What is Stroke?


Q1. What is Stroke?
Stroke is a cerebrovascular disease. It can be ischaemic or haemorrhagic. Ischaemic stroke may occur as a result of obstruction caused by narrowing blood vessels in the brain or neck, or embolisation due to the flowing into cerebral vessels of blood clots caused by atrial fibrillation. Haemorrhagic stroke can be caused by high blood pressure or cerebrovascular problems such as brain aneurysm, arteriovenous malformation, etc..
Q2. How do I know if I suffer from a stroke?
Most strokes occur suddenly. One can look totally normal immediately before onset. Remember the acronym “FAST” for stroke symptoms, i.e. “Face” for asymmetrical facial expressions, “Arm” for weakness in the arms or legs, and “Speak” for speaking difficulties. If any of these symptoms occur, it is “Time” to call for emergency medical service. Besides the above symptoms, people with haemorrhagic stroke may have sudden headache, or even lose consciousness or fall into coma in severe cases.    
Q3. What are the treatments for stroke?
Treatments for ischaemic and haemorrhagic strokes are different. For ischaemic stroke, the blood vessels must be unblocked as soon as possible by using thrombolytic medication, or by removing of blood clots through interventional treatment. For haemorrhagic stroke, the treatment objective is to prevent the enlargement of blood clot by controlling blood pressure. When the intracranial pressure increases to a particular level, surgery is considered to remove the blood clot and relieve intracranial pressure. Under special circumstances, such as haemorrhagic stroke due to brain aneurysm rupture, surgery is performed to close off the aneurysm and prevent repeated bleeding.
Q4. It is said that stroke is best treated within the “Golden 3 Hours”. Will everything be alright if I can seek medical attention within 3 hours after onset?
The “Golden 3 Hours” refers to the period of 3 hours after onset, which is the best time for thrombolytic therapy to maximise the chance of self-care upon recovery. All in all, the blood vessels should be unblocked as soon as possible. Thanks to technological advance, the time window of stroke treatment is now extended to 6 or even 24 hours under specific conditions.     
Q5. How can stroke be prevented?
To prevent stroke, we need to put the risk factors such as hypertension, diabetes, high cholesterol level, etc., under control. Everybody should quit smoking and do more exercise.  Patients with atrial fibrillation may consider taking anticoagulants to reduce the risk of blood clot formation. Those with carotid artery stenosis may consider balloon angioplasty to open narrowed arteries and reduce the risk of stroke.

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