Ojo: Best Cure For Stroke Is Prevention

Dr. Omolara Ojo is a lecturer and consultant neurologist at the College of Medicine, University of Lagos and Lagos University Teaching Hospital (LUTH). In this chat with GERALDINE AKUTU, she throws light on stroke, its causes and solution.

What is stroke?
IN layman’s term, a stroke is a disease caused by sudden interruption of blood flow to the brain or bleeding into the brain tissue, but the World Health Organisation (WHO) defines stroke as the sudden onset of a focal or global neurologic deficit, of vascular origin, lasting more than 24 hours or leading to death. There are two types – the ischemic type caused by clots blocking blood flow to the brain and a haemorrhagic type caused by rupture/tear of a vessel with bleeding into the brain.

What happens during a stroke and why can’t some victims identify the symptoms?
When either the blood supply is lost or there is bleeding into the brain, the overall consequence is that the brain cells (neurons) stop functioning and die. When neurons die, the part of the body controlled experiences reduced unction or loss of function. So, people can experience loss of the ability to speak, loss of muscle strength, loss of vision or numbness on one side of the body, depending on the region of the brain affected.

Sometimes, a stroke is associated with loss of consciousness, which will make the person afflicted unaware of his/her symptoms. Some patients may also become confused or may not be able to express themselves.

What are the risk factors for stroke?
Risk factors for stroke are traditionally categorised as modifiable and non-modifiable risk factors. The non-modifiable risk factors are those that cannot be changed or altered in any way by the individual e.g. age (in men, 65 years and in women, 55 years), male gender, ethnicity (Africans), and a family history of stroke. The modifiable risk factors are those that the individual can take care of or seek treatment for and are the target of primary prevention strategies for stroke -hypertension, diabetes mellitus, cigarette smoking, alcohol ingestion, dyslipidemia (hypercholesterolaemia), some heart diseases, sickle cell disease and infections like syphilis and HIV. Obesity (and a sedentary lifestyle) are also risk factors.

Is there any treatment for stroke?
Yes, there is treatment for stroke. However the symptoms have to be recognised immediately by the patient or relatives and the person taken to a hospital (either with a neurologist on staff or visiting) immediately.

For the ischemic type (must be confirmed by imaging) there is a clot-dissolving medication (only available in few facilities and expensive) that can be given within 4.5 hours of stroke onset. Whether the patient is getting this medication or not, the sooner treatment starts the better; deficits (e.g. paralysis can be limited and sometimes even eliminated). Other modalities of treatment are directed towards prevention and treatment of complications, improving recovery and reducing the risks of other strokes in future.
What can be done to reduce the risk of stroke?

For people who have not had a stroke, prevention is the key (primary prevention) – lifestyle modifications (regular exercise, healthy eating, reducing and stopping cigarette smoking and alcohol ingestion, especially above the age of 40). Periodic health checks are also important – checking the blood pressure, glucose level and cholesterol levels. This helps detect diseases like hypertension and diabetes early. For those who are already living with hypertension and/or diabetes, good medication compliance and regular physician follow-up is essential.

To prevent another episode of stroke in those who have already experienced one (secondary prevention) lifestyle changes (healthy eating habits – low salt, low cholesterol diet, increase intake of fruits and vegetables and regular exercise), optimising blood pressure and glycaemia (blood glucose) control, controlling cholesterol, quitting smoking and alcohol intake; and in addition with the ischemic type of stroke lifelong, use of medications that prevent platelet aggregation (anti-platelets) or blood thinners depending on the risk factor are important.

The most common risk factors in our environment are undiagnosed hypertension and diabetes. Both are silent killers meaning they are asymptomatic until they cause complications, not limited to stroke. The best cure is prevention (check your blood pressure, blood glucose and cholesterol levels today and every six months if above the age of 40years).