World stroke day- 29 October, 2021

Dr Bobby Varkey Maramattom,
Senior Consultant Neurologist,
Aster Medcity, Kochi

The theme for the 'World stroke day , 29 October, 2020' is 'Join the movement; One in 4 people will ultimately have a stroke. #Don't be the One'.

A stroke is a 'brain attack'. Just like a heart attack, blood vessels and blood flow to the brain can be affected in people with a stroke.

There are two types of stroke; Ischemic stroke and Hemorrhagic stroke. The vast majority of people will have an ischemic stroke :>85% and ~ 15% will have a hemorrhagic stroke. 20 years ago, there were very few effective treatments for stroke and most patients received only some blood thinners and physiotherapy.

In the last 20 years, there has been a tremendous improvement in the treatment options for stroke. For Ischemic stroke, new medications such as IV 'clot busters' like actilyse and Tenecteplase are now administered within a few hours after the onset of stroke. These can potentially improve outcomes after stroke and open up blood vessels. Some patients have blockage of the large blood vessels to the brain, which may not open up with 'clot busting' medications. Such patients require to be taken to a hospital where there are facilities for stroke 'intervention'.

In the 'cath lab', small catheters can be inserted through arteries in the groin and taken up in to the area of the blocked vessel in the brain. The clot can then be pulled out or sucked out and the artery can be opened. If necessary, stents can be placed in blocked arteries to keep them from collapsing and closing again.

A stroke is a devastating event and often affects the young, breadwinner of the family. It is a catastrophe for the individual as well as for the family and caretakers. Many patients have residual deficits after stroke and are troubled for the rest of their lives by debilitating symptoms. These might be difficuly in speaking, understanding, reading , writing, walking, abnormal sensations, spontaneous pain, difficulty with balance or swallowing. It is important that these symptoms are nipped in the bud . The earlier, one avails of specific treatment for stroke, the better the outcome.

At Aster Medcity, we have laid out a stroke programme and an efficient stroke pathway that ensures prompt and rapid treatment of stroke for all patients landing up in our emergency department. We emphasize the AHA acronym to recognize stroke at the earliest ; FAST. 'F' stands for face, if the face starts drooping on one side, A stands for arms, if the arm starts dropping on one side, S stands for speech; if the speech starts becoming slurred and T stands for time; it means one should not waste time. The patient should be brought to the hospital at the earliest.At Aster, 'FASTER' care results in better outcomes after stroke.