Text by Henrylito D. Tacio
Photo: Stroke Awareness Foundation
Stroke strikes anytime – and without warning! This is the reason why the friends of film actor Fernando Poe, Jr. didn’t know it was coming. “We were drinking and eating. We were on our second beers and the conversation was lively,” then-Rep. Francis Escudero was quoted as saying.
The movie icon was into his fourth beer when he complained of dizziness. “Initially, he thought it was only because he changed his eyeglasses but later he could no longer stand his dizziness,” Escudero said. “He did not fall to the ground but his condition was no longer normal so we rushed him to the hospital.”
The 65-year-old Poe succumbed to “cerebrovascular accident,” the technical term for stroke. The condition is similar to an accident that attacks so suddenly, like a thief waiting for its next prey to fall.
Stroke is the third leading cause of death worldwide, according to the Geneva-based World Health Organization (WHO). In the Philippines, stroke is the second leading cause of death, and among the top five diseases with the greatest burden, studies show.
It threatens to affect 400 to 500 Filipinos at any given time.
A stroke happens in the brain rather than the heart. In fact, it is also called a “brain attack.” Explains Dr. Willie T. Ong, a consultant with the Manila Doctor’s Hospital and Makati Medical Center: “A stroke occurs when a blood clot blocks a blood vessel or artery, or when a blood vessel breaks, interrupting blood flow to an area of the brain. When a brain attack occurs, it kills brain cells in the immediate area. The cells usually die within minutes to a few hours after the stroke starts.”
Experts classify two types of stroke. Explains the U.S. National Institute of Neurological Disorders and Stroke (NINDS): “The most common is an ischemic stroke, caused by a blood clot that blocks a blood vessel or artery in the brain. The other, less common, is a hemorrhagic stroke, caused when a blood vessel in the brain ruptures and spills blood into the surrounding tissue.”
Strokes frequently occur without warning. The most common signs and symptoms include sudden numbness, weakness, or paralysis of the face, arm, or leg – usually on one side of the body; loss of speech, or trouble talking or understanding speech; sudden blurred, double, or decreased vision; dizziness, and loss of balance or loss of coordination.
Other signs and symptoms include a sudden, severe “bolt out of the blue” headache or an unusual headache, which may be accompanied by a stiff neck, facial pain, pain between the eyes, vomiting or altered consciousness; and confusion, or problems with memory, spatial orientation or perception.
For most people, a stroke gives no warning. But one possible sign of an impending stroke is a transient ischemic attack (TIA). “These TIAS have no lasting damage but are extremely important warning signs,” explained Dr. Alberto G. Romualdez, Jr., when he was still the health secretary. “A person who has had one or more TIAs is 10 times more likely to suffer a stroke than someone of the same age and sex who has not.”
Who is most likely to suffer from stroke? If you have high blood pressure (hypertension), you are most likely to suffer from it, according to Dr. Joseph V. Campellone of the Division of Neurology at the Cooper Hospital/University Medical Center in New Jersey. “The risk of stroke is also increased by age, family history of stroke, smoking, diabetes, high cholesterol, and heart disease,” he added.
Certain medications promote clot formation and may increase a person’s chance of a stroke. One example is birth control pills, especially if a woman taking them also smokes and is older than 35. Women have a risk of stroke during pregnancy and the weeks immediately after pregnancy. Overall, however, more men have strokes than women.
Other factors that can increase the risk of stroke include heavy or binge drinking, the use of illicit drugs such as cocaine, and uncontrolled stress, says the Minnesota-based Mayo Foundation for Medical Education and Research.
If you think you are a contender for stroke, be sure to consult your doctor immediately. Doctors diagnose a stroke by performing a short neurological examination, as well as blood tests, computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans, Doppler ultrasound, and arteriography, if needed.
“Stroke, like heart attack, is preventable and treatable,” said Dr. Romualdez. But preventing a stroke is a much better option than treating it. The main preventive strategy is managing the risk factors. Physicians recommend the following: Get screened for high blood pressure at least every two years, especially if you have a family history of high blood pressure. Has your cholesterol been checked? Treat high blood pressure, diabetes, high cholesterol, and heart disease if present. Follow a diet low in fat and salt. Quit smoking. Exercise regularly. Lose weight if you are overweight. Avoid excessive alcohol use.
What happens to those who suffered from a stroke and lived? The NINDS shares this information: “The effects of a stroke range from mild to severe depending on the type of stroke, area of the brain affected, and the extent of the damage. Those who have survived a stroke may experience paralysis, pain, or numbness, as well as problems with thinking and speaking, and emotional changes.”
The NINDS continues: “Many individuals will require physical therapy to regain strength and mobility, and occupational therapy to relearn how to perform everyday activities, such as eating, dressing, using the bathroom, among others. Speech therapy is appropriate for those who have trouble reading, understanding speech, or forming language.”
“Right now there is no direct treatment for reversing the neurologic damage of a stroke months after it occurs,” said Dr. Douglas Kondziolka, professor of neurological surgery and radiation oncology at the University of Pittsburgh Medical Center. “The only treatment for these patients is rehabilitation through physical or occupational therapy.”
But hope is on the horizon. Transplanting neural cells grown in a laboratory into the brains of stroke patients appears to be safe and may help the patients regain mobility. However, more testing is necessary before researchers know whether the treatment is truly effective in helping to reverse the paralysis and other impairments characteristic of stroke.