One could lose as many as 1.9 million nerve cells per minute during a stroke; so time is the most crucial factor here for minimising brain damage.
When oxygen-rich blood supply does not reach any body part, cells get damaged and eventually die. But what happens when the blood-carrying oxygen fails to reach our brain? Most of us are aware of the dangers - after all, the brain controls all critical functions of the body. But it is time to delve deep and understand what could be done to prevent brain stroke. This is crucial because of an increased incidence of stroke among the young. "Earlier, people in their 60s and 70s had a stroke, but now, stroke rates are rising among those in their 30s and 40s," says Dr S. Meenakshi Sundaram, Senior Consultant Neurologist at Apollo Speciality Hospitals, Madurai. In fact, the number of such cases (stroke among younger people) has doubled over the past 10 years, he adds.
So, what happens when you have a stroke? Doctors call it a cerebrovascular accident, or CVA, similar to a heart attack where blood flow to a part of the heart is hindered due to a blood vessel blockage. When the blood flow to the brain gets blocked, the impact is severe - around 1.9 million neurons or nerve cells could die in a minute. If left unattended, it could lead to massive damage, which is why neurophysicians have coined the phrase 'time is brain', emphasising that nerve tissues in the brain die rapidly with the onset of stroke symptoms. And the longer the duration, the worse the damage. The protocol here calls for a quick infusion of tissue plasminogen activator (tPA), which means clot-busting drugs such as alteplase or tenecteplase. At times, it is followed by a mechanical intervention to remove the blood clots.
Some lucky people, about a third of the total cases, get some early warning - a hand or a leg paralysed for a short duration, numbness experienced very briefly on one side of the body, a sudden inability to speak or other speech problems called aphasia or momentary loss or blurring of vision, usually in one eye.
If you are worried about these symptoms, a quick check called the FAST test can help, says Dr Sundaram. Here, F stands for facial drooping: Ask the affected person to show his/her teeth. The nasal furrow should be equally there on both sides of the face and not drooping down on one side. A stands for arm weakness: Ask the person to raise his/her hands; any inability to do so should be noted. S indicates speech difficulties: Be wary of any sudden speech impairment. Finally, T stands for time: If there is any abnormality in any of the above three areas, get medical help.
Identification of risk factors also helps. These include lack of physical activity/obesity, lack of sleep, diabetes, rising stress levels and high blood pressure. Excess salt intake is bad for your blood vessels. So, cut down on those salt-garnished salads and pickles, and quit smoking, which triggers blood clotting. Whether you are young or old, staying fit and pursuing a healthy lifestyle could help ward off stroke risks.
Focus on Neuroprotection
Current research is focussing on neuroprotective drugs which will keep the nerves in the brain safe, thus preventing or minimising brain damage, says Dr Sundaram. Researchers are also looking at drugs that can help extend the window for stroke treatment. As of now, tPA/other medications must be used within four hours and a half. But soon there could be procedures to expand the time span nearly six times and still minimise the effects of stroke. Also, newer molecules with fewer side effects are explored for better clot-busters and newer mechanical interventions using more sophisticated techniques are being worked upon.