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A neurosurgeon, Dr. Biodun Ogungbo, tellsARUKAINO UMUKORO why stroke can also affect young people
What is stroke?
Stroke is simply the ack of blood supply to a part of the brain. The brain needs constant and continuous blood supply since it does not store food or nutrients. Hence, any sudden interference with blood supply will cause injury or death to the brain tissue.
What are the major causes of stroke?
The major or leading cause of stroke in Nigeria is hypertension. Hypertension damages the vessels carrying blood to the brain. It can lead to narrowing of the vessels, complete occlusion of the vessels or rupture leading to bleeding into the brain. Other causative factors of blood vessels damage are: diabetes, sickle cell disease and smoking.
What are the signs and symptoms of stroke?
Stroke is sudden weakness of an arm or a leg, sudden blindness, sudden severe headaches, confusion or difficulty walking. It is most often sudden, as if someone switched off the blood supply to the part of the brain affected.
Stroke is usually associated with old age, but now it also affects younger people, what is the cause of this?
Stroke can actually affect anybody and any age. It can affect the rich, poor, rural or urban dwellers. It affects Christians, Muslims or traditional religion adherents. It is more common in older people and more common as we get older. This is because of the damage to our blood vessels by hypertension, diabetes and obesity over time.
Which age group is most at risk of having stroke and why?
Unfortunately, we are seeing more and more people in their 40s and 50s suffer from stroke in Nigeria. I suppose this is because our life expectancy is pretty low and these age groups are actually ‘old people’ in Nigeria. In younger people, below the age of 20, stroke is often due to congenital conditions that they were born with, things such as sickle cell disease and abnormalities of the blood vessels themselves. Above the age of 20, lifestyle diseases such as obesity, diabetes, sedentary living, lack of exercise, and hypertension take over as the major causes.
Does age affect the recovery of someone who suffered a stroke?
Younger people do better than older people and their powers of recovery of more functions are higher. Stroke patients can recover fully if treated early. This is why we advocate early presentation or transfer to a hospital, early identification that a stroke has occurred and early treatment in the hospital. Everything must be done to reopen the blood vessels that are blocked or to remove the bleeding from the brain to prevent permanent injury or death.
Are there particular diets for people who have had stroke or are recovering from stroke?
People who have had a stroke need special diets depending on the cause of the stroke and the underlying disease. For example, those with diabetes need less sugar and starchy foods, those with hypertension require less salt in their food and others may need less fat and weight reduction programmes. Stroke affects different people in different ways and the treatment is specially developed for each person.
How can one avoid having a stroke?
The key strategies are actually pretty simple. People must know what stroke is and that it can be prevented. The prevention is to watch the dirt and keep the weight down. This reduces the level of fat in the body and layers of fat that may obstruct the blood vessels of the brain. It is also important to control the diseases that lead to stroke. These include hypertension, diabetes and sickle cell disease. Regular exercise and not smoking are also vitally important.
Can stroke be cured?
Stroke can be prevented in most cases but rarely cured. The most important is the prevention of the first stroke and then prevention of further strokes. The risk factors must be identified and managed expertly and by the affected person to prevent further strokes. Minor strokes are sadly, a harbinger of bigger and worse strokes and must not be ignored. Minor strokes are warning signs that the person is predisposed to having a stroke and must be managed effectively by doctors to prevent a bigger stroke. Anyone with symptoms of stroke must go to the hospital immediately. Churches, pastors and herbalists cannot treat or cure stroke. Even doctors cannot cure stroke, but we do the best we can to limit the damage and prevent further strokes.
Are there available statistics for the number of stroke sufferers in Nigeria?
We do not have good, reliable statistics because such research is not funded. So, we cannot reliably say the number of Nigerians suffering a stroke each day, hour or minute. This is sad and does not help with planning or resource allocation. The government needs to be encouraged to see stroke as a national tragedy. Many people with stroke die or become disabled, that we know as doctors. Many Nigerians know someone living with stroke. Stroke is a common health issue in Nigeria.
Is the country’s health system well equipped to care for stroke patients and help them recover fully?
No, the healthcare system is not well equipped and many shortcomings are evident everywhere. The lack of an emergency number to call, well equipped and staffed ambulances in Nigeria are some of the major issues. Lack of diagnostic equipment, properly trained staff, free early treatment for stroke patients are major hindrances to good recovery and survival.
What can be done to improve this aspect of healthcare in the country?
There should be better research and funding of the health sector to deliver life-saving drugs, techniques, personnel and free investigations are important. People with stroke cannot wait for the bank to open before being offered treatment. Time is critical. Time wasted is brain wasted.
How can more awareness be created about the effects of stroke?
The main focus in Nigeria must be on preventive strategies and ways to harness local resources in the acute treatment of stroke patients. Health education of the community, with emphasis on control of the predisposing factors, especially hypertension, would reduce the burden of stroke in the country. Risk factor management should begin in childhood, with emphasis on exercise, nutrition, weight and blood sugar control, avoidance of tobacco and excessive intake of alcohol.
What should one immediately do to help someone who suffered a stroke before the person is taken to the hospital?
Prevention is important. Next to that is early presentation to hospital. ‘Brain attack’ is a term that has been coined to emphasise the need for urgent action. Studies have shown that delays in presentation are caused mostly by lack of awareness of stroke. Stroke victims must be taken to hospital immediately. Do not waste time at home.
What is the relationship between a stroke and a cardiac arrest?
Stroke is simply lack of blood supply to a part of the brain. So, any sudden interference with the blood supply will cause injury or death to the brain tissue. On the other hand, cardiac arrest, also known as cardiopulmonary arrest, is the cessation of normal blood circulation due to failure of the heart to beat properly. The heart beats 70 to 80 times a minute in a normal adult. The heart beat must also be full and complete to get the blood to all the areas it needs to reach, like the brain, in adequate quantity.
A cardiac arrest is different from (but may be caused by) a heart attack, where blood flow to the muscle of the heart is impaired. Arrested blood circulation prevents delivery of oxygen and glucose to the body. Lack of oxygen and glucose to the brain causes loss of consciousness, which then results in abnormal or absent breathing. Brain injury is likely to happen if cardiac arrest goes untreated for more than five minutes. For the best chance of survival and complete recovery, immediate and decisive treatment is necessary. The cardiac arrest must be reversed and heart function restored, by whatever means.
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