|
|
|
|
|
|
|
|
|
Damaging strokes
Stroke is the third most common cause of death and disability worldwide. It occurs due to brain damage because of decrease in blood supply to brain because of a blockage in the blood vessel feeding the brain. Sometimes it occurs when a blood vessel bursts, leading to bleeding in the brain. Stroke is also referred to as "brain attack". As a result of it part of brain doesn't get oxygen and blood it needs and dies. A brain (cerebral) aneurysm is a bulging, weak area in the wall of an artery that supplies blood to the brain. Bleeding due to aneurysms is called as subarachnoid haemorrhage. It is accepted that about 3 per cent to 5 per cent of the population harbour an intracranial aneurysm and one in every 20 strokes is caused by rupture of intracranial aneurysm. Women are vulnerable Strokes due to brain bleeding because of brain aneurysm are more common in women. Women over the age of 35 are particularly exposed to the risk. In fact, results of various studies shows that females are two times more likely to develop cerebral aneurysms compared with males. Smoking, high blood pressure, and a family history of brain aneurysms seem to further increase a woman's risk of developing this potentially fatal condition. A recent data from University of Texas Southwestern Medical School in Dallas recommend early aneurysm screening for young women smokers, alcoholic at risk, that is, those who have hypertension or a family history of brain aneurysms. Hormonal factors Pre and post-menopausal women are more likely than their younger counterparts to harbour aneurysms. Some research also suggests that level of estrogen is also responsible for the cause. However, it is still too early to derive any conclusion. Most brain aneurysms causes no symptoms and may only be discovered during tests for another, usually unrelated, condition. In other cases, an unruptured aneurysm will cause problems by pressing on areas in the brain. When this happens, the person may suffer from severe headaches, blurred vision, changes in speech, and neck pain, depending on what areas of the brain are affected and how bad the aneurysm is. Many patients (up to 30 per cent) do not survive initial bleeding. Even the patients who survive more than 50 per cent may not survive without treatment even for a month because the aneurysm bleeds again. Haemorrhage due to aneurysms is a medical emergency that is frequently misdiagnosed. The aneurysms are diagnosed by angiography and early aneurysm treatment is must to prevent repeat bleeding. Major risk factors of brain aneurysm include hypertension, smoking and heavy alcohol consumption. Even those with family history of stroke or high blood pressure may be at risk. Brain magnetic resonance imaging (MRI) is used to detect hidden aneurysms. This non-invasive, safe technique might save lives. Signs of a silent killer Approximately half of all aneurysms rupture. And often, only rupturing will provide clues of its existence. A sudden, explosive headache — often described as the "worst headache of the patient's life" — is the cardinal symptom of a burst aneurysm. But many people walk around with silent aneurysms for years. Other symptoms of a ruptured brain aneurysm may include:
Surgery has been the conventional method of aneurysm treatment. Surgery entails direct exposure of the aneurysm and occlusion by placement of a metallic clip on the aneurysm. Problems with surgery include invasiveness and trauma to normal brain parenchyma. However, now a minimally invasive approach is available in which a neuro-interventionist treats the aneurysm by endovascular means from leg blood vessel avoiding open surgery. A micr-ocatheter (a thin tube) is placed into the brain aneurysms through the leg blood vessel. Then the aneurysm is occluded by using specialised coils. This procedure known as "coiling" ensures minimal injury to normal brain leading to better outcomes. The number of stroke patients is increasing in our country. WHO estimates for India that number of deaths from stroke to increase from 5,98,000 in 2000 to 9,45,000 in 2020. Early treatment in first few hours can reverse stroke in many patients. New treatments are available which can significantly reduce the damage. However, these treatments work best soon after the brain attack. By following Act FAST norms that stands for early signs of stroke that which are (F) Face drooping, (A) Arm weakness, (S) Speech difficulty and (T) Time to call can save many lives. Almost 80 per cent of all strokes are preventable. To reduce risk of stroke one should follow life's simple seven rules.
The writer is Head, Neurovascular Intervention Centre, Medanta, The Medicity, Gurgaon
|
|||
|
|
|||
