each year and accounts for two-thirds of all strokes in developing countries. Over the past few decades, the burden of stroke has been increasing worldwide, especially in developing countries. In a developing country like Pakistan, the prevalence and incidence of stroke is largely unknown because of a lack of data collection and availability. A review of the case series reported from medical literature on the incidence of stroke in Pakistan shows that Pakistan has one of the highest per capita stroke rates in the world. In a small series of stroke patients from Islamabad, the incidence of crude age and sexually adjusted stroke was found to be 95 per 100,000 people per year between 2000 and 2016, of which 584,000 out of 650,000 Most cases were reported in people over 75 years of age. 85. However, the ground reality speaks volumes otherwise where we see younger groups of any gender facing paralysis. The high prevalence of diabetes and hypertension in the population at an early age may be the reason for the age gap and the onset of stroke in Pakistan. Temporary ischemic attack on other populations. [TIA] The incidence rate averaged 100,000 people per year from 2014-2016.
In a developing country like Pakistan, we see a ‘this is God’s will’ mentality in most hospitals and the patient receives only basic medical care. [Blood pressure, diabetes etc.] And left it to fate. The lack of a national emergency transport system contributes to the deterioration of disease and mortality when it comes to the treatment of preventive emergencies such as acute stroke / neuro trauma.
In industrialized countries, the overall death rate from stroke in people over the age of 65 is about 10-12. In recent decades, the use of better prophylactic medications and aggressive acute stroke interventions and treatments has led to a steady decline in the incidence of stroke in most developed countries since the 1970s. Paralysis awareness and aggressive treatment given during the acute period. In the developed world, it has been the mantra of survivors of paralysis more than in the will of the developing world.
Stroke-related neurological emergencies still occur 800,000 times a year in the United States, the fifth leading cause of death in the country.
Paralysis is also a major cause of long-term disability. Three-quarters of all strokes occur in people 65 years of age or older, and the risk of stroke doubles every decade after the age of 55.
The good news is that about 80% of strokes can be prevented. A stroke is described as a “brain attack” and is different from a heart attack. Brain attacks. [ischemic stroke] Basically painless, with severe chest pain and heart attack. This difference should be widely recognized by both the patient and the public so that the patient with a stroke can be referred to a dedicated neurology department capable of treating severe stroke. Ischemic stroke is the most common type of stroke, caused by a blockage in blood flow to the brain that causes brain cells to die within minutes. If a severe evolutionary stroke is not treated within the first 6 hours of onset, [two] Millions of neurons [brain cells] Strokes die every minute during evolution. The average ischemic stroke can last up to 10 years. [ten] Hours of both types of strokes. [ischemic & hemorrhagic] Are serious and need immediate medical attention. Numerous myths revolve around paralysis, its causes and treatment. Many people think that paralysis only affects older adults or that they are incurable. The fact is that paralysis can happen to anyone at any time, and proven treatments are available – but only if the paralyzed sufferer receives medical help quickly and at the right medical facility.
You do not need to see a doctor if your paralysis symptoms go away. The symptoms of a temporary stroke are called transient ischemic attacks, or TIAs, and serve as an important warning sign before the actual stroke – a warning that needs to be taken seriously. Some TIAs are called “mini strokes” and occur about 15% before the actual stroke.
During a stroke, the part of the body that controls the part of the brain that is paralyzed stops working. Warning symptoms include sudden numbness or weakness of the face, arms or legs – especially on one side of the body.
Other symptoms include confusion, difficulty speaking or understanding. The victim may have difficulty seeing with one or both eyes, and may have difficulty walking or maintaining balance. If for no apparent reason, a sudden, severe headache can be a sign of a stroke.
If you think your loved one or friend is having a stroke, remember the acronym.
“Beef and Fast”
Balance: Ask the person if he has balance problems or dizziness.
Eyes: Ask the person if he is having difficulty seeing.
Face: Ask this person to smile. Does the facial aspect fall off?
Arms: Ask the person to lift both arms. Does one arm move downwards? Or is it difficult to lift one arm?
Speech: Ask this person to repeat a simple sentence. Is the speech dirty?
Time: With any of these symptoms, call 1122 immediately. Using an ambulance with a siren saves valuable time.
If paralysis is suspected, seek immediate medical attention. We, here at Services Hospital Lahore, have the slogan “Stroke is not the end of the story – it’s just the beginning”. Don’t wait for symptoms to improve or worsen, instead note the time and call 1122 or the Area Ambulance Service immediately. A freezing medicine called IV. [intravenous] TPA[tissue Plasminogen Activator] Can be used for patients with ischemic stroke – but should be given internally within 0-3 hours of the onset of stroke symptoms.
Basically, immediate stroke medical attention is important to improve the chances of surviving a stroke and reducing the chances of complications. The Department of Neurology at Services Hospital, Lahore has an Acute Stroke Service Line which provides 24 × 7 stroke care and manages frozen TPA if the patient arrives within the stipulated time. [0-3 Hours] Meets symptom onset and inclusion criteria. Once a stroke patient is identified, he or she may need to have an emergency CT brain test and some necessary blood tests before considering the administration of anticoagulants. Therefore, treatment can be started as soon as the stroke is detected. Studies show that first aid shows significant improvement compared to those who arrive late at the emergency department / hospital.
Some patients may be eligible for catheter-based procedures. [Thrombectomy, Aspiration] Other procedures to remove blood clots, or to open narrowed arteries from fatty deposits that reduce the chances of another stroke.
There is nothing better than prevention. To prevent a pre-stroke or recurrent stroke, it is important to control the risk factors for a changed lifestyle such as being overweight, smoking, physical inactivity, excessive alcohol consumption, energy drinks and sodas. And illicit drug use (cocaine, amphetamines, heroin, etc.). Medical risk factors – many of which are directly related to lifestyle – include high blood pressure, high cholesterol, diabetes, sleep apnea and heart disease.
Controlling high blood pressure and diabetes are the most important things that can be done to prevent stroke. Thus, it is important to exercise, manage stress, maintain a healthy weight, limit sodium, sugar and alcohol intake, and take prescribed medications. Doctors may also prescribe prescription medications such as anti-platelet medications, anticoagulants, and cholesterol-lowering medications, diabetes medications, CPAP machines for sleep apnea, and smoking cessation aids.
For hemorrhagic stroke, the risk factors are very similar, hypertension is the main cause. Head injuries, blood disorders and thinning of the blood are also additional causes. Catheters or surgery can be used to repair blood vessels or other vascular disorders associated with hemorrhagic stroke, and non-invasive stereotactic radio surgery is an option in some cases.
After a stroke, rehabilitation and rehabilitation efforts are focused on restoring work to allow for the return of freedom. Physical, occupational, speech and cognitive therapy all play an important role in recovery and reduction of complications. It is also important to modify risk factors to reduce the risk of other strokes. At the Department of Neurology, Services Hospital, Lahore, patients are managed in a dedicated neurocritical unit, after which both the patient and the outpatient are rehabilitated. State-of-the-art neurocritical and neuro-rehab units have been set up so that patients can be transported to the community without minimal dependence.
So all strokes – big or small – should be taken seriously and acted upon as soon as possible, the good news is that they can be preventable and treatable.
Remember – Acute ischemic stroke is a treatable condition.
“Stroke is not the end of the story – it’s just the beginning.”
(The author is the head of the neurology department at the Services Institute of Medical Sciences.) [USA] Accreditation of Neuro Endovascular Surgery. He has also been the President of Pakistan Stroke Society.
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