The word 'stroke' can cause some people to experience goosebumps. It is a scary term for some people, and yet it it! The World Health Organisation estimates that 15 million people suffer from stroke annually worldwide and is one of the leading causes of disability in the world. It can be prevented though. Therefore, everyone should know the risk factors and how to reduce the risk of getting one.

There are two types of stroke; the more common is ischaemic stroke (fig.1) which is characterised by sudden loss of blood circulation to an area of brain and caused by thrombotic or embolic occlusion of a cerebral artery, and hemorrhagic stroke (fig.2) in which bleeding occurs directly into the brain parenchyma.

                                

                      Fig. 1                                                                       Fig. 2

Both types, when happen, will reduce oxygen and nutrients supply for brain cells and so these cells cannot survive. Some might have heard about TIA or transient ischemic attack. According to American Heart Association and the American Stroke Association (AHA/ASA), TIA is a transient episode of neurologic dysfunction caused by focal brain, spinal cord or retinal ischaemia without acute infarction, and the symptom duration lasting less than 24 hours. It is a warning sign of a stroke that might happen later and the best thing to do when it is suffered is to see a doctor immediately so thorough investigation can be done.
Symptoms of stroke can be easily remembered as FAST (fig.3). Emergency line to call will be different in every country. The number 112 is the international emergency number and can be dialled free of charge from most mobile telephones even without SIM card reception.

  

Fig. 3

There are many risk factors of stroke. The ones cannot be changed or controlled are gender, age, ethnicity, hereditary high cholesterol, and family history. The controllable ones are high blood pressure, smoking, diabetes, high fat intake, sedentary lifestyle and obesity.

Some ways to reduce the risk factors are:

1. Control blood pressure, by reducing salt intake in foods.
2. Quit smoking.
3. Reduce sugar intake in foods and drinks.
4. Reduce or avoid foods with high fat content; eat more vegetables, fruits, nuts and legumes, lean meat, and fish. 
5. Increase physical activity to achieve and maintain ideal and healthy weight. Walking fast for 20 - 30 minutes per day is recommended.

Below is a Stroke Risk Card that can be used for self assessment. Immediate intervention for prevention will be needed for people with caution and high risk results.

People with acute stroke need to go to the hospital right away. This is important to stabilise vital signs. Once vital signs have been stabilised, acupuncture treatment and physiotherapy can be prompted.

Acupuncture, when applied correctly along with medication and physiotherapy, can shorten recovery time and restore function to over 95% patients. More research is needed to understand the mechanism of acupuncture. It is believed to promote reperfusion of the brain through activation of collateral blood vessels and dissolution of fibrin on the clots. It also triggers chemical changes in the brain to protect brain cells from necrosis and to promote myelin regeneration on nerve cells. Medical acupuncture is a treatment that involves needling on the scalp and other body parts affected, physical and psychological counselling to encourage and build patients' confidence to heal, helping them to relax, and to teach them how to gain their physical functioning back.

Yenny Vandalita, MD.