Q. My father died at 65 because of stroke. What is stroke and what causes it? Is this disease preventable?

–Elmer J., San Juan City

A. Stroke refers to death or damage to an area of the brain that happens when the blood vessel or artery supplying the area with blood gets clogged (ischemic stroke) or ruptures (hemorrhagic stroke).

Ischemic stroke accounts for 80 percent of all strokes. It usually occurs when a brain artery that has previously been narrowed by atherosclerosis gets clogged by a blood clot that develops within the artery; or, when a blood clot or other particle that forms in the heart or a blood vessel somewhere in the body finds its way into and clogs a brain artery.

Hemorrhagic stroke, on the other hand, which accounts for 20 percent of all strokes, occurs when a weakened blood vessel ruptures allowing blood to spill into brain tissue. The rupture of the blood vessel compromises blood supply to the brain. In addition, the spilled blood irritates brain tissue and serves as a space occupying mass that compresses and damages the brain.

Stroke is primarily a disease of the elderly. More than two-thirds of all strokes victims are 65 or older.

The signs and symptoms of stroke vary depending on the location and, to a certain extent, the size of the involved area of the brain.  Its more common manifestations include numbness, weakness or paralysis—often, one-sided—of the face, arms or legs; headache that may be accompanied by vomiting; blurring of vision; loss of balance and coordination resulting in disturbances in gait; slurring of speech; inability to understand; and, impairment of consciousness.(e.g., confusion, disorientation, incoherence, coma).

A stroke usually occurs suddenly, then it develops rapidly and stabilizes within a matter of hours. But it can progress over a period of days. Regardless of the progression of the illness, however, early recognition and treatment often helps in ensuring a favorable outcome.

About one in four people who develop a stroke dies. Some stroke survivors regain complete function of their affected body part. More commonly however, stroke survivors are left with moderate to severe impairment that disables them for life.

The risk factors for stroke include hypertension, high blood cholesterol level, diabetes mellitus, smoking, cardiac disease, drug abuse, heavy alcohol consumption, family history of the disease, and intake of certain drugs (e.g., anticoagulants, cocaine and amphetamines).

Stroke is preventable because most of the risk factors that are associated with the condition are modifiable. The following measures should go a long way in lowering ones risk for stroke—and for that matter, also heart attack.

• Don’t smoke.
• Stick to a low-salt, low-fat, high fiber diet.
• Indulge in a regular exercise program.
• Maintain a desirable body weight through proper diet and exercise.
• Drink alcohol moderately—no more than two drinks a day. Better still, don’t drink at all.
• Avoid stress. If you can’t, learn to relax through exercise, sports, listening to music, etc.
• Refrain from taking illegal drugs
• If you have hypertension and/or diabetes, these chronic conditions must be controlled with the help of a physician.

Incidentally, there is a condition called transient ischemic attack (TIA) that has the same manifestations as stroke. But in TIA, the signs and symptoms usually last less than 30 minutes and seldom more than 24 hours. What’s more a TIA does not lead to permanent brain damage.

However, a TIA has the same cause and can in fact herald an impending ischemic stroke. Consequently, people with TIAs need to be observed in the hospital and subsequently, followed up regularly.

(E-mail inquiries on health matters to: medical_notes@yahoo.com or wellbeing@mb.com.ph.)