Times of India
29 October 2010
Pune, India

"Learn to identify brain stroke" – that’s the message neurologists underlined on the occasion of World Stroke Day on Monday. It was also revealed that as per the estimates of the World Health Organisation 61 million people are likely to lose their lives due to brain stroke by the year 2020, of which, 52 million (84 per cent) will be from the developing countries.

According to WHO, the stroke incidence in India are approximately between 130 per lakh and 225 per lakh. Every day around 2,000 strokes happen and many are untreated because of lack of awareness, both among patients as well as physicians, neurologist Sudhir Kothari said in a press meet on October 27.

"The easiest ways to recognise symptoms of brain stroke is to remember the mnemonic FAST which stands for F (face) – Is one side of the face droopy? A (Arms) – Is one arm weak or numb? S (speech) – Is the speech slurred? T (time) – If any of these symptoms are present, rush the person to the nearest hospital where a CT scan is possible," he explained.

Kothari elaborated, "A stroke (also known as cerebro-vascular disease) occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood and oxygen it needs, so it starts to die."

The extent and location of the brain cell damage determine the severity of the stroke, which can range from minimal to catastrophic. Because different areas of the brain control different functions, the specific effects of a particular stroke depend on which area of the brain is injured, he added.

"A small brain stroke in a critical area of the brain can be permanently disabling. Because brain cells do not regenerate, damage to the nerve cells is permanent. Millions of brain cells die each minute a stroke is untreated. Acute stroke therapy can be given up to eight hours of onset of symptoms. The drug called t-PA (alteplase) only works when you treat the patient within 4.5 hours of stroke. Otherwise, the risk increases compared to the benefits," said Kothari.

At the global level to design effective preventive strategies, WHO has proposed a "Global Stroke Initiative" on step-wise approach to stroke surveillance with increasing details in data collection.

"The primary purpose of a brain stroke surveillance system is to provide health workers and policy makers data on risk factors, disability status and health practices. Government of India, too, is aware of rising stroke incidence. Recently the 1st National programme for control of noncommunicable disease for diabetes, heart disease, cancer and stroke was launched by the centre which aims at mass screening and controlling the disease," said Kothari.

What Is Brain Stroke?
Abrain stroke or ‘brain attack’ occurs when a blood clot blocks an artery (a blood vessel that carries blood from the heart to the body) or a blood vessel (a tube through which the blood moves through the body) breaks, interrupting blood flow to an area of the brain. When either of these things happen, brain cells begin to die and brain damage occurs.

Warning Signs

• Sudden numbness or weakness of face, arm or leg, especially in one side of the body
• Sudden trouble in vision in one eye or both
• Sudden confusion, trouble speaking and understanding
• Sudden difficulty in walking, dizziness, loss of balance and coordination
• Sudden onset of severe headache with no known causes