Heed the warning signs of stroke

Every minute counts when it comes to surviving a stroke which can cause disability or death. Neurosurgeon Dr Keith Goh from Parkway East Hospital tells you how to recognise the early warning signs and get help quickly.

Stroke is a “brain attack” where the blood and oxygen supply to the brain is cut off. It happens when an artery to the brain is blocked or ruptured.

“The blockage is caused by blood clots from the heart or other parts of the body, or from the gradual buildup of cholesterol and fatty deposits. The blood vessel rupture is usually from high blood pressure (hypertension), or the result of an abnormal blood vessel such as an aneurysm (abnormal ballooning of an artery section due to weakness in the blood vessel wall), causing it to burst,” says Dr Keith Goh.

It is the fourth leading cause of death in Singapore, and the main cause of disability and long-term hospitalisation. Heart disease and stroke combined is the top cause of death in women.

The effects from a stroke depend on which part of the brain is damaged, and the disability may be temporary or permanent, partial or complete. “Hence, it is crucial that people seek medical attention immediately as soon as they feel the symptoms so that they can minimise or better still prevent any disability arising from a full-blown stroke. It is better to be safe than sorry,” says Dr Goh.

There are several factors that can increase your risk of a stroke, and they include:

• Personal or family history of stroke, heart attack or Transient Ischaemic Attack (a mini stroke usually lasting a few minutes and causing no permanent damage)
• Increasing age – the risk of stroke increases as you get older
• If you are suffering from hypertension, diabetes, heart disease, high cholesterol
• Cigarette smoking or exposure to second-hand smoke
• Lack of exercise
• Obesity

According to Dr Goh, some ethnic groups have a higher incidence of stroke than others – for example in Singapore, Chinese and Indian men have a higher risk of getting a stroke than Malay men.

Signs and symptoms of stroke
Watch out for these signs and symptoms which include:

• Sudden weakness, loss of sensation or numbness of the face, arm or leg, usually on one side of the body
• Confusion, or difficulty in speaking
• Sudden loss of vision in one or both eyes
• Sudden dizziness, loss of balance or difficulty walking
• Sudden severe headache
• Memory loss, confusion

Dr Goh advises: “Seek medical attention immediately if you suspect that you or someone else is having a stroke. Every minute counts. The longer a stroke goes untreated, the greater the potential for brain damage and disability.”

Treatment for stroke
To determine the best treatment for your stroke, the doctor must first find out what type of stroke you are having and which part of your brain it is affecting.

These investigations include magnetic resonance imaging (MRI) brain scan, angiogram – to assess the blood vessels of the brain, and blood tests – to determine cholesterol level, glucose level, kidney and liver function.

Depending on the type of stroke, treatment options include carotid endarterectomy which is a surgical procedure to open up the severely narrowed arteries, or stenting to dilate the blood vessels and improve poor blood flow for those who suffer from ischaemic stroke as a result of a blood clot in the brain.

For those who have had a haemorrhagic stroke which happens when a blood vessel “balloons” and then leaks or bursts – this part of the blood vessel can be clipped surgically or blocked by the insertion of a coil to prevent further bleeding into the brain. Or, if the stroke is the result of arteriovenous malformation which is a defect in the blood vessels, this can be treated with surgery or gamma knife radiosurgery.

Publication of article by courtesy of Dr Keith Goh from Parkway East Hospital