Reversing the damage of a stroke

If you experience a sudden onset of a headache, dizziness, speech difficulty, drooping of one side of the face, weakness on one side of the body and loss of balance, you may be having a stroke.

A stroke occurs when the blood supply to a part of the brain is interrupted, or reduced, preventing brain tissues from getting oxygen and nutrients. This may be due to a clot or bleeding. When blood flow cannot reach a particular region of the brain that controls a specific body function, that part will not work properly. For example, moving one hand can be difficult.

A person can suffer from a major stroke which causes a severe outcome to certain parts of their body, or a minor one that causes damage that can be reversed by the help of quick medical intervention.

What are the risk factors for stroke?

Although many patients diagnosed with stroke are older adults, strokes can occur at any age. Many factors can increase a person's chances of getting a stroke. These include:

· Trauma e.g. from an accident or a fall

· Being overweight

· Excessive consumption of alcohol

· Smoking cigarettes

· High blood pressure and cholesterol

· Diabetes, or cardiovascular diseases

Are there warning signs days before a stroke?

The signs of a stroke often appear suddenly. However, some people experience symptoms such as headache, numbness or tingling several days before they have a stroke.

What is a mini-stroke?

A mini-stroke occurs when part of the brain experiences a temporary lack of blood flow. Unlike a full-blown stroke, pre-stroke or mini-strokes only last a few minutes and do not cause permanent damage. One experiences the symptoms of stroke for this period. Nevertheless, it is a warning sign that a possible stroke may be coming in the future and it is therefore important to seek immediate medical care.

What is a silent stroke?

A silent stroke doesn’t cause any noticeable symptoms. Most strokes are caused by a clot or bleeding that blocks a blood vessel in the brain.

But sometimes, the area of damage is quite small and occurs in a part of the brain that doesn't control any vital functions, so the stroke remains undetected.

How fast should I be seen if I experience signs of stroke?

People who experience the signs of stroke are advised to go to the nearest hospital immediately. It is also critical that patients receive the right care from well-trained clinicians. At Aga Khan University Hospital, Nairobi (AKUH,N) we have put in place a standardised clinical pathway which is followed by all our clinicians when a patient who has suffered a stroke comes to us.

Our standard is benchmarked against the American Heart Association. In recognition of these standards, the hospital has been accredited as a Centre of Excellence for the management of Acute Primary Stroke by Joint Commission International (JCI), the recognised global leader in health quality standards.

What is the standard care for patients suffering from stroke?

Research has found out that patients have better outcomes when they receive care within 4 hours from the onset of the symptoms of a stroke. When a stroke patient gets to a hospital, they should immediately inform the nurse at the casualty section of their symptoms for them to be attended to immediately. A brain scan is done and reviewed within 45 minutes of arrival.

If there is a blood clot causing the stroke, a clot-busting drug is administered to help re-establish blood flow to that part of the brain and improve chances of recovery. This is done within 60 minutes of arrival. Sometimes the clot may be too big, requiring to be removed mechanically within 75 minutes of arrival, a procedure called mechanical thrombectomy.

Is a stroke reversible?

The effects of a stroke can cause temporary, or permanent disabilities depending on the extent of the damage. However, the health outcomes for stroke patients are different depending on the time between the onset of symptoms and care, the level of care and rehabilitation received, other underlying conditions among other factors.

In the past, there were no treatments available to reverse stroke, but now the situation has changed dramatically over the last decade and treatments are available that can restore stroke patients to a better level of function and minimise disability. Some stroke patients have even been reversed back to normality within hours. Rehabilitation is also part of stroke treatment. This includes speech, physical and cognitive therapies and relearning sensory skills. Early action and effective treatments can help prevent brain damage and other complications caused by a stroke.

Dr Margarita Mwai is the Head of Accident and Emergency, Aga Khan University Hospital, Nairobi