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Brain Attack

FAST action can fix a Brain Attack

What is a Brain attack?

A brain attack is the loss of brain function, many times permanentlydue to abnormalities in brain blood circulation. As the brain controls all bodily functions any sudden loss of its function results in an attack. A major brain attack is a life threatening condition similar to heart attack. ‘Stroke’ is the medical term for a brain attack.

How common is a brain attack?

It is the leading cause of acquired disability and third leading cause of death in India. Worldwide one in six people have a stroke in their lifetime; one in five women are at risk.It kills more women than breast cancer and one person develops a stroke every 45 seconds. Yet there is little awareness about the condition. is less. 20 lakh people are affected every year in India. Worryingly, 20-30% of these stroke patients are less than 45 years old!

What are the types of brain attack?

Brain attack can beeither due to a blocked artery supplying blood to the brain or due to a ruptured brain blood vessel. The blood from a ruptured brain vessel caneither remain within the brain tissue (intracerebral haemorrhage, ICH) or on the surface of the brain (subarachnoid haemorrhage, SAH).

What are the symptoms of a brain attack?

The signs include sudden:

  1. Arm or leg weakness
  2. Loss of sensations (numbness)
  3. Vision problem in one or both eyes
  4. Loss of balance/walking difficulty
  5. Understanding and speaking difficulty
  6. Dizziness
  7. Onset of worst ever headache of life

What does ‘FAST’ stand for?

FAST stands for F–Face droop, A-Arm weakness, S-Speech slurring and T– Time is brain. This easy to remember term can help anyone to identify a stroke within seconds. Bystanders can ascertain stroke symptoms by:

  1. Patient is either unable to lift an arm or it drops upon being lifted
  2. Face becomes asymmetric when smiling
  3. Patients can’t understand or speak or speaks with a slur
  4. Time is brain: every second 33,000-brain nerve cells start dying. Call and move patients immediately to a ‘stroke-ready hospital.’

It is sad that prompt action could have saved the life of one stroke patient every 30 minutes.

What to do when a stroke is identified?

A brain attack is a medical emergency. It can, however, be effectively treated if the patient is shifted to a ‘stroke ready’ hospital within six hoursof the attack. Stroke-ready hospitals have CT scan facility, stroke specialists 24 x 7 stroke specialists and advanced stroke treatment facilities.

What does the brain scan tell?

All patients suspected to have suffered a stroke must undergo a CT or MRI scan. The images provide useful data about a brain’s status like like whether a stroke is due to a clot ora brain bleed. In addition, the amount of brain that can be saved by early treatment can be determined. Bottomline: scan results determine the course of treatment.

What are the treatment options available for brain attack?

If a brain blood vessel is blocked by a clot, dissolving the clot with clot-bursting drugs intravenously or/and removing the clot directly using special devices in a cath lab may be the best option. The latter is proved to be more effective for large artery blocks. Treating a ballooning brain artery may require a keyhole surgery or sometimes opening the skull and clipping.

What is the role of surgery in stroke patients?

If acute treatment fails, a large part of the damaged brain may swell up causing compression of the adjacent normal brain. In such conditions, removing a part of the skull bone (craniectomy) may save lives. The removed skull bone flap is kept under the abdominal skin for few months. Once the danger, the bone flap can be restored.

In some patients, fat deposits in brain blood vessel (carotid atherosclerosis) may causea partial blockage of the artery. In such conditions, urgent surgical removal of such deposits (endarterectomy) prevents future strokes.

Can we prevent the ‘first’ stroke?

Yes, 90 per cent of strokes can be prevented by treating modifiable risk factors like elevated blood pressure, cholesterol and blood sugar as also obesity, sedentary lifestyle andunhealthy dietary practices.

Can we prevent a stroke from recurring?

To an extent yes. Lifelong treatments with blood thinners (either anti-platelets or anticoagulants) can significantly reduce the risk of recurrent strokes. Apart from the risk factors mentioned above, certain heart conditions like atrial fibrillation/flutter, valvular diseases can be identified by investigations and treated. Identifying fat deposits (called plaques) in brain blood vessels and addressing them also reduces the risk. Identification of some rare diseases which causea stroke also helps.

What can family physicians do in a brain attack?

The role of family physicians is critical in stroke care. Often he is the first to attend to a stroke patient. Therefore, his ability to identify a stroke, explain it to caregivers and initiate appropriate action promptly like moving the patient to a stroke-ready hospital can be of life and death importance. Also, the responsibility of long-term care post-stroke falls on the family physician.

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