Stroke

The World Health Assembly (WHA) has recently adopted its first-ever resolution on stroke, urging member countries to recognize stroke as a major public health priority and strengthen measures related to prevention, treatment, rehabilitation, and long-term care.

What is a Stroke?

A stroke is a medical emergency that occurs when the blood supply to the brain is interrupted, either because a blood vessel is blocked or because it bursts and causes bleeding. The lack of oxygen and nutrients results in the rapid death of brain cells, which can lead to permanent brain damage, disability, or even death if immediate treatment is not provided.

Stroke is among the leading causes of mortality and long-term disability worldwide and constitutes a major burden on public health systems.

Types of Stroke

Ischaemic Stroke

An ischaemic stroke occurs when a blood clot blocks an artery supplying blood to the brain. This is the most common type of stroke and leads to a reduction or complete stoppage of blood flow, depriving brain tissues of oxygen and nutrients.

Haemorrhagic Stroke

A haemorrhagic stroke results from the rupture of a blood vessel within the brain, causing bleeding into the surrounding tissues. This condition, also known as intracerebral haemorrhage (ICH), damages brain cells both by interrupting blood supply and by the pressure exerted by accumulated blood.

Transient Ischaemic Attack (TIA)

A Transient Ischaemic Attack (TIA), often called a mini-stroke, involves a temporary blockage of blood flow to the brain. The symptoms are similar to those of a stroke but usually disappear within a few minutes and do not cause permanent damage. Nevertheless, a TIA serves as an important warning sign of a possible future stroke.

Risk Factors for Stroke

Most cases of stroke are associated with modifiable risk factors, which can be controlled through lifestyle changes and medical intervention. The major modifiable factors include high blood pressure, air pollution, smoking, elevated LDL cholesterol levels, excessive sodium intake, high blood glucose levels, kidney dysfunction, obesity, physical inactivity, and harmful consumption of alcohol.

Certain non-modifiable risk factors also increase vulnerability to stroke. These include advancing age, a previous history of stroke, chronic kidney disease, atrial fibrillation, heart failure, and other pre-existing cardiac conditions.

Symptoms of Stroke

The symptoms of a stroke usually appear suddenly and require immediate medical attention. Common warning signs include sudden numbness or weakness of the face, arm, or leg, particularly on one side of the body; confusion and difficulty in speaking or understanding speech; problems with vision in one or both eyes; dizziness, loss of balance, and difficulty in walking; and a severe headache without any known cause.

The internationally recognized FAST method helps in identifying stroke symptoms:

• F – Face drooping

• A – Arm weakness

• S – Speech difficulty

• T – Time to call emergency services

Early medical intervention significantly improves survival and recovery outcomes.

Treatment and Prevention

The treatment of stroke depends on its type and severity. Medical management may involve clot-dissolving drugs, surgical procedures, and comprehensive rehabilitation programmes aimed at restoring physical, cognitive, and speech functions.

Preventing recurrent strokes is equally important because individuals who have experienced one stroke face a higher risk of subsequent episodes. Preventive measures include maintaining a heart-healthy lifestyle, controlling blood pressure and diabetes, avoiding tobacco and excessive alcohol consumption, engaging in regular physical activity, and taking prescribed medications.