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Help at hand
Life after stroke is not easy, be it for the survivor or his family.
Rehabilitation is part of the treatment for stroke and professionals
can help survivors regain control of their lives.
2 Stroke Awareness SUNDAY STAR, 28 OCTOBER 2018

Story of Judy Lee

Judy Lee (pic) suffered an ischaemic

stroke two years ago in August. The
Zest for life
blood clot in her left brain left her face
distorted, speech hampered and right JUDY Lee and Maria Othman, two
The unaffected
limbs unable to move. gregarious stroke survivors who are brain needs to be
trained by doing a task
Lee’s stroke was caused by high currently undergoing rehabilitation, instil
blood pressure and uncontrolled hope in the hearts of other survivors and
cholesterol. Without consulting a doctor,
she stopped taking her medication once
their loved ones.
Not ones to be bogged down by a tragedy, over and over. This allows
her pressure and cholesterol were under
control, a move that eventually led to
they decided to get right back up, in the
process inspiring other stroke survivors to
it to rewire itself to learn
her stroke. do the same. and take over this new
“I was having a cup of Milo in the
morning, before leaving for a family
While the experiences and journey from
stroke to recovery are very different for Lee function. This is what is
fun day with my sister, brother-in-law
and grandniece, when I felt my
and Maria, they were unanimous in
emphasising the two most important factors
essentially done in stroke
drink dripping from the side of my that helped them get back up – support and rehabilitation – making
“My grandniece noticed it too and my
According to both women, the one the stroke survivor
speech slurred when I tried to talk to
her. I somehow managed to
positive effect that stroke has had in their
lives is realising how loved they are and the
perform repetitive
communicate to my grandniece to call extent of human kindness. tasks.
her grandma and granddad. A friend of Lee’s volunteered to
“My family took one look at me pay off her existing loans, and Maria’s Dr Ramesh Narenthiranathan
and knew there was something wrong friends flew from Japan, Thailand and the
since a side of my face had drooped. Philippines to visit her. The love,
They rushed me to the hospital understanding, care and support that they people in her life. However, with a little
where I was told that I had suffered a received were the greatest motivating understanding and patience from loved
stroke. factors that helped them regain their ones, in addition to timely treatment and
“I was completely ignorant about confidence and zest for life. proper rehabilitation, stroke survivors can
stroke before it happened to me. I did National Stroke Association of Malaysia successfully take back control of their lives.
not even know what it was and how it (Nasam) communications coordinator Maria and Lee, along with many other
was caused. Vanaja Dhanan stresses the importance of stroke survivors, are testament to this.
“It took me a long time to accept what friends and family in the rehabilitation of
happened and I was depressed about my
condition. My friend talked me into
stroke survivors.
She says, “Support from loved ones has a
Regaining control
going for rehabilitation and that was the major role to play in boosting the morale of Stroke treatment does not end with
turning point for me. a stroke survivor, because willingness is the removing the blood clot or stopping the
“I started getting better with first step to recovery. haemorrhage. Rehabilitation is a vital part
rehabilitation. Now after two years I can friends and family for “Imagine not being able to walk, talk of treatment.
speak, although I take a little more time supporting me throughout and do all the other things that we “The final goal of doctors in treating
to say certain words. this journey.” usually take for granted. This inability stroke patients is not saving lives but
“I am now working on being able to Lee’s advice to people with risk causes depression in stroke survivors. bringing back functionality. The only way to
move my right limbs with the help of factors for stroke is to make undergoing In such scenarios, care from loved ones bring back this functionality is to start
physiotherapy and am thankful to my regular health check-ups a priority. is imperative in inspiring them to rehabilitation as soon as possible,” says
move forward and fight against these Dr Ramesh Narenthiranathan, consultant
disabilities. neurosurgeon at Ara Damansara Medical
“Stroke survivors are more motivated to Centre.
undergo rehabilitation when they have Many hospitals in Malaysia begin the
encouragement from friends and family. process of inhouse rehabilitation as soon as
We have seen what wonders this drive can a patient is declared medically fit by the
do in bringing back functionality faster and doctor. It is up to the patient and his family
more effectively.” to continue with it afterwards.
Stroke affects not just the patient as it
also shakes up the circumstances and > SEE NEXT PAGE

