Dr. K. S. V. Surya Teja Reddy, Chief Consultant, Interventional Neuroradiologist, KIMS Hospitals, Kondapur
Hyderabad: Brain strokes, once commonly associated with older adults, are increasingly being reported among younger and middle-aged people as well. In clinical practice, around 15 patients with stroke are seen in the outpatient department in a month, including a considerable number of middle-aged individuals. This highlights the need to improve public awareness about stroke risk factors, warning signs and the importance of seeking immediate medical attention.
World Stroke Day is observed every year on October 29 to raise awareness about stroke prevention, early recognition and access to timely treatment. The message “Every Minute Counts” emphasises the importance of acting quickly when stroke symptoms appear. According to global estimates, approximately one in four people aged 25 and above may experience a stroke during their lifetime. When blood supply to a part of the brain is interrupted, brain cells begin to suffer damage rapidly, making time a critical factor in treatment.
What causes a brain stroke?
A stroke occurs when blood flow to a part of the brain is interrupted by a blocked blood vessel or when a blood vessel ruptures, causing bleeding in the brain. These are known as ischaemic and haemorrhagic strokes, respectively. Without adequate oxygen and nutrients, brain cells begin to die, potentially resulting in weakness on one side of the body, difficulty speaking, impaired vision, loss of balance or difficulty walking.
Recognising the symptoms and reaching a hospital equipped to manage acute stroke are essential steps. Depending on the type of stroke, the time since symptom onset and the patient's clinical condition, doctors may consider treatments such as intravenous thrombolysis to dissolve a clot or mechanical thrombectomy to remove a clot from a blocked blood vessel. Mechanical thrombectomy uses specialised devices, including stent retrievers, in appropriately selected patients. These treatments are time-sensitive and are not suitable for every patient.
Major risk factors for stroke
1. High blood pressure: Hypertension is one of the most important modifiable risk factors for stroke. It can damage blood vessels and increase the risk of both ischaemic and haemorrhagic strokes.
2. Blood clots in blood vessels: A clot that blocks an artery supplying the brain can interrupt blood flow and cause an ischaemic stroke.
3. Diabetes and high cholesterol: Poorly controlled blood sugar and elevated cholesterol can contribute to blood vessel damage and atherosclerosis, increasing the risk of stroke.
4. Heart conditions: Certain heart conditions, particularly atrial fibrillation, can cause blood clots to form in the heart. These clots may travel to the brain and block an artery.
5. Smoking and tobacco use: Tobacco damages blood vessels and increases the risk of clot formation and cardiovascular disease, including stroke.
6. Rupture of a blood vessel in the brain: Uncontrolled hypertension, aneurysms and other blood vessel abnormalities can lead to bleeding in the brain.
Can stroke affect people at any age?
Yes. Although the risk generally increases with age, stroke can also occur in young adults and middle-aged individuals. Hypertension, diabetes, obesity, physical inactivity, smoking, certain heart conditions and a family history of vascular disease may contribute to the risk. In some younger patients, further investigations may be required to identify the underlying cause.
Changing lifestyle patterns are an important public health concern. Irregular working hours, prolonged sitting, inadequate sleep, unhealthy dietary habits and limited physical activity may contribute to conditions such as hypertension, diabetes and obesity. These factors are particularly relevant among people working in sedentary occupations, including information technology. However, stroke usually results from a combination of risk factors, and lifestyle alone may not explain every case.
Steps to reduce stroke risk
Several preventive measures can help reduce the risk of stroke:
Check blood pressure regularly and follow medical advice to keep it under control.
Monitor blood sugar and cholesterol levels.
Stop smoking and avoid tobacco products.
Follow a balanced diet with limited salt and appropriate portion sizes.
Engage in regular physical activity, as advised by a healthcare professional.
Maintain a healthy weight and adequate sleep routine.
Seek appropriate treatment for heart conditions and take prescribed medicines regularly.
Recognise the warning signs and act immediately
The BE FAST approach can help people identify common warning signs of stroke:
B – Balance: Sudden loss of balance or coordination.
E – Eyes: Sudden difficulty seeing or loss of vision.
F – Face: Drooping of one side of the face.
A – Arms: Sudden weakness or numbness in an arm.
S – Speech: Slurred speech or difficulty understanding or speaking.
T – Time: Seek emergency medical assistance immediately.
If any of these symptoms occur suddenly, emergency medical services should be contacted without delay. The time when symptoms first appeared should be noted, as it helps doctors assess treatment options. Even if the symptoms disappear after a few minutes, urgent medical evaluation is necessary because they may indicate a transient ischaemic attack, which can precede a major stroke.
Aspirin or other medicines should not be administered without medical advice, as some strokes involve bleeding in the brain and such medicines may worsen the condition.
Stroke prevention begins with awareness, regular health checks and appropriate management of risk factors. Recognising warning signs and reaching a suitable hospital promptly can improve the chances of receiving time-sensitive treatment and may reduce the risk of long-term disability.
