06 November 2012 | last updated at 09:56PM
The risk of stroke is higher among diabetics, making it more imperative for them to manage their condition
STROKE is the third main cause of death in the country and a leading cause of adult disability. By 2020, stroke mortality in the world would have almost doubled, mainly because of the increase in the number of older people and an inadequate control of major risk factors.
With the number of adults over 30 with diabetes increasing drastically, stroke is also on the rise.
“Stroke is the sudden damage to part of the brain, caused by either reduction of blood flow to the brain or bleeding into the brain,” says Sunway Medical Centre consultant neurologist Dr Tan Swee Teng.
He says that in order to confirm that it is a stroke, there must be an area of damaged brain demonstrated on CT or MRI scanning of the brain.
There are also instances where a person suffers from a Transient Ischaemic Attack (TIA), which many of us label as mini-stroke.
Technically, TIA is not a stroke but Dr Tan says it’s a warning sign of a possible stroke and up to 10 to 20 per cent of TIA patients do suffer a stroke in future.
Strokes, which may be called brain attacks, are categorised into two types — infarcts and haemorrhages. Infarcts (or ischaemic strokes) make up approximately 60 to 70 per cent of all stroke cases. This occurs when there is a lack of blood flow to the brain caused by the narrowing or blockage of an artery. It is caused by a blood clot blocking an artery supplying blood to the brain.
Cerebral haemorrhages (bleeds) happen when a blood vessel in part of the brain becomes weak and bursts open, causing blood to leak into the brain at high pressure. This can cause compression of tissue in the brain, where the pressure may also lead to a loss of blood supply to the surrounding brain tissue.
SYMPTOMS OF A BRAIN ATTACK
SYMPTOMS OF A BRAIN ATTACK
Stroke symptoms typically develop suddenly and without warning. These depend on the area of the brain affected. The more extensive the area of brain affected, the more damage there is and the more functions that are likely to be lost.
Stroke symptoms include trouble seeing in one or both eyes, sudden dizziness, trouble walking, sudden confusion, trouble speaking, sudden numbness or weakness of face, arm or leg (especially on one side of the body). Weakness of the face may cause drooping of one side of the mouth and drooling.
The signs and symptoms that follow a stroke happen because the brain cells die when deprived of oxygen and other nutrients due to lack of blood flow.
PREVENTION BETTER THAN CURE
PREVENTION BETTER THAN CURE
Some 52,000 Malaysians suffer strokes each year. This means that someone is suffering a stroke every 10 minutes on average. But this can be prevented.
“Up to 80 per cent of all strokes are preventable through risk factor management,” said Dr Tan.
The No. 1 risk factor for stroke is high blood pressure or hypertension. In addition, diabetics are up to four times more likely to have a stroke than healthy people.
Other preventable risk factors for stroke are cigarette smoking, high cholesterol and a condition called atrial fibrillation which causes irregular heartbeat.
Type-2 diabetes is associated with high blood pressure, high cholesterol and being obese or overweight — therefore the risk of stroke in people with diabetes is compounded.
Because of the high incidence of stroke in diabetics, prevention plays a very important role in stroke prevention.
“The most important thing is to ensure blood sugar is optimised by controlling and regularly monitoring the blood glucose level. Diabetics should control their diet, exercise, achieve an ideal body weight if they are obese and take their prescribed medication,” advises Dr Tan.
The risk of having a stroke can be effectively reduced by managing diabetes well.
ACT FAST
ACT FAST
Call for an ambulance or go to the hospital immediately if stroke is suspected. A stroke cuts off oxygen to the brain and with delay, more brain damage can occur.
Apart from taking the patient’s medical history, further imaging tests are needed to pinpoint the type and size of a stroke. Doctors can then use this information to give patients the best treatment.
Detecting stroke as early as possible is so important that doctors often rely on Magnetic Resonance Imaging (MRI), now available in 3.0 Tesla. MRI uses magnetic fields, instead of X-rays, to create pictures of the brain, posing no radiation risk to a patient. Even though the scanning examination takes longer than a CT scan, MRI images are more accurate.
BE STROKE SMART
With more advanced diagnosis and treatment methods, the survival and recovery potential for stroke patients has improved. Nevertheless, prevention to reduce the risk of stroke is still the best way of eliminating the consequences that come with the disease.
“The outcome of stroke for both diabetic and non-diabetics patients are similar. But the risk of recurrent stroke is higher in diabetics due to the health problems associated with diabetes which increase their risk for another stroke,” says Dr Tan.
