A stroke is a paralytic attack, also known to you as a brain stroke. As many as 1800 people lose their lives from stroke everyday, in our country. A stroke or a paralytic attack is a situation where there is loss of blood flow (ischaemia) or bleeding (hemorrhage) in a portion of the brain, causing death of brain cells, through lack of nutrition or through pressure.

“Magical” Improvement

Advances in technology have led to the development of specific drugs directed towards dissolving the clot – in a blocked artery, or in the brain. These drugs have to be administered within the prescribed time limit, and can produce remarkable and near magical remission of the paralysis and other clinical signs. The time window and the cost of the drugs are major hurdles to their wider usage. Improvement of transport facilities and greater familiarity with the drugs in the future, will ensure that within an hour of the onset of a stroke attack, a CT scan/angiogram is obtained and the appropriate drug administered, to cure the patient completely.

The right medication

Earlier generation drugs like streptokinase or urokinase were hazardous as they could themselves precipitate brain hemorrhage. For several years now rt-PA has been used to dissolve the clot. The clot-bursting drug is safe, although expensive, and should be used within 3 hours of the onset of an attack. Administering this drug beyond 3 hours is risky. rVIIa (Recombinant factor VII) is a new and promising drug and the only molecule which controls the bleeding. This drug too should be administered within 3 hours of the onset of the attack.

Look for these symptoms

Just as angina heralds a major heart attack, transient ischemic attack (TIA) denotes the onset of a major paralytic stroke. It may manifest as blindness, weakness of one limb, or facial muscle dysfunction. An individual with a history of TIA is 10 times more prone to suffer a major episode of stroke than an individual who has not had TIA. In many cases of TIA, the obstruction may be in the major neck vessels, like the carotid artery. Such problems can be managed by a stent or by a surgery called endarterectomy. Sometimes, when the BP shoots up, a small blood vessel of the brain bulges in a balloon-like manner and bursts. This is termed an aneurysmal emorrhage and can be lethal. Interventional radiologists can facilitate clotting of blood in the bulge through various methods or it can be treated surgically by a neurosurgeon, using silver clips to nip the aberrant blood vessel. Whatever the cause, modern day medicine holds the answers to the brain stroke problem. Seek early neurological consultations for the best results, as the time window to achieve dramatic cures is very short – less than 3 hours in most cases.

Stay healthy!

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