An Introduction

Hurray, Today is World Stroke Day! Stroke is not a joke and you know what?  It is preventable. Stroke was first recognized by Hippocrates, father of modern medicine, over 2400 years ago. It was then called apoplexy, which means ‘’struck down by violence’’ in Greek. It was not until the mid-1600s that Jacob Wepfer found that patients who died with apoplexy had bleeding in the brain. He also discovered that a blockage in one of the brain's blood vessels could cause apoplexy. Medical science continued to study the cause, symptoms and treatment of apoplexy and, finally, in 1928, apoplexy was divided into categories based on the cause of the blood vessel problem. This led to the terms stroke or "cerebrovascular accident (CVA)." Stroke is now often referred to as a "brain attack" to denote the fact that it is caused by a lack of blood supply to the brain, very much like a heart attack is caused by a lack of blood supply to the heart. The term brain attack also conveys a more urgent call for immediate action and emergency treatment by the general public. Stroke is defined as rapidly developing focal or global neurological deficits lasting longer than 24 hours or leading to death and which is of no other aetiology other than vascular. Stroke can be ischaemic; blood supply to part of the brain is decreased leading to dysfunction of brain tissue in that area. This can be caused by thrombosis (obstruction of a blood vessel by a clot formed  locally), embolism (obstruction due to embolus (blood clot, fat, cancer cells etc) from elsewhere in the body), cerebral venous sinus thrombosis and systemic hypotension as in shock. Stroke can also be haemorrhagic (bleeding within the brain or subarachnoid space). Stroke can manifest as paralysis of one side of the body and/or face, difficulty with speech, altered gait, inability to swallow, loss of consciousness, vertigo, blurring vision, severe headache etc . Risk factors for stroke   Hypertension, diabetes mellitus, age (>65 years), transient ischaemic attack (a sudden focal loss of neurological function with complete recovery usually within 24 hours; caused by a brief period of inadequate perfusion in a portion of the territory of the carotid or vertebro-basilar arteries), polycythaemia (an increase above the normal in the number of red cells in the blood), sickle cell anaemia, oral contraceptive pills (OCP) ,hormonal replacement therapy (HRT), heart disease like atrial fibrillation, cancer, auto-immune diseases like systemic lupus erythematosus (SLE), hypercoagulable states like homocysteinaemia, obesity, cigarette smoking and recreational drug use like cocaine. TIME IS SO PRECIOUS IN THE MANAGEMENT OF STROKE. PROMPT REFERRAL TO A NEUROLOGIST CAN DO WONDERS. So don’t allow yourself or your relative to either die or be severely debilitated because of stroke. By Chidimma Rhoda.