Today October 29 2017 is World Stroke Day!




Do you know that technically a stroke is called a cerebrovascular accident (CVA)? Do you also know that in several parts of the world, it is also called a ‘brain attack ’ in order to draw attention to the medical and neurological emergency that it is?   

Some epidemiology of stroke
It is the 2nd commonest cause of death worldwide and the leading cause of disability worldwide. Low and middle income countries (Nigeria is one of the former) account for the largest burden of stroke mortality (> 85%). There are some regional variations in the pattern of stroke presentation.

Ischaemic stroke (due to obstruction of blood supply to the brain) is much commoner than the haemorrhagic type (due to bleeding into the brain). However intracerebral haemorrhage (a subtype of haemorrhagic stroke) is most commonly seen in Africa than in other regions. In Africa, some data show that southern African countries tend to have these bleeds more than other parts of the continent.
Stroke is the leading cause of medical admissions in Enugu and is second in Nnewi. It is the 2nd commonest disorder seen in the Neurology clinic in UNTH Enugu, after epilepsy. 

Common risk factors for stroke
Worldwide and in Nigeria, the commonest preventable risk factor for all stroke types is hypertension, but more so for intracerebral haemorrhage than ischaemic and especially in people < 45 years. Other preventable risk factors include diabetes mellitus, obesity, smoking, high cholesterol and alcoholism. 

Of recent, conditions such as HIV and certain nutritional deficiencies have come to play increasing roles in causing stroke in our people. 

There are non-preventable risk factors such as black race, male sex, genetics (such as sickle cell disease) and age > 65years amongst others.

Recognizing early signs of stroke
This is cardinal as very early presentation of stroke can make the difference between life and death. In some cases, use of clot busters such as streptokinase can result in complete recovery of functions. Thus it is important to everybody to be able to recognize the beginnings of a stroke. The acronym FAST has been developed to help in this with attention being called to observing the Face, Arms, Speech and Time to act. The attached poster for the World Stroke Day beautifully captures this.

Managing stroke
Stroke is best attended to as early as possible because ‘Time is Neurones’! All cases of stroke are best managed by Neurologists where available. Such patients do very well when managed in stroke units with the benefit of having multidisciplinary care involving other professionals including physiotherapists, nurses, occupational therapists etc.

It has been shown by studies that consumption of more fish and fruits (but not vegetables) is associated with a reduced risk of stroke.

As we celebrate this day to highlight the great dangers inherent in a stroke, please do well to live a healthy lifestyle, check your blood pressure regularly, eat more fish and fruits, quit smoking, keep fit and see your neurologist at the first suspicion of a change in speech, use of limbs, appearance of the face or consciousness.

May stroke not fall on you!






Neurologist, Professor, Researcher, Scientist, Mentor.

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