When a 64-year-old woke up from his afternoon nap earlier this month, his family noticed his slurred speech. With great presence of mind, they immediately rushed him to hospital. It turned out he had two clots in his brain that triggered a stroke, paralysing the left side of his face and right side of his body.
He spent five days in hospital and was advised physiotherapy. Initially he had problem speaking and swallowing. Today, with regular physiotherapy and exercise, he is slowly recovering, trying to perform his day-to-day activities himself. His family said recovery has been relatively quick as he reached hospital within three hours of the attack.
Doctors describe a stroke as the sudden onset of neurological deficit due to vascular causes. They emphasise the patient should reach the hospital within three or four few hours of the stroke. G.T. Subhas, professor and Head of the Department of Neurology, Bangalore Medical College, said: “Earlier, providing thrombolytic treatment for a patient within three hours was considered essential to restore normal brain function. However, according to recent studies, the American Stroke Association states that normal brain function can be restored if thrombolytic agents are administered even 4.5 hours after the stroke.”
If the patient is brought to the hospital early, morbidity and mortality is greatly reduced.
The WHO has recognised stroke as one of the leading causes of death worldwide and according to the World Stroke Organization, one in six people worldwide will suffer a stroke in their lifetime.
There are two types of strokes: ischemic stroke, which occurs when the arteries to the brain are blocked, and brain haemorrhage.
Risk factors include diabetes, high blood pressure and high cholesterol.
Treatment depends on the type of stroke. If there is no bleeding, then thrombolytic treatment helps burst the blood clot in the brain. But, if there is bleeding, then a non-surgical procedure, known as endovascular coiling, is performed.
The cost of the treatment is as high as Rs. 2 lakh at private hospitals. However, those from deprived backgrounds can benefit from the Yeshasvini and Vajpayee Arogyasri schemes.
Patients can develop severe complications, which include motor impairment, respiratory problems, speech, sensory, vision and hearing impairment. Concentration, memory and learning ability can also be affected.
Vikram Huded, head of interventional neurology at a private hospital, said with proper treatment, improvement can be seen after three to six months. “If a part of the brain is affected, then gradually the other part begins to perform the function associated with the part that was damaged.”
Over the past few years, Dr. Huded has been seeing more patients below 40. He attributes this to “stress, smoking and alcohol consumption”.
S. Vijendran, a physiotherapist, stressed on the role of physiotherapy in patient rehabilitation. “The therapy is not a short-term goal; it depends on the extent of brain injury.”
The patient’s family also undergoes stress. A caregiver, who didn’t want to be named, said the event interferes with individuals’ routine. “It can be extremely frustrating and depressing for the patient, especially if the patient is independent-minded or the breadwinner.”
(October 29 is World Stroke Day)