Stroke is becoming increasingly younger, grasp the golden opportunity for rescue.

Dr Phua Chun Seng, a specialist in neurology and internal medicine at Subang Jaya Medical Center (SJMC), emphasizes that treating a stroke requires seizing the golden rescue time. Otherwise, the death rate of damaged brain cells is extremely rapid. Therefore, any symptoms suspected of being a stroke should be promptly addressed by seeking medical attention. 

Stroke is a leading cause of death and disability globally, and it can occur at any age, affecting anyone. What's even more concerning is that in recent years, there has been a growing severity and trend toward younger individuals experiencing strokes.

Dr. Phua Chun Seng, a specialist in neurology and internal medicine at Subang Jaya Medical Centre (SJMC), analyses the main reasons for the increasing trend of strokes among younger individuals. He attributes this trend to a rising number of young people suffering from chronic diseases and obesity, coupled with unhealthy lifestyle habits such as staying up late, smoking, and alcohol consumption:

“Similar to heart disease, strokes seem to occur suddenly with symptoms like sudden numbness in the limbs, facial drooping, slurred speech, and more. However, strokes are not sudden but rather the result of various factors accumulated over time.”

“People may not anticipate that the real reason they have a stroke, is actually because they are not aware of their health conditions or may have underlying diseases - such as hypertension, high cholesterol, diabetes, combined with unhealthy habits like smoking, drinking, overweight, or obesity.

Dr. Phua stresses the importance of timely stroke intervention, highlighting that once the brain lacks oxygen, brain cell death occurs rapidly, leading to various complications such as aspiration pneumonia, impaired swallowing function, and seizures.

Furthermore, he notes the numerous potential consequences of stroke, ranging from limited mobility, cognitive decline, instability while walking, and impaired abilities in understanding and speaking, to more severe outcomes like paralysis or death.

Remember the acronym F.A.S.T

Dr. Phua urges the public to be aware of stroke warning signs, such as a sudden unusual or numbing sensation in the face, arms, or legs (often on one side of the body), vision problems, difficulty speaking or understanding speech, unexplained severe headaches, loss of balance, fainting, or loss of consciousness. He recommends remembering the F.A.S.T. acronym to promptly identify early stroke symptoms and seek medical attention within the golden hour.

F – Face

the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.

A – Arm

Unable to lift up one side of the arm due to sudden weakness or numbness.

S – Speech

Their speech may be slurred, or the person may not be able to say simple words.

T – Time

Act in a timely manner to rescue stroke! Call 999 or the nearest clinic if you see any of the symptoms above.

How much do you know about stroke?

“Stroke” may seem like a common term, but actually is stroke? What types of stroke are there? Dr. Phua explains that strokes refer to sudden cerebrovascular diseases caused by either vascular blockage or rupture, resulting in the sudden dysfunction of a specific or entire part of the brain.

Strokes are mainly classified into ischemic strokes (caused by vascular blockage) and hemorrhagic strokes (caused by blood vessel rupture). Ischemic strokes are more common, accounting for about 80% of all strokes, while the rest account for about 20%.

Transient Ischemic Attack (TIA), commonly known as "mini-stroke," is another form of transient stroke symptom that typically lasts for a few minutes. It is primarily caused due to insufficient blood supply temporarily to specific areas of the brain, resulting in no apparent lasting impact on the patient. Currently, it is generally believed that individuals who experience TIA have a higher risk of subsequent stroke episodes, and immediate medical attention with necessary measures is therefore required.

Ischemic Stroke (also known as Cerebral Infarction):

The most common type of stroke. When blood vessels are blocked, causing a lack of blood supply to the brain, an ischemic stroke occurs. This can lead to facial paralysis, limb weakness, balance difficulties, and may even affect language ability or vision.

Hemorrhagic Stroke (also known as Cerebral Hemorrhage):

This type of stroke is caused by the rupture of blood vessels, resulting in bleeding. It leads to a decrease in consciousness and the emergence of severe symptoms such as intense headaches, vomiting, and other neurological disorders. High blood pressure, aneurysms, or vascular malformations are potential triggering factors.

Clarifying four common misconceptions

Dr. Phua points out that there are many misconceptions among the public regarding the prevention and treatment of strokes. Especially during the critical period from the onset of a stroke to reaching the hospital, people often lack a clear understanding of the correct procedures. By dispelling the following misconceptions about strokes, individuals can be better equipped to act promptly and secure the golden hour for treatment:

Misconception 1: Pricking the fingertips or earlobes can rescue a stroke victim. Wrong!

Many believe that pricking, which promotes blood circulation, can help rescue a stroke or alleviate symptoms. However, Dr. Phua emphasizes that pricking has no scientific basis and is absolutely not a method of stroke rescue. He urges people that when faced with any suspected stroke symptoms, they should not waste time and immediately call for an ambulance or go to the hospital. Time is crucial in the first 3-4 hours of a stroke, as only through brain scans (such as computerized tomography scans), can the precise type of stroke—whether ischemic or hemorrhagic—be determined. The treatment approaches for these two types are entirely different. Urgent medical attention is the correct way to rescue a stroke, not wasting time on unscientific methods.

Misconception 2: Minor strokes are not serious or dangerous, and there's no need to worry. Wrong!

The term "minor stroke" refers to "transient ischemic attacks (symptoms lasting less than 24 hours)," but these incidents usually leave traces of strokes in the brain. Dr. Phua asserts that both minor and major strokes are equally important clinically. He emphasizes that minor strokes often serve as warning signs and precursors to major strokes. Individuals who have experienced minor strokes have a high probability of suffering a major stroke within 1 to 2 weeks. Therefore, even if the symptoms last only a few minutes or hours, it is essential to consult a doctor, undergo a brain scan, and check for brain damage or bleeding. Ignoring these symptoms is not advisable.

Misconception 3: Once a stroke occurs, paralysis is inevitable. Wrong!

While strokes can easily lead to prolonged weakness and paralysis, Dr. Phua states that statistical data shows only 20% of stroke survivors experience long-term paralysis. Common post-stroke effects may include one-sided body paralysis, decreased mobility, memory loss, unclear speech, and vision impairment. The severity of long-term effects depends on various factors, including the affected brain region and the quantity of damaged brain tissue. Even in cases of post-stroke paralysis, some patients can improve through rehabilitation therapy. Stroke recovery may take months or even years, with a critical period of recovery within the first 2-3 months. During this time, increased chances of recovery can be achieved through exercise and rehabilitation. Even beyond this critical period, improvement is still possible, albeit at a slower pace.

Misconception 4: Stroke is exclusive to the elderly. Wrong!

Although statistics indicate that the majority of strokes occur in middle-aged and elderly individuals, strokes are not exclusive to the elderly. The increasing trend of strokes among younger individuals should not be overlooked. "Many people believe that only the elderly can have strokes; however, this is a misconception. In clinical practice, we observe many cases of young individuals experiencing strokes. The youngest stroke patient I've encountered was in their early twenties. In fact, one-third of stroke patients are under the age of 65."

“In addition, the likelihood of strokes in women is higher than in men, partly due to women having a longer average lifespan and a higher prevalence of atrial fibrillation (a risk factor for strokes) compared to men.” Dr. Phua underscores the increasing trend of strokes in younger individuals, attributing common causes to dietary habits, obesity, lack of exercise, irregular sleep patterns, smoking, alcohol consumption, and high stress levels. Moreover, genetic factors such as familial hyperlipidemia, high cholesterol, specific inflammatory immune disorders, congenital vascular abnormalities, arteriovenous malformations, and congenital vascular tumors make it easier for strokes to occur in younger individuals.

Rescuing brain cells - every second counts

Dr. Phua emphasizes that rescuing a stroke patient is like a race against time. The longer the delay, the more brain cells are damaged or die, affecting the functions controlled by that part of the brain. Complications and sequelae also increase. If rescue is not timely, it may lead to a loss of life. Dr. Phua frequently encounters cases where patients delay seeking medical attention, especially in the case of minor strokes. In general, stroke patients need to undergo a scan (either computerized tomography or magnetic resonance imaging) upon arrival at the hospital to confirm whether the stroke is ischemic or hemorrhagic. Thrombolytic therapy is an effective method for rescuing ischemic strokes, involving the injection of a clot-dissolving agent to dissolve the thrombus blocking the cerebral blood vessel, reducing the risk of hypoxia and cell death, thereby increasing the chances of post-stroke recovery. For hemorrhagic strokes, the need for surgery depends on factors such as the severity of the stroke, the location of cerebral hemorrhage, and the presence of complications.

He emphasizes that delayed rescue poses a risk to life, and the type and severity of the stroke are crucial in determining the treatment plan. Therefore, individuals suspecting stroke symptoms in themselves or their family members should go to the nearest large comprehensive hospital with well-equipped medical facilities and personnel. This ensures a faster and more accurate diagnosis and targeted treatment, minimizing the damage caused by the stroke.

Strokes typically has no warning signs and can occur within seconds to minutes, catching most patients and their families off guard. For them, it feels like stepping onto a journey with no visible endpoint, and the road to recovery seems uncertain and dim. However, by establishing correct awareness and promptly identifying stroke warning signs, individuals have the potential to change the outcome.

Source
China Press

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