THE administration of treatment within the first three hours after the onset of stroke symptoms is crucial in limiting the amount of brain damage suffered by the patient, a neurologist said yesterday.
“Time is brain,” Neurological Society president Dr Michalis Protopapas said.
“Time is important. It’s what you manage to do in the first three hours because then there are far fewer symptoms. This is why we need to raise awareness.”
Protopapas was speaking at a news conference ahead of the society’s annual two-day international neurology seminar.
The seminar, the eighth of its kind, will be held at Nicosia’s Hilton Hotel and will run today and tomorrow.
The neurologist said around 15 per cent of the Cypriot population suffered strokes, in line with EU statistics.
He added: “In a population of 80 million, 181 suffer a stroke daily. Of that number, 40 per cent die in a year.
“Comparatively, around 175 people suffer heart attacks daily, and around 100 people are diagnosed with lung cancer.”
Protopapas said strokes could be divided into two basic categories: ischemic and hemorrhagic.
Ischemic strokes, which account for 80 per cent of all strokes, are set in motion when a blood clot forms in a blood vessel or other internal site, such as the heart. Travelling up the blood vessel, the clot then narrows or blocks arteries leading to the brain or within it, which in turn prevents blood flow to particular portions of the brain, thus starving cells of oxygen and causing them to die.
Hemorrhagic strokes, on the other hand, are caused, not by blood clots, but by bleeding in the brain from a ruptured artery or from an aneurysm on a weakened portion of a blood vessel wall, he said.
Protopapas said ischemic strokes were caused, in order, by high blood pressure, increasing age, high cholesterol, smoking, diabetes, obesity, lack of exercise, and stress. Other risk factors include drug and alcohol use, being male, a family history of strokes, heart conditions, and previous strokes.
He said: “Smokers are two to three times more at risk of suffering a stroke, the same goes for people with diabetes, and people with high blood pressure are 12 times more at risk. However, people with multiple risk factors, such as a smoker with high blood pressure, who doesn’t exercise, are 20 times more at risk.”
By reducing those risk factors, a stroke could be headed off before it started, he said.
Protopapas said half of all people who suffered a stoke were left disabled and in need of care. Others died, and others made a full recovery, he said.
But diagnosis and treatment of stroke within three hours following the onset of symptoms increased the likelihood of a good prognosis.
“Every unexploited minute increases brain damage. So that all necessary measures can be taken, the patient must be treated as soon as possible.”
He said this was why as soon as symptoms appeared people should call an ambulance immediately. Just over half an hour after arriving at the hospital, doctors should then have performed the necessary diagnostic tests to determine the type of stroke and the necessary treatment needed, he said.
The neurologist said stroke symptoms included sudden numbness or weakness of the face, arm or leg, especially on one side of the body, sudden confusion, trouble speaking or understanding, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or co-ordination, and sudden, severe headache with no known cause.
Protopapas added that a bonus in the fight to limit stroke damage would be the creation of a stroke unit, something the island’s hospitals currently lacked.
Health Minister Charis Charalambous, who was present at yesterday’s news conference, said the ministry was currently examining setting up such a unit at Nicosia general hospital and concentrating the island’s four public neurologists there rather than having them spread out at hospitals across the island.
“This is still only a thought and a committee is still examining all possible scenarios, including what will happen if someone has a stroke in Paphos, for example. Nothing has been set in stone and we are still at the discussion stage,” the minister said.
