Brain Emergency Stroke

Brain Stroke – A Medical Emergency – How to Identify and What to do?

Written by ZINI

First and foremost Stroke is a Medical Emergency and TIMELY ACTION is the Key to survival in this condition.

So Today we wish to write this Article to make the general people aware of this Deadly yet preventable as well as Potentially recoverable condition if Proper and TIMELY actions are taken by the patients family or friends to help him in time.

Stroke is Commonly known as a Silent Killer because it goes misidentified many times. This is also known as a ‘Cerebrovascular accident or CVA’ in Medical terms or ‘brain attack’ commonly in layman language.

What most bothers me about this Medical Condition Personally is that 80% of the People suffer from the ill effects of Stroke ONLY because of a DELAY in Identifying the Condition and Seeking Proper Medical Care in time.

This condition is not so uncommon. Every year around half a million People suffer from some kind of Stroke in India. Figures are similar in most countries based on their Population Ratio.

TIMELY Action is the Most Important Part of Stroke treatment and recovery. If Proper Testing and Treatment is Provided within the first 3-5 hours, especially the first 1 hour(also known as the Golden hour of survival) Chances are the Patient will Completely Recover if no vital areas of the Brain are affected. Recovery & Survival chances are best within this Period. After this as time passes the chances of a complete recovery or survival start to dimish. And this Crucial time is what is Mostly wasted and Missed by most victims of a Stroke Attack.

 

What is a STROKE?

 

Stroke is a Medical Condition wherein Blood Supply to a Part/region of Brain is either Stopped or Compromised. This leads to damage or death of nerve cells in that region. There can be 2 types of Stroke based on the Cause,

a) Ischemic Stroke: This is the more common variety wherein a BLOOD CLOT is formed in some Blood vessel in the Brain leading to Clogging and Blockage of that vessel and hence all its tributaries. The Part of the Brain supplied by that vessel gets devoid of blood supply and oxygen and experiences nerve damage.

b) Haemorrhagic Stroke: This is a less common variety where a Blood Vessel gets ruptured either due to a trauma/injury or other causes like old Aneurysms or a chronic High BP from many years and some other Conditions leading to leakage or rupture of some blood vessel in the brain.

Be it any Cause, The blood supply to an area of the Brain is Severely compromised and a variety of Symptoms can Arise out of it.

 

How to IDENTIFY A STROKE?

 

It is CRUCIAL to identify a Patient that may be suffering from a Brain stroke in time and Take Immediate steps to Help them. TIME is a Crucial factor in this case and can be the difference between life and death.

 

The FAST acronym to identify a Stroke Patient.

 

Here are some common Warning Signs / Symptoms that must never be neglected. When found, Visit the NEAREST Emergency Department of a Hospital or the nearest healthcare facility without delay.

  1. Sudden Onset loss of Consciousness
  2. Sudden Onset Loss of Power or control in 1 of the limbs (arms or legs)
  3. Sudden Onset weakness on one side of the Body.
  4. Sudden Onset Drooping of Eyelids on one or both sides.
  5. Loss of Facial Expression One one side of the face
  6. Inability to lift or move an Arm or Leg.
  7. Sudden Onset difficulty Speaking or Slurring of Speech
  8. Sudden onset loss of vision in 1 or both eyes
  9. Numbness or Weakness in a Part of body or limbs.
  10. Loss of balance or Vertigo development.
  11. Sudden onset Confusion, Irritability, and Inattention.
  12. Sudden onset severe headache
  13. Uttering nonsense Words that are unable to be understood easily.
  14. Nausea, Vomiting, and Uneasiness
  15. Loss of control over bladder and Bowel movements
  16. Sometimes Seizures or Fits can also be present in the patient.

 

Depending upon the Brain area affected, symptoms may Vary from a mild headache to severe Confusion, paralysis, and Loss of consciousness

 

These are some of the Warning Symptoms of Stroke. If some of these are seen in a Person then some Immediate steps be taken as mentioned below.

 

What to do if Stroke is Suspected?

If you suspect a close by stranger, a friend or family member is having a stroke, Follow the advices below without Delay. Remember Caution and Action is better than delay and inaction.

  1. Immediately Call an Ambulance or Reach Emergency Department of the Nearest Hospital: As Explained Survival and recovery in Stroke is Time dependent. Hence reaching a Proper medical facility as soon as possible will result in Quick Identification and hence quick action on treatment.
  2. Do not give the Stroke victim anything to drink or eat till Medical care has arrived. Sometimes loss of coordination and attention can accidentally cause asphyxiation.
  3. Stay with your Patient and loved one to make sure he/she is attended properly and in time and no further injury harm comes till medical care is on the way.
  4. Avoid giving Medications Without Consulting your Doctor: Some Medications like Aspirin are also Potential Blood thinners as in they prevent blood from clotting quickly. This can be useful in case of an Ischemic Stroke but in case of a Haemorrhagic stroke can further increase the risk of bleeding. Hence, identifying the cause of stroke is Very important to being sure of what medications are best suited for the Patient.
  5. Keep Notes on Patients history with you: Is the Patient a known case of High Blood pressure or Diabetes? Does he take any Chronic medicines on a Daily or long-term basis? Does he/she take any Blood thickening or thinning drugs? Is he a chronic smoker or alcoholic? Any Previous history of similar events or sugeries? And what is his usual job or occupation? This kind of basic History or information can help Healthcare Providers and Doctors in better decision making during the treatment. Be ready to share this with the Resident Doctor in Charge. You can also use the ZINI Health App to keep track of a Person’s Medical History in the Emergency section of the APP.
  6. Try to stay calm and trust your Doctors: Although an Emergency, keeping calm will help you take better quick decisions. It is also to be noted that most severe symptoms are oaty in the start of an attack and later recovery will progress on its own and as Medical care is started. So do not fear and let your doctors do their best. Above all, trust your Doctors, they know best.

