“Time is brain,” said Neurological Society of South Africa (Nasa) president Dr Patty Francis ahead of World Stroke Day which is observed on October 29.
It has been estimated that for every minute of diminished blood flow to the brain, two million neurons are lost. Life changes irrevocably for many stroke survivors who lose mobility, memory, and speech abilities, along with their independence and quality of life.
The second biggest cause of death worldwide, after heart disease, is strokes. A stroke is manageable, provided symptoms are immediately recognised and treatment is sought promptly.
Stroke is a cerebrovascular disease, not a cardiovascular disease, which means while cardiovascular disease affects the blood vessels of the heart, causing angina or heart attacks, cerebrovascular disease affects the blood vessels of the brain, resulting in strokes and disabilities that arise from a blockage of the brain's blood vessels. This distinction is crucial because when members of the public hear the word "stroke", they most commonly associate it with heart disease, Dr Francis told IOL Lifestyle.
She explained a stroke was a brain attack caused by a blockage of blood flow to a specific part of the brain, with the physical manifestations following after that.
“The one key characteristic that sets cardiovascular disease or heart attack apart is the single hallmark which is the crushing chest pain,” she said.
Unlike heart attacks, strokes are painless, which puts patients at risk of ignoring the symptoms until it is too late, Dr Francis said.
Unfortunately, a stroke does not cause pain and does not cause a singular symptom which says if you get this symptom then you are likely to be having a stroke. There are several symptoms based on the various regions of the brain that can be robbed of blood flow, hence the acronym FAST or the modified acronym: BEFAST acts as a reminder of both the signs and the need for swift action, Balance (sudden loss of), Eyesight (loss, blurred or fuzzy), Face (drooping to one side), Arm (weakness in one arm/leg), Speech (slurring, difficulty speaking/understanding, not making sense) and Time (call for help).
She adds: “Each of these is an important warning sign that something is going wrong in the brain and while a stroke is treatable if caught early enough, other problems with the brain may also exist. Any sudden change in these functions should raise the alarm, act fast and act immediately.”
When a stroke occurs, every second counts. The longer the brain is deprived of blood and oxygen, the more severe the damage and the higher the likelihood of death or disability. Quick action to restore the blood supply to the brain is therefore vital to arrest the damage and prevent further loss of function, she said.
There are genetic predispositions to developing a stroke, there's a common colloquial expression that goes, "Genetics is the loaded gun and the lifestyle pulls the trigger," said Dr Francis.
There are, however, some exceptionally specific single-gene causes of stroke, including CADASIL, a gene that predisposes to certain stroke categories. It is generally known that in strokes of more common types, there are genetic predispositions toward hypertension, diabetes, and genetic hyperlipidemia. All of these factors contribute and combine to increase the risk of vascular disease overall. Some of that vascular disease will affect the brain, some will affect the heart, she said.
Although up to 15% of strokes occur in those under 50, stroke can happen to anyone at any age. However, the risk is higher in people over 65, as well as in those with a family history of stroke and those who have HIV.
Additionally, there are genetic predispositions to certain diseases, but there are also numerous lifestyle factors that, if rigorously controlled, such as quitting smoking, controlling blood pressure, maintaining a healthy weight and cutting alcohol consumption can significantly reduce the risk of developing those diseases, Dr Francis said.
BEFAST – numbers to call at the first sign of a stroke:
112 from any mobile phone, to be connected to an emergency service closest to you.
10177 to call an ambulance.
If you have medical aid, car insurance, and/or a home armed response service, make a note of their emergency numbers to call in a medical emergency.
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