Stroke ( Cerebrovascular accident)

According to the latest WHO data published in 2017, Stroke Deaths in Malaysia reached 15,642 or 11.31% of total deaths. 

Stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.

A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.

Risk Factors

Many factors can increase your stroke risk. Some factors can also increase your chances of having a heart attack. Potentially treatable stroke risk factors include:
 
Lifestyle risk factors
  • Being overweight or obese
  • Physical inactivity
  • Heavy or binge drinking
  • Use of illicit drugs such as cocaine and methamphetamines
Medical risk factors
  • Blood pressure readings higher than 120/80 millimeters of mercury (mm Hg)
  • Cigarette smoking or exposure to secondhand smoke
  • High cholesterol
  • Diabetes
  • Obstructive sleep apnea
  • Cardiovascular disease, including heart failure, heart defects, heart infection or abnormal heart rhythm
  • Personal or family history of stroke, heart attack or transient ischemic attack
Other factors associated with a higher risk of
  • Age —People age 55 or older have a higher risk of stroke than do younger people.
  • Sex — Men have a higher risk of stroke than women.
  • Hormones — use of birth control pills or hormone therapies that include estrogen, as well as increased estrogen levels from pregnancy and childbirth.

Symptoms

Watch for these signs and symptoms if you think you or someone else may be having a stroke. Pay attention to when the signs and symptoms begin. The length of time they have been present can affect your treatment options:

  • Trouble with speaking and understanding.
  • Paralysis or numbness of the face, arm or leg. You may develop sudden numbness, weakness or paralysis in your face, arm or leg.
  • Trouble with seeing in one or both eyes. You may suddenly have blurred or blackened vision in one or both eyes, or you may see double.
  • Headache. A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness.
  • Trouble with walking, loss of balance or loss of coordination.

Complications

A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part was affected. Complications may include:

  • Paralysis of loss of muscle movement
  • Difficulty talking or swallowing
  • Memory loss or thinking difficulties
  • Emotional problems/ depression
  • Pain, numbness or other strange sensations may occur in the parts of the body affected by stroke
  • Changes in behavior and self-care ability

Prevention

Knowing your stroke risk factors, following your doctor’s recommendations and adopting a healthy lifestyle are the best steps  you can take to prevent a stroke. 
  • Have annual health check ups in order to check for risk factors
  • Controlling high blood pressure (hypertension)
  • Exercising
  • Stress management
  • Maintaining a healthy weight
  • Limit salt and alcohol intake
  • Control cholesterol and sugar level
  • Stop smoking
  • Treating obstructive sleep apnea (OSA)

Diagnosis

Knowing your stroke risk factors, following your doctors recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke
 
  • Blood tests to determine complete blood count (CBC)
  • Tests to determine blood glucose and cholesterol levels
  • Electrocardiogram to check for irregularities in heart rate and rhythm
  • Computerized tomography (CT) scan to identify blood deficiencies or hemorrhaging in the brain
  • Carotid duplex scan (CIMT), an ultrasound test using high-frequency sound waves to measure blood flow in the carotid arteries; the carotid arteries are located in the neck and supply blood to the brain
  • The carotid intima-media thickness test (CIMT) is a measure used to diagnose the extent of carotid atherosclerotic vascular disease. The test measures the thickness of the inner two layers of the carotid artery—the intima and media—and alerts physicians to any thickening when patients are still asymptomatic.
    • Early detection may indicate the need for a more aggressive approach to managing the risk factors associated with heart disease and stroke.
  • Magnetic resonance imaging (MRI) to examine the brain, cerebral arteries, and carotid arteries

Treatment

The treatment of stroke depends on the type of stroke – Ischemic or Hemorrhagic stroke, mainly with medication and surgical intervention.