A stroke occurs due to interrupted or reduced blood supply to part(s) of the brain. This prevents brain tissue from getting oxygen and nutrients and kills the affected brain cells in just minutes. The severity of a stroke depends on which blood vessels are compromised; if there is a clot or block in one of the main arteries that supply blood and nutrients to the brain, for example, there will be widespread damage and severe loss of function – prompt action is encouraged to lower the risk of long-term brain damage and improve a patient’s chances of survival.
World Stroke Day has been established by the World Stroke Organization to provide “a global platform for the stroke community to increase awareness and drive action on stroke around the world.” For 2021 and 2022, the World Stroke Organization’s “#Precioustime” campaign aims to raise awareness of the signs of stroke and the need for timely access to quality treatment.
In southern Malaysia, privately-owned Regency Specialist Hospital (RSH) is committed to providing high-quality holistic care for stroke patients. RSH is the first to obtain both Gold and Platinum Status for achieving international standards in stroke care practices.
Serena Yong, Chief Executive Officer, RSH, said, “Given our nationwide recognition in the management of acute stroke, we believe it our responsibility to instill in the public a greater sense of urgency to get the right treatment in case of a stroke.
“We [RSH] have an amazing team of medical professionals, including neurologists, neurosurgeons, intervention radiologists, rehab physicians, mental health providers, and physical, speech, or occupational therapists, who are deeply involved in helping patients recover after a stroke. Since a patient may be unable to help themselves at that moment when they are having a stroke, we believe that the public needs to be better informed about what to do in such a scenario.”
Patients have a much greater chance of avoiding long-term brain damage if they arrive at the hospital and receive treatment with a drug to break down clots within the “Golden Hour” therapeutic window. The earlier the patient receives the acute stroke treatment, the better the outcome.
At RSH, the goal of acute stroke management is to stabilise the patient and complete the initial evaluation and assessment within just 60 minutes of the patient’s arrival. Many patients are given intravenous TPA —tissue plasminogen activator—to help dissolve a clot. Alternatively, surgeons may carry out a thrombectomy which involves the use of tools to physically break down and remove the clot.
According to Malaysian National Burden of Diseases Study and study on vital registry system (2000) stroke is the second leading cause of death, largely caused by a lack of awareness. Dr. Goh Kwang Hwee, Consultant Neurologist & Internal Medicine, RSH, said that symptoms of an acute stroke may develop in minutes without warning, “People need to know how to respond if someone around them has a stroke, and take the necessary precautions to reduce their likelihood of getting a stroke.
“People should live active, healthy lives and lower the well-known risks of stroke which are high blood pressure, diabetes, hyperlipidaemia, and smoking. And they should use the “F.A.S.T” method to quickly identify a stroke.”
Experts at the RSH often use the F.A