Brain Attack

Do you know what stroke is?

Are you taking the steps to prevent stroke?

Do you know the symptoms of stroke?

If you answered ‘no’ to one or more of these questions, Sunway Medical Centre Neurologist, Dr. Syed Abdullah Al-Haddad gives you the answers. He also reveals what you need to know about stroke and how it can affect your life.

UH: What is stroke?

Dr. Syed Abdullah Al-Haddad: Stroke is also known as a ‘brain attack’. This is a condition whereby the blood supply to the brain is affected or a part of the brain is damaged, resulting in a neurological deficit. This can lead to muscle or arm weakness and/or speech difficulties, which are common symptoms of stroke.

UH: How does stroke occur?

DSAAH: It is essentially a vascular phenomenon. We can divide the source of stroke into two main causes. One is the blockage of blood vessels to a part of the brain and the other is due to bleeding into the brain. For the former, the blockage can be due to the blockage of the blood vessels or more often than not, it is because part of the wall of the blood vessel travels to the brain and this causes a disruption of blood supply.  Narrowing of the blood vessels can cause parts of the wall to disperse into your blood and head to the brain (Image 1). The latter involves bleeding in the brain which is caused by a ruptured blood vessel in the brain (Image 2).

 

UH: Are there different types of stroke?

DSAAH: Yes, there are. It depends on what it is such as its cause and how long the symptoms of stroke persist. If it is a sudden onset of the problem and it lasts for more than 24 hours, it is classified as a classical stroke and in most cases, this is what happens. If it resolves spontaneously within the first 24 hours, this type of stroke is called Transient Ischemic Attack (TIA) or also known as a ‘mini stroke’.

UH: What is the prevalence of stroke?

DSAAH: The prevalence of stroke in Malaysia is about 14,000 new cases each year. Globally, there has been a decrease of about 10 percent of stroke cases in developed countries. However, in developing countries, there has been an increase of 10 percent of stroke cases. Stroke tends to be prevalent among men compared to women. Risk factors such as diabetes and high cholesterol increase the prevalence of stroke.

UH: Why do you think there is a decrease in stroke cases in developed countries?

DSAAH: In the developed part of the world, I think there is a high level of public awareness about stroke. This helps to prevent this condition, as people are more likely to take care of their health.

UH: What are the other risk factors of stroke?

DSAAH: The risk factors for stroke is divided into two categories – modifiable and non-modifiable risk factors. They are:

Insert: Divide into two boxes and each point has an image linked to it.

Non- modifiable risk factors

  • Age
  • Gender – Male
  • Family history of stroke

Modifiable risk factors (Insert: Emphasize the first letter of each words. It spells out DOCS)

  • Diabetes
  • Obesity
  • Cholesterol
  • Smoking

UH: What can be done to prevent stroke?

DSAAH: Probably the best thing to do is to modify the modifiable factors.

UH: What are the treatment options available?

DSAAH: First of all, we need to confirm that it is stroke and some basic tests will be conducted to confirm the diagnosis. If it has been confirmed that it is stroke, the treatment options in majority of the cases involves medication and rehabilitation. The medical expert will also look for risk factors, which were mentioned earlier, such as diabetes, cholesterol and obesity and manage them accordingly.

For patients who have deficits after stroke such as speech difficulties, they will need to go through a period of rehabilitation with a physiotherapist, speech therapist or occupational therapist, depending on their problem. It’s a multidisciplinary approach.

UH: How about surgery for stroke patients?

DSAAH: Surgery may be required by a small minority of stroke patients such as those who have increased intracranial pressure (increased fluid pressure inside the skull) or patients with massive haemorrhaging which requires the removal of a blood clot.

Generally, surgery is not needed to relieve the symptoms of stroke. The patient will usually be able to recover on his or her own.  However, as a preventive measure, for those who have stenosis (narrowing of the blood vessel in the neck), surgery, which involves placing a small stent in the blood vessel, can be conducted to prevent the likelihood of stroke from occurring.

UH: How can one prevent the reoccurrence of stroke?

DSAAH: The primary rule is to be health conscious and be aware of symptoms and causes of stroke. I need to stress the importance of the fact that prevention is better than cure. So, you would want to try and modify your lifestyle so you practice healthy habits.

UH: How will stroke affect family members and loved ones of the patients?

DSAAH: It depends on the severity of the condition and disability of the patient. Unfortunately, one third of patients with stroke may succumb to it. This can, of course, have a severe repercussion towards the family relationship of the victim.

UH: What is your advice to Malaysians?

DSAAH: The earlier you receive treatment, the sooner a medical expert can provide it. Stroke usually occurs without warning but it is important to receive treatment as soon as possible.

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