 

 

What Your Doctor Will Need to Do?

 

  1. Diagnostic Testing: One of the Most important Steps in starting Stroke Treatment is identifying and being sure of
    a) If it is a Stroke
    b) What Kid of Stroke it is – Haemorrhagic or Ischemic.
    Without identifying the type of stroke, Proper treatment cannot be Started. The best initial Diagnostic test of Choice is a CT SCAN of the Head. So agree with your Doctor and GET it Done as well as REPORTED ASAP.

    An MRI may also be needed in Some cases as this is one of the most accurate tests available for this Condition. Your doctor may have to go for One or both the tests in time depending on the Condition of the Patient and time that has passed since first symptoms appeared.

  2. In an Ischemic stroke, Blood has clotted and blocked a Vessel in patients Brain, So administring Clot-dissolving drugs within the Crucial 4-5 hour Window is most important and can be Life-saving.  Later with proper conservative treatments, rehabilitation, other medical care, the patient may fully recover in time to his / her full health again. Some Common Drugs include tPA and other clot-dissolving medications. But the Purpose of this Article is to make you aware of the Condition and not go into details of all treatments given.
  3. In a Haemorrhagic Stroke, No Pain Killers or Blood thinners should ever be given. The treatment can be conservative, or Surgical depending upon the extent of Blood leakage and current situation. In case of a Minor bleed that has stopped the doctor may recommend you to go for a conservative treatment and recovery with proper medicines and rehabilitation measures. Slowly depending on the age, with proper care and other medically approved therapies performed patient may recover fully. In case of a Major internal hemorrhage or bleed, Surgery may be needed Immediately in an emergency to Relieve Pressure in the brain developed from Blood accumulation. Surgery may also be needed to Clip any bleeding vessels and also to fix any aneurysms in the patient’s brain. The Surgery is risky but has good survival rate if done in time. After the Surgery again, Conservative treatments with Pressure relieving drugs, Body fluids, Diuretics, Blood pressure lowering drugs and other Conservative medical care is done for a few days till the patient is able to take care of himself independently or is ready to go home.
  4. Other Management and Treatments to Manage any Potential Complications can be given by your Doctor depending on the Situation of the Patient that he/she thinks is best suitable for best recovery of the Patient. Once again all these steps, from Diagnostic Testing to Administring the right treatment based on the type of Stroke should be Started and finished Preferably within a GOlden period of 4-5 hours. If due to any reason delays occur, that may have a negative effect on Survival or recovery of the Patient.

 

COMMON MISTAKES that CAUSE DELAY and should be avoided:

  1. Many a times Patient ignores the symptoms as minor or temporary, so do his/her relatives or family members.
  2. Many times in rural areas patients do not go to a properly equipped Hospital but instead, waste time seeking temporary relief by asking for treatments for minor headaches from local pharmacies or chemist shops.
  3. Worse is when they go to Quacks or ill-equipped Practitioners for relief, this wastes Very crucial time that may be used to save the patient.
  4. Worst case scenarios are when some care centers or health facilities are unable to identify and refer the patient in time.
  5. Sometimes Patients may go to a dispensary or Clinic but later refuse to go to a higher or Better Healthcare center that is better equipped to handle this condition for fear of un-necessary testing and high cost involved.  Patients attendants may also refuse Performing of the MOST  IMPORTANT DIAGNOSTIC TESTS like CT Scans or MRIs on the Patient not understanding the gravity of the Situation. This Apprehension is understandable. The general Public has come under an unwanted fear that undue and unwanted testing will be performed by bigger Multispecialty hospitals. In spite of all apprehensions and fears, we must assure you that this PARTICULAR Case is in fact 1 Emergency where Delay could mean death and Action could mean Survival and Recovery. A CT SCAN of the head is THE MOST IMPORTANT DIAGNOSTIC INVESTIGATION and also an Investigation without which a Doctor cannot be sure if the Stroke is Haemorrhagic or Ischemic which is crucial to know to start treatment Regimes.

These are some of the Major reasons Many patients with Stroke have a DELAY IN IDENTIFYING AND TREATING the Stroke Event.

The Purpose of this Article was to make you aware of this Condition and what to do and what not to do in case of this Emergency. Hope this information can help save a life by promoting awareness about what to do in case do a Medical Emergency related to Stroke or CVA.

In another article, we will Share what are the Causes or Risk factors that can promote the Risk of Stroke in any individual. This was Primarily focussed on Promoting awareness on what the condition is, How to identify it in time and what timely and immediate steps should be taken in case someone is suspected of having a Brain Stroke in your vicinity or Connections.

 

For more Info and Guidance on the topic, You can Consult one of our Physicians as well.

Just Contact us at ‘ZinitheApp@gmail.com’ with Subject line ‘Article Consultation’.

 

***** Article Finished*****

Thank You

 

Contributed by:
Dr. Rohit Sharma

Reviewed by:

To Submit Reviews & Suggestions to this Article at ‘ZinitheApp@gmail.com’ with Subject line “Article Review”

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