From Zerodha’s Nithin Kamath to actor Mithun Chakraborty, this year the word stroke has been making headlines like never before.
Renjen, senior neurologist at Indraprastha Apollo Hospitals, New Delhi, who has been dealing with stroke patients for over 40 years.
This type of stroke is mostly caused due to head injury, high BP, drug abuse or a brain tumour.
It also noted that in 2019, India had the highest number of stroke cases in Southeast Asia.
So despite about half of the stroke patients having these early signs, most will not go for further investigation.
From Zerodha’s Nithin Kamath to actor Mithun Chakraborty, this year the word stroke has been making headlines like never before. But doctors say the information about it on the internet and in the public domain is still half-knowledge and nowhere enough to preventing or diagnosing strokes on time.
“If someone has pain in the heart, they will rush to the hospital. But almost all patients have early signs of strokes, which they don’t take seriously because it gets okay within a few minutes. There is still fear and guilt surrounding the idea of a stroke because people simply don’t know how treatable strokes are in the early stages,” says Dr P.N. Renjen, senior neurologist at Indraprastha Apollo Hospitals, New Delhi, who has been dealing with stroke patients for over 40 years.
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“Stroke is a terminology we use for a vascular insult to the brain, which would mean the arteries of the brain get blocked. These arteries are crucial for blood supply to the brain,” explains Dr Renjen.
There are two types of strokes. An ischemic stroke happens when a blood clot, or a thrombus, blocks the artery. A haemorrhagic stroke is when a blood vessel bleeds uncontrollably inside the brain. This type of stroke is mostly caused due to head injury, high BP, drug abuse or a brain tumour.
A 2023 Lancet journal study, done in collaboration with the Indian Council of Medical Research (ICMR), found that brain strokes could lead to 10 million fatalities in low- and middle-income countries, including India, by 2050. It also noted that in 2019, India had the highest number of stroke cases in Southeast Asia. ICMR data from 2021 shows that stroke is the third leading cause of death and sixth leading cause of disability in India.
Early signs?
A 2022 online survey of 4,742 Indians across 12 cities by Boehringer Ingelheim India, a research-driven pharmaceutical company, found that under one in four Indians knows the stroke symptoms and only 10 per cent of them about the treatment options. “Misinformation or no information often makes people feel that a stroke is the end of the world. So, if the symptoms become okay quickly, there is no need to act,” says Dr Renjen.
Minor strokes do happen. Known as transient ischemic attacks, these manifest as weakness on one side of the body, skewing of the face to one side, vision problems, imbalance, slurring of speech, or arm and leg weakness. “But they become okay in a matter of minutes. So despite about half of the stroke patients having these early signs, most will not go for further investigation. The first one or two times, they will recover. But the third time could be a major episode, and you’ll be in a wheelchair for the rest of your life,” says Dr Renjen.
Can stroke kill?
“Gone are the days when you should keep quiet and suffer. We are here to help stroke victims and improve their quality of life,” says Dr Renjen. One of the most important developments in treatment of stroke is a tissue plasminogen activator drug, which helps dissolve blood clots blocking the arteries almost immediately.
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“If you come to me within three hours of stroke and your CT scan shows no haemorrhage, I can give you this drug and there is a 30 per cent chance you will totally recover. Even if you can come at 4.5 hours, I can still give you this medicine and it will work. The earlier you come, the better result. But if you come within six hours and have a clot in the artery, I can give you a thrombectomy. Even at 12 hours and 24 hours, we can treat it with extensive imaging,” says Dr Renjen.
Keeping the brain healthy
While treatment has improved, there is need for more emphasis on preventing strokes. A series of lifestyle mishaps tend to contribute to worsening blood and arterial health. “You need a balanced diet no matter what. The developed brain needs carbs for energy and fats for functioning; if you reduce or overdo either, you are causing harm. Nutrients must be taken in balance, according to our body’s requirements,” says Dr Renjen.
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Other avoidable risks include managing conditions that increase plaque build-up in the arteries. This includes high cholesterol, uncontrolled diabetes, hypertension and even poorly managed oral contraceptive consumption.
“There are two other things I advise patients. One, health is a combination of mental, physical and social wellbeing. So one must look after all three—regular exercise, a good diet, healthy company and less mental stress. I also believe vitamins B12 and E and antioxidants can improve our cognitive reserve and add to brain health. If we look after these things, I can guarantee you will live longer and have a good quality of life,” says Dr Renjen.
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Published By: Shyam Balasubramanian Published On: Apr 14, 2024
