The irreversible stroke

What happens when you have a stroke and why is the damage to the brain extensive or irreversible..

Here are some answers.

A stroke is a medical condition where the brain cells suddenly die because of a lack of oxygen. The cells die a natural death when there is an obstruction in the blood flow or a rupture of an artery that feeds blood to the brain.

The average human brain generally weighs three pounds or 1.35 kilograms and it contains anything between 10 billion to 100 billion neurons and even a larger count of glial cells.

When a person is affected by stroke, close to two million cells die  and the person may suddenly lose the ability to speak, think or walk, talk. There may also be memory problems or one or two sides  of the body can become paralyzed.
The blocked cell form a clot and it is this clot that stops circulation of blood to the tissue in the brain, leading to neurological damages. The stoppage in the flow of oxygen and blood to the brain is a deadly Natural act which requires to be reversed if the damage is to be undone or lessened.

An unfortunate fallout of a stroke is paralysis and this kills lakhs of people all over the world. In US alone, paralysis in stroke victims kills one and a half million or thereabouts every year.

There is some good news though. Half the victims of stroke do survive with varying and often deteriorating degree of paralysis.

A stroke in nothing but a brain attack. Just as there is a heart attack, there is also a brain attack and this is called stroke which is the third leading cause of death in the United States. Approximately 20 million people each year will suffer from stroke and of these five million will not survive.  In developed countries, stroke is the first leading cause for disability, second leading cause of dementia and third leading cause of death. By 2015, India will report 1.6 million cases of stroke annually, at least one-third of whom will be disabled.

Stroke is also classified as a major cause for loss of life, limbs and speech in India, with the Indian Council of Medical Research estimating that in 2004, there were 9.3 lakh cases of stroke and 6.4 lakh deaths due to stroke in India. What is tragic is that most of these people are 45 years old or less.

The World Health organization says  by 2050, nearly 80 per cent  stroke cases in the world would occur in low and middle income countries including India China and Brazil.

This is the main reason why India has now come out with national guidelines for stroke management. This guideline has been Prepared by Dr Kameshwar Prasad, director of the clinical epidemiology unit of the All India Institute of Medical Sciences, doctors from Nizam's Institute of Medical Sciences, Hyderabad, Command Hospital in Lucknow and PGI in Chandigarh.

The guidelines are fairly comprehensive and they cover the management of stroke from onset to chronic care.

Stroke has a propensity for people with high blood pressure, diabetes and high blood fat, which is also called as cholesterol. What makes Indians more vulnerable to stroke is that 16 per cent or more above 20 years of age suffer from high blood pressure (BP). Shockingly, Fifty per cent of those with high BP are not even aware of it. Of those who are aware, only 50 per cent take measures to control it, and even among those only 50 per cent  are adequately controlled. This, means just about 12.5 per cent of patients with high BP are adequately controlled against stroke.

The guidelines make it mandatory for hospitals to set up a Acute Stroke Team, written care protocols for such patients and an emergency department whose personnel should be trained to diagnose and treat all types of stroke.

Early and timely diagnosis of stroke can help in a large way in the treatment and further spread or deterioration of paralysis.

The National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, has done far reaching studies on several aspects of neurological disorders, stroke, brain related diseases and other related aspects. More about them in the coming posts.

(The next post is on a net to fish blood clots and thus reverse brain damage and paralysis).