21 Dec How to identify a stroke?
Stroke means something which happens suddenly. The name ‘stroke‘ is used to describe a medical illness of brain in which either the blood supply to a specific part of brain stops or there is leakage of blood from the blood vessel within the brain. Consequently, one may suddenly lose one or more functions of the brain.
Examples of Stroke
The following are a few examples of stroke –
- Inabilty to speak clearly, using incorrect words, saying something that does not make any sense or the inability to speak at all
- Turning the mouth to one side while speaking or smiling
- Paralysis i.e. the inabilty to move any body part
- Partial or complete loss of sensation
- Inabilty to see, loss of vision on one side, double vision or blurred vision
- Imbalance while walking
- Lack of coordiantion of the hands
- Severe headche and vomitings
- Losing consciousness
These symptoms often start suddenly. Commonly, this happens during sleep. The patient may wake up from sleep and is not able to speak clearly or walk and stand. This is called as ‘wake up stroke.’
What should I do?
At home, unfortunately there isn’t much that can be done. However, you should try to do the following – provide the patient with support so that he doesn’t fall & immediately shift him to a hospital, which has a stroke facility to provide clot busting therapy.
The clot busting treatment can be done only within 4.5 hours from onset of symptoms. As time passes, more and more brain cells die and loss of function is irreversible. Hence any loss of time means increased likelihood of permanent damage.
What does a neurologist do in this situation?
First the emergency doctor and neurologist try to identify and determine whether the current symptoms are due to a brain stroke. The patient is stabilised and the neurologist conducts a brain imaging (CT scan or MRI brain). If brain stroke is confirmed, he may give clot busting treatment if it is a blokage of an artery in the brain (provided the patient’s other parameters permit). If it is a case of brain haemorrhage, he may follow a different line of treatment.
What is normal line of action in such cases?
Such patients need to be hospitalised and admitted to the ICU initially. Patients will be given the required treatment; neurophysiotherapy, speech therapy & occupational therapy.
What is the long term outcome in such cases?
It has been seen that most of the recovery tends to occur in the first 3 months after the stroke. After this the speed of recovery slows down, but recovery may continue for upto 2 years .
3 scenarios for a stroke patient are –
- Patient may recover completely with no residual paralysis
- Patient may recover partially with residual paralysis
- Patient may remains paralysed or may even die
A stroke patient’s recovery depends on many factors such as severity of initial brain damage, timely treatment and good supportive treatment for the first few months.
Dr. Kapil Agarwal
MBBS Gold Medalist | MD Internal Medicine | DM Neurology (AIIMS New Delhi)
Senior Consultant and Head of Department, Neurology