Story of Maria Othman

Unlike Judy Lee, stroke survivor Maria getting to the hospital and speaking
Othman (pic) did not have any risk incoherently to my husband about the
factor. What she did have was a ruptured pain in my head. I didn’t know what had
aneurysm. happened to me when I regained my full
Aneurysm is the ballooning of a vessel consciousness. Because I could not feel
that carries blood to the brain, which can my legs, I thought I was in an accident
burst and cause a stroke. and that my legs had been amputated.
According to Dr N. Ramesh “For a long time, I did not accept what
Narenthiranathan, consultant happened to me since I was healthy one
neurosurgeon at Ara Damansara Medical day and could not even sit up without
Centre, “Although aneurysms are help the next.
believed to be congenital, they can also “I was angry initially but eventually
develop with time.” accepted what had happened. With this
The only way to diagnose an acceptance and the help of rehabilitation
aneurysm, congenital or otherwise, at the National Stroke Association of
is through a professional Malaysia, I gained back my positive
health check-up since outlook and also some of my
unruptured aneurysms functionality.”
oftentimes have no clear While Maria could still speak, she
symptoms, making lost her ability to move or even sit.
aneurysm unpredictable Rehabilitation has helped Maria regain
and dangerous. her strength so she can not only sit but
Maria narrates her story: move around in a wheelchair and walk
“I was working late into the a few steps with help.
night and all I remember An expert diver, dancer and
was suddenly enthusiastic traveller, Maria
collapsing on top of remains positive about her
my husband. I did second shot at life.
not have any other “I am 59 years young
stroke symptoms since I am learning
such as drooping everything again like a
of face or small baby. I am still
slurring of alive, and I want to
speech. make use of it. I have
“I was only hopes that I will be able
vaguely to go diving again
conscious of someday.”
SUNDAY STAR, 28 OCTOBER 2018 Stroke Awareness 3

Regaining hope for the future Story of Ronnie Ding

> FROM PREVIOUS PAGE new function.
“This is what is essentially done in stroke Ronnie Ding, husband and full-time “Talk to people who understand when
Tracy Chan, head of rehabilitation at rehabilitation – making the stroke survivor caregiver of stroke survivor Maria it becomes too much to handle, but make
Nasam, explains the importance of starting perform repetitive tasks,” he adds. Othman, shares his experience of sure you do not lose your positivity
rehabilitation early: “The target is to prevent Chan says, “It takes time to see the results supporting a stroke survivor while coping because motivation and support have an
secondary complications that may occur of rehabilitation. Initially, it can be with the ordeal himself: amazing effect on the outcome of
after a stroke and rewire the brain to speed frustrating for the stroke survivor as well as “I thank God that Maria fell on me rehabilitation for stroke survivors.”
up recovery. the caregivers. instead of falling to the other side of the
“The longer the duration between stroke “It is, however, important to have bed. I woke up and knew instantly that
and rehabilitation, the weaker and tighter patience. Yes, progress may be slow, but something was wrong because even
the muscles will get, and they would also be however little, there is still progress and it is though she could speak, she seemed Ding (standing) with Maria.
deconditioned, making the recovery of important to cheer them on for every little confused and could not open her eyes. I
functionality more difficult.” accomplishment and motivate them to fight immediately took her to the emergency
With timely rehabilitation, neuroplasticity harder.” room.
kicks in. Dr Ramesh elucidates, Experiencing a stroke is not the end “Initially, the doctors could not
“Neuroplasticity is training the unaffected of the world. With a little patience and a understand what was wrong since there
part of the brain to take over the functions of lot of support from loved ones, stroke were no external telltale signs of stroke.
the affected part.” survivors can bounce back to living their However, some quick scans and tests
According to him, neuroplasticity is the lives. revealed that she had suffered a
same as training the brain of a child. “The In line with the theme for this year’s haemorrhagic stroke caused by
unaffected brain needs to be trained by World Stroke Day – Up Again After Stroke – it aneurysm.
doing a task over and over. This allows it is crucial that every stroke survivor gets a “She was released from the hospital
to rewire itself to learn and take over this second chance at life. within a few days. Initially, she was very
negative, angry and frustrated with her
“It was depressing for me to see her
like that because I didn’t know how to
help her. Slowly, with rehabilitation and
counselling, she started to become more
positive, especially when she started
regaining her functionality.
“On the other hand, I started becoming
more confident with my role as the
caregiver after meeting therapists and
other stroke survivors at the National
Stroke Association of Malaysia.”
Advising caregivers of stroke patients
to be understanding above everything
else, Ding adds, “With understanding
comes patience, and you would need to
garner all your patience when dealing
with a stroke survivor.
“You must understand that they are not
themselves anymore and are helpless in
what they are doing or not doing.
4 Stroke Awareness SUNDAY STAR, 28 OCTOBER 2018

Helping you make time for fitness

WE know that maintaining an active

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Understanding the
subtle differences
ISCHAEMIC stroke and haemorrhagic stroke risk factors and methods of prevention, they
happen independently of each other. are different in their manifestation and
Although both types of stroke share the same treatment requirement.

Ischaemic stroke Haemorrhagic stroke

Blood clots Bursting and bleeding of blood vessel

l Ischaemic stroke occurs when there is a l Haemorrhagic stroke occurs when a
blockage in the blood vessels that supply weakened blood vessel ruptures, causing
blood to the brain. the vessel to bleed. Sometimes, blood
clots will start to form on the outside of
the blood vessel.

More common Less common

l According to the American Heart l Haemorrhagic stroke makes up 13% of
Association, ischaemic stroke accounts for all stroke cases.
87% of all strokes.

Higher survival rate Lower survival rate

l While more common, ischaemic strokes l Due to the rupture of blood vessels,
generally have a slightly higher survival haemorrhagic stroke is more critical than
rate than haemorrhagic stroke. ischaemic stroke, lowering its rate of

Treatment Treatment
l During the first four hours of stroke, l As haemorrhagic stroke is more lethal,
patients can be given emergency emergency treatment must be done to
thrombolytic therapy medication to control the bleeding and pressure exerted
dissolve the blood clot in the brain. by bleeding in the brain. Drugs will be
l In the four- to six-hour window of given to the patient to lower blood
occurrence, a mechanical thrombectomy pressure and slow blood flow to contain
procedure can be done to remove the clot the situation.
from the brain. l Depending on the condition of the
l Between six and 24 hours, mechanical patient, surgery may be required to repair
thrombectomy can be carried out if the the rupture or remove the blood clot
patient’s condition is eligible for it. formed in the brain.
l General cases can also be treated with
blood thinner to dissolve the clot in the
6 Stroke Awareness SUNDAY STAR, 28 OCTOBER 2018

Recognising the signs

MANY people have this idea that a
stroke does not come with any
warning and can strike anyone at
any time.
According to Dr Lee Yik Yong,
consultant internal medicine
physician at Columbia Asia of the body months is possible, but with acute
Hospital – Petaling Jaya, this is only l Slurring of speech, confusion, strokes, permanent disability
partially true.
“In some people, there are no
sudden inability to understand
l Sudden loss of vision in one or
Haemorrhagic cannot be prevented.”
However, stroke survivors
symptoms before a sudden attack both eyes or blurring of vision stroke occurs when who suffer disabilities can

one or a few of
of stroke, but in some others, there l Severe headache, dizziness or undergo further treatment
are warning signs in the form of loss of consciousness, imbalance, such as physiotherapy and
minor strokes known as transient
ischaemic attack (TIA), which
loss of coordination
the blood vessels speech therapy to help them with
precedes a full-blown stroke,” he
If such signs are noticed in
a person, it is important to
in the brain burst “Individuals who are at a high

and blood floods

risk of getting a stroke include
“These mini strokes have similar get medical help immediately. people with high cholesterol,
indications of a full-blown stroke,
such as numbness or a tingling
Otherwise, it might turn fatal.
Dr Lee informs, “Strokes are in. Haemorrhagic uncontrolled diabetes, high blood
pressure, who binge on alcohol
sensation on one or both limbs on
one side, dizziness and speech
mainly of two kinds – ischaemic
and bleeding or haemorrhagic.
stroke is more and are heavy smokers.
“By addressing the risk factors
incoherency, but these symptoms Ischaemic stroke happens when common in people through medications and a healthy
do not last for long.”
Dr Lee warns that TIA should
there is a blood clot in the brain
that cuts off oxygen supply to a with uncontrolled lifestyle, the risk of getting a stroke
can be diminished significantly,”
not be ignored since people who
have had a mini stroke are at a
part of the brain and the part
slowly dies off. stroke, the blood clot needs to be
hypertension. says Dr Lee.
Celebrated on Oct 29 annually,
higher risk of getting a full-blown “Haemorrhagic stroke occurs dissolved, which can be done with World Stroke Day highlights the
stroke later in life. when one or a few of the blood the help of medication. Dr Lee Yik Yong responsibility of every person
vessels in the brain burst and “As for haemorrhagic strokes, around the globe to be aware of
The indicators blood floods in. Haemorrhagic
stroke is more common in people
blood pressure needs to be reduced
first to control the bleeding before ischaemic stroke, the latter has a
the symptoms of a stroke, the
damages it can cause and the
To identify whether a person is with uncontrolled hypertension.” brain surgery is performed to higher rate of occurrence. ways to prevent it. Widespread
having a full-fledged stroke, Dr Lee repair the damaged blood vessels,” Regarding the recovery awareness is crucial in saving
points out the following symptoms
to look out for:
Seeking treatment he explains.
According to Dr Lee, while
prospects of strokes, he says,
“Recovery depends on the extent of

l Sudden numbness in the arm, Treatment differs for the two mortality rate is higher with the stroke. For mild to moderate n For more information, call
leg or face, especially on one side kinds of stroke. “For ischaemic haemorrhagic stroke compared to strokes, recovery within six 03-7949 9999.

STROKE is ranked as the second

most common cause of death in the
world and third most common
cause of disability-adjusted life
Stroke rehabilitation programmes
years, according to a 2010 study
titled Global Burden of Disease,
Injuries and Risk Factors.
The effect of stroke on a person
depends on the area of his brain
affected by the stroke. Some
patients may become hemiplegic
with some loss of sensation while
others may lose the ability to
comprehend speech or express
Stroke can be mild in that it may
cause minimal weakness, affecting
only the hand, or it can be severe,
causing profound disability or even
death. The main types of
disabilities that a stroke can cause
are: who do not. The type of
l Paralysis rehabilitation programme depends
l Sensory loss on:
l Communication difficulties – l The disability caused by the
inability to talk/express oneself, stroke
understand speech or both l The severity of the stroke
l Difficulties in thought
processes KPJ Tawakkal Health Centre’s RILUs have spacious, wheelchair-friendly living and dining/cooking areas.
l Memory problems
l Other medical problems the Stroke rehabilitation works best following acute medical care to
Rehabilitation is an important
part of recovery after stroke. There
stroke patient has
l Family and community
when the patient, family and
rehabilitation team work together.
stabilise the patient. It is then
continued as inpatient treatment
Rehabilitation is
is currently no medication that has support There should be achievable goals until the patient is stable enough to an important part
of recovery after
shown good evidence of reversing decided mainly by the patient and go home.
disability from stroke. The goal of Stroke rehabilitation is best his family with guidance from the The patient can then be
rehabilitation is to help the patient
relearn skills lost due to stroke.
carried out by a multidisciplinary
team of health professionals such
The therapy is then designed to
transferred as an inpatient to a
rehabilitation hospital or
stroke. The goal
Research has shown that as physiotherapists, occupational meet these goals, which are
reviewed regularly by the team,
outpatient at a rehabilitation of rehabilitation is
to help the patient
participating in a focused stroke therapists and speech therapists centre such as the KPJ Tawakkal
rehabilitation programme helps under the leadership of doctors patient and his family to ensure Health Centre.
patients perform better than those trained in rehabilitative medicine. the goals are met and readjusted if
not, and make new goals. There
A rehabilitation centre would
have the expertise and the relearn skills lost
should be an agreed time frame for
these goals. Hence, each
necessary equipment to enable the
patient to become as independent
due to stroke.
programme is individualised to as possible. The centre has Rehab
meet each person’s specific needs. Independent Living Units (RILUs)
Some general treatment where patients can be trained to be discussed with a rehabilitation
components include: independent in a homelike setting. medicine specialist.
l Treating complications of This enables patients to be Stroke rehabilitation can help a
stroke such as spasticity, difficulty independent not only in terms of person recover from the effects of
swallowing, pressure sores and personal care such as grooming or a stroke, relearn skills and develop
pain using the toilet, but also new ways to do things. However,
l Improving a person’s function performing domestic activities of the patient must be motivated and
in terms of self-care and ability to daily living such as preparing their realise that the process takes time.
perform housework and his work own meals and cleaning up. A good relationship with his
l Providing adaptive equipment The discharge destination rehabilitation team is vital for the
and ensuring the environment is and type of rehabilitation service success of the programme.
safe such as installing grab bars for recommended is dependent on
the toilet and shower chairs in the the severity of stroke the patient n For more information, call
bathroom. had and his rehabilitation 03-4021 0464, send a WhatsApp
potential. It should ideally be message to 017-614 3166 (mention
Stroke rehabilitation should be decided after the patient’s RILU) or visit
A comfortable bedroom at KPJ Tawakkal Health Centre's RILU. started as soon as possible condition has been assessed by and KKLIU No.2358/2018
SUNDAY STAR, 28 OCTOBER 2018 Stroke Awareness 7

Prevention is better than cure

ACCORDING to National Health and Products made of oat bran such as
Morbidity Survey 2015, non-communicable Biogrow Oat BG22 Oat Bran Powder contain
diseases such as cardiovascular disease – a high amount of soluble dietary fibre
including heart attack and stroke – known as beta-glucans.
contribute to an estimated 73% of mortality The health benefits of oat beta-glucans,
in Malaysia. especially in lowering blood cholesterol,
Hypercholesterolemia is one of the risk have been extensively studied.
factors for heart disease and stroke. The In addition, oat beta-glucans help
formation of plaque in the arteries from high control blood glucose level. Many health
levels of blood cholesterol restricts professionals recommend including oat beta-
oxygenated blood flow to the brain, causing glucans in the diet of individuals suffering
a stroke. from or who are at risk of type 2 diabetes.
The risk of heart disease and stroke can be Made of natural Swedish oat bran, which
minimised by adopting a healthy lifestyle, consists of soluble and insoluble fibre,
which includes: Biogrow Oat BG22 Oat Bran Powder is free
l Eating a high-fibre diet containing fruits, from artificial ingredients, thickeners and
vegetables, whole grains or other cereal fillers.
products that are high in soluble fibre (such Two scoops/sachets (≈18g) of the oat
as oat beta-glucans) bran powder daily provide 3g bioactive oat
l Eating foods that are low in saturated beta-glucans, which help lower blood
fat, trans fat and cholesterol cholesterol and blood glucose levels
l Limiting salt (sodium) intake effectively. The product has a low glycaemic good viscosity, producing a gelling effect in This article is contributed by Legosan
l Engaging in physical activity for at least index value (< 55) and is suitable for the gut for optimal cholesterol-lowering Company (Malaysia) Sdn Bhd.
30 minutes on most days of the week diabetics. effect.
l Drinking in moderation or avoiding The powder’s solubility allows it to Start your prevention programme today n For more information, call
alcohol dissolve well in cold or lukewarm water. by adopting a healthy lifestyle and 03-7956 2220 or e-mail
l Avoiding smoking It is also scientifically shown to have incorporating oat beta-glucans in your diet. my

Are you at risk?

STROKE is one of the most and obesity.
prevalent causes of death among
the global population. While l Heavy alcohol
more common in men, fatality consumption
from stroke among women Risk factors of stroke such as
is higher than that of breast hypertension, diabetes and
cancer. obesity are associated with heavy
However, the risk of stroke can alcohol consumption. Besides
be reduced through awareness of that, excessive alcohol intake can
risk factors. Several major ones trigger atrial fibrillation, which is
are listed below. a type of irregular heartbeat that
l High blood pressure can cause blood clots to form in
Also known as hypertension, the heart. If these clots travel to
this condition occurs when the brain, a stroke may occur.
blood pressure is above the
rate of 140/90. This causes high l Smoking
pressure to be exerted on blood When smoke is inhaled,
vessels, weakening them and various chemicals such as carbon
increasing one’s risk of getting monoxide, formaldehyde, arsenic
haemorrhagic stroke. and cyanide can damage healthy
cells in the body, increasing one’s
l High cholesterol level risk of stroke. Smoking can
High cholesterol can lead to increase cholesterol and blood
the formation of a substance pressure levels as well as the
called atheroma in the blood likelihood of blood clots forming.
vessels. This substance sticks to
artery walls and causes l Obesity
atherosclerosis, which is a Because of excess fat in the
condition involving the body, poor blood flow and
narrowing and hardening of the blockages (the two major causes
arteries. Stroke can happen of stroke) can occur. Besides that,
when normal blood flow is people with obesity are more
slowed or obstructed. likely to have comorbidities such
as high blood pressure, high
l Diabetes cholesterol and diabetes.
High blood sugar level can
contribute to the occurrence These are the main risk
of atherosclerosis. The lack factors, but studies show that
of insulin in the body to there may be lesser-known
break down glucose for cell causes of stroke. Stroke can
consumption can lead to excess happen to anyone, even people
fatty deposits and clots in the who look generally healthy on
bloodstream, increasing the risk the outside. Thus, you should
of stroke. Diabetes is usually always be aware of your health
accompanied by other risk and undergo regular medical
factors such as high cholesterol check-ups.
8 Stroke Awareness SUNDAY STAR, 28 OCTOBER 2018

A stitch in time saves lives

TIME is of the essence when
dealing with a stroke. Dr Ramesh
Narenthiranathan, consultant
neurosurgeon at Ara Damansara
Medical Centre, explains, “When
someone suffers a stroke, it means
that brain tissue damage has
already occurred.
“What we need to do is to
control and limit the amount of
damage as much as possible by
starting treatment immediately.”
Strokes are of two kinds –
ischaemic and haemorrhagic. The
latter is more lethal.
“In case of an ischaemic stroke,
which is caused by a clot within a
blood vessel that obstructs oxygen
supply to a part of the brain, there
is a time frame within which the
blood clot needs to be dissolved to
revascularise the brain tissue,” says
Dr Ramesh.
“In haemorrhagic strokes, when
a blood vessel ruptures, damage is
caused not only to the part of the
brain where the primary rupture Arteriovenous malformation is a cause of stroke. A scan showing brain cavernoma. Dr Ramesh Narenthiranathan.
occurred. Other parts of the brain
could be damaged as well due to be needed.
secondary pressure exerted by the
blood clot mass.
“An ischaemic stroke patient
may need to undergo surgery if his
Going under the knife
“People often assume that a brain experiences secondary
blood clot only happens inside a swelling. Once the swelling exerts The type of brain surgery prevent internal compression of (AVM) (alternatively, AVM
blood vessel, which can be pressure on the surrounding parts performed on a stroke patient the brain) can be embolised using
dissolved with medication. of the brain, immediate surgery is depends on the kind of stroke, its l Evacuation of large endovascular route or treated
However, for haemorrhagic required to decompress the brain,” cause and the amount of damage hematoma (usually 3cm and with radiosurgery)
strokes, blood clots form outside he says. done. more) l Microsurgical excision of
the blood vessels within the brain Dr Ramesh assures that surgery According to Dr Ramesh l Microsurgical clipping of cavernomas
tissue, making brain surgery is not always necessary to treat Narenthiranathan, consultant aneurysm (alternatively, l Brain bypass surgery
necessary in some cases. haemorrhagic strokes. The need neurosurgeon at Ara Damansara aneurysms can be coiled using for moya moya disease or
“This pressure needs to be for surgery depends on the size of Medical Centre, the types of endovascular route similar to syndrome and large giant
reduced by removing the external the blood clot and how much of surgery are as follows: cardiac stents) aneurysms
blood clot as soon as possible to the brain is affected. A blood mass l Decompression craniectomy l Microsurgical excision of l Endoscopic lavage of
minimise damage to the brain.” of roughly more than 3cm in (removal of the skull bone to arteriovenous malformation ventricular haemorrhages
According to Dr Ramesh, diameter usually needs to be
ischaemic strokes are usually operated on.
treated by neurologists. He insists that treatment for much functionality as possible. Stroke rehabilitation should not rehabilitation, stroke patients can
However, if there is a swelling strokes involves more than just For this reason, he says, “It be considered an option, but a get a second shot at life.
that exerts pressure on the removing blood clots. The aim is important to undergo necessary part of the full
surrounding brain tissues, the of stroke treatment is not just rehabilitation as soon as the treatment process. With timely n For more information, call
assistance of neurosurgeons may saving lives but to bring back as patient is medically stable.” treatment and proper 03-5639 1212.

Identify the symptoms and be prompt in taking action

“A STROKE is a sudden onset of Dr Gunasundari says, “There are
focal neurological deficit due to recent breakthroughs in ischaemic
infarction or haemorrhage lasting stroke treatments. Currently,
more than 24 hours. In layman’s within the first 4.5 hours of
terms, you are suddenly losing experiencing a stroke, thrombolytic
your bodily functions due to blood therapy medication can be given
clot or bleeding,” explains Dr intravenously to dissolve the clot in
Gunasundari Pushparasah, the brain.
consultant physician and “This is a new emergency
neurologist at ParkCity Medical management treatment. However,
Centre. eligibility for this treatment
Generally divided into two types, depends on the patient’s medical
ischaemic and haemorrhagic, history.
stroke is a serious condition as “If a patient seeks treatment
patients can permanently lose within 4.5 to six hours of
bodily functions or lose their life. experiencing a stroke, a
Ischaemic stroke is the more mechanical thrombectomy
common type of stroke, accounting procedure can be done. This is
for 80% of all stroke cases. While it where an interventional radiologist
is usually not fatal, patients need to Dr Gunasundari Pushparasah. inserts a device into the patient to
be aware of the symptoms to remove the blood clot from the
ensure they seek early and stroke are atherothromboembolism brain.
appropriate treatment to prevent (blockage of main blood vessels to “In the time range of six to 24
permanent loss of bodily functions. the brain), cardioembolism (clots hours, certain patients are still
Dr Gunasundari recommends that are lodged in the brain due to eligible for mechanical
the FAST acronym as a helpful way irregular heartbeat) and lacunar thrombectomy. This is because
to remember the danger signs to stroke (small vessel disease). medical innovations over the past
look out for and take action before According to Dr Gunasundari, decade have increased the critical
it is too late. prevention of ischaemic stroke is window for ischaemic stroke
l Facial weakness divided into two parts – primary treatment.”
l Arm/Limb weakness and secondary. In the case of a milder stroke or
l Speech difficulty Primary prevention takes place of a stroke is important in also treated with anti-platelet transient/temporary symptoms,
l Time to seek medical before a person experiences a determining the best methods of medication. Clots caused by blood thinner is given to prevent
treatment stroke. It focuses on addressing the prevention to avoid a recurrence. cardioembolism, which is due to further clot formation.
risk factors, which include high “Patients with clots in the main irregular heartbeat, are treated “If you experience stroke
“Other symptoms include a blood pressure, diabetes, irregular blood vessels can be treated with with anticoagulant medication.” symptoms, go to the hospital early
sudden loss of vision, unsteadiness heart rate, truncal (apple-shaped) anti-platelet medication,” says Dr She stresses that stroke survivors so you can be properly assessed
when walking and giddiness. obesity and lifestyle choices such Gunasundari. must adhere to primary preventive and given the right treatments,”
Individuals who experience these as smoking and drinking alcohol. “If you have significant measures on top of their secondary she advises.
symptoms should go to the She adds that the rising blockages (carotid stenosis) of prevention methods to lower the “The misconception that stroke is
emergency room immediately.” prevalence of stress, depression more than 70% in the neck, a risk of recurrence. not an emergency should be
and unhealthy lifestyles among the carotid endarterectomy procedure debunked, as ignoring the
Prevention through younger generation may also
contribute to stroke.
or carotid stenting can be done to
overcome the blockage. A vascular
Timely treatment symptoms could spell significant
knowledge Secondary prevention focuses on surgeon will either insert a stent or Treatment procedures for
stroke survivors. Dr Gunasundari surgically remove the blockage. patients depend on the time frame n For more information, call
The main causes of ischaemic explains that identifying the cause “Patients with lacunar stroke are of stroke detection and treatment. 03-5639 1212.