Sudden Strike - Hypertension

17/10/2012 11:26

Stroke is often perceived as a problem that comes with old age but in reality, even the young and sporty can be vulnerable. Consultant Neurosurgeon Timothy Lee shares some insights on the condition.

A stroke can affect anyone. Case in point: Popular local radio DJ Rod Monteiro. Despite being relatively young at 44, and leading a sporty lifestyle including running marathons and cycling regularly, Mr Monteiro made the news recently when he suffered a stroke while at work.

Even children are not spared. Consultant Neurosurgeon Dr Timothy Lee’s youngest patient for stroke was just 12 years old. “He fainted and was found to be bleeding from a congenital blood vessel abnormality. We had to operate on him immediately,” said Dr Lee.

While you may have little control over congenital problems, there are risk factors which can be moderated to prevent or reduce the chance of a stroke. Things you can do proactively include adopting a healthy diet, avoid smoking and controlling diabetes and hypertension if you have the conditions.

Stroke also need not be viewed as a permanently debilitating condition. According to Dr Lee, about half of all patients who suffer a stroke make a good recovery, usually within the first three months.

Dr Lee’s young patient is one such success story. “He made an excellent recovery and returned to school. He even regained the top position in his class,” shared Dr Lee.

Q&A

What is a stroke?

A stroke is a condition where blood flow to the brain is interrupted – either due to blockage or bleeding, starving brain cells of necessary oxygen and glucose, and leading to brain damage which can manifest in impairment to speech, movement and memory.

According to Dr Lee, in most cases (about 80%), the stroke is due to a blocked artery; while bleeding accounts for the rest. Both result in a lack of blood flow to the brain and a build-up of pressure in the brain which leads to the death of brain cells.

How can one tell if someone is having a stroke?

The common signs are weakness or numbness of the limbs and a sudden headache. Transient weakness or numbness are possible warning signs of a blocked artery, while a sudden and unusual headache may be a sign of internal bleeding. Slurring of speech or sudden blurred or double vision are possible tell-tale signs too.

Does it help if you get to a doctor quickly?

Like most diseases, the earlier you get treated, the better. Prompt treatment can make all the difference in one’s prognosis for recovery.

Are all strokes the same?

Not all strokes are alike and they can be of different severity. The impact of a stroke depends on how much of the brain is affected and the location. Smaller strokes may result in weakness on one side of the body, difficulty speaking and incontinence. Larger strokes may result in paralysis. Some strokes can be fatal.

What risk factors should I look out for to prevent a stroke?

I sometimes use the acronym Cholesterol DISH to summarise the key risks factors that can lead to a blocked artery. ‘D’ is for Diabetes; ‘I’ for ‘I or myself’, which basically means your genetics; ‘S’ is for Smoking; and ‘H’ is for Hypertension. As for the other major cause of stroke –bleeding, the main risk factor to monitor is hypertension.  

Can anything be done to mitigate the occurrence of a second stroke after a patient has suffered the first one?

You should first try to reduce the risk factors. While you may not be able to do anything about your genetics, you can help yourself by making lifestyle changes such as giving up smoking and opting for a healthier diet. It is also important to get proper medical attention and medication, for example an anti-platelet agent may be prescribed by the doctor to open up the blocked artery. Regular medications may be needed to control diabetes, high cholesterol or hypertension.

What is the treatment for stroke patients?

The primary goal is to restore brain function and prevent future strokes. Besides the use of an anti-platelet agent, surgery to remove a narrowing in the artery may sometimes be required. Post-stroke, rehabilitation may be necessary to help the patient recuperate and recover mobility.

Final words of advice

Listen to your doctors and therapists, and follow their instructions. It is important to control the risk factors and don’t stop your medication without discussing it first with your doctor.

For more information on hypertension & high blood pressure, visit the Mount Alvernia Hospital website. Dr Timothy Lee’s clinic is at Mount Alvernia Medical Centre A, Unit #02-23. Vigilance & treatment for hypertension.