By Dr Rupanta Das
Stroke statistics for women are surprising and distressing. Though one may think of stroke as a man’s disease, women are at a greater risk of suffering a major disability from brain stroke and, worse, are more likely to die from a stroke than men. In the language of the CDC (Centre for Disease Control and Prevention) “more women than men die from stroke each year”. Six out of 10 who die due to stroke are women. According to the estimates by the tiol Commission on Macroeconomics and Health, India, there will be 1.67 million stroke cases in India in 2015.
A stroke is a medical emergency. Strokes happen when blood flow to the brain stops and within minutes, brain cells begin to die. The effects of a stroke can be devastating and can result in early death or permanent disability. Furthermore, when someone does survive a stroke, it often puts an enormous burden on the family/carers.
Being able to spot the warning signs is crucial. Because stroke is usually not painful, patients
with symptoms may ignore the signs and not seek medical attention in the hope that they will feel better. People need to know that stroke is a medical emergency and that if they see any
of the warning signs they need to act FAST.
The five most common signs and symptoms of a stroke are:
l Sudden numbness or weakness of the face, arm, or leg
lSudden confusion or trouble speaking or understanding others
l Sudden trouble seeing in one or both eyes.
l Sudden dizziness, trouble walking or loss of balance or coordition
l Sudden severe headache with no known cause
FAST is an easy way to remember and identify the most common symptoms of a stroke. Recognition of a stroke and calling helpline will determine how quickly someone will receive help and treatment. Getting to a hospital rapidly will more likely lead to better recovery.
F Face: Ask the person to smile. Does one side of the face droop?
A Arms: Ask the person to raise both arms. Does one arm drift downwards?
S Speech: Ask the person to repeat a single phrase. Is their speech slurred or strange
T Time: If you observe any of the signs, call emergency services or go to the hospital immediately
Women may report symptoms that are different from the common symptoms. They can include:
l Loss of consciousness or fainting
l General weakness
l Difficulty or shortness of breath
l Confusion, unresponsiveness or disorientation
l Sudden behavioural change
l usea or vomiting
Unique symptoms create a problem, as they are often not recognized as a stroke symptom and treatment is often delayed. The most effective stroke treatments are only available if the stroke is recognized and diagnosed within the first three hours of the first symptoms.
One way to improve the odds for not having a stroke is to learn about the lifestyle changes and if necessary, medications, which can lower the stroke risk. In addition to the general risk factors like family history, high blood pressure, high cholesterol, diabetes, smoking, lack of exercise, and being overweight, woman face unique risk factors which include:
l Taking birth control pills: The greatest concern about using oral contraceptives is for women with additiol risk factors, such as age, cigarette smoking, high blood pressure or diabetes.
l Being pregnt: Stroke risk increases during a normal pregncy due to tural changes in the body such as increased blood pressure and stress on the heart.
l Using Hormone Replacement Therapy (HRT), a combined hormone therapy of progestin and estrogen, to relieve menopausal symptoms.
l Suffering from migraine headaches with aura: Migraines can increase a woman’s stroke risk two and a half times
Diabetics should constantly monitor blood sugar level and also other metabolic parameters such as cholesterol. Lifestyle and dietary changes should be made if any of these are found to breach normal limits. Hypertension is another major risk factor. The symptoms of stroke are easily understandable and primary level physicians can identify these. With imaging systems such as computed tomography available, detection is not a problem. Yet, physicians must approach the patients showing the symptoms (see graphics) with a high degree of suspicion so that accurate diagnosis is not missed.
(The writer is Consultant Neuro Surgeon, raya Superspeciality Hospital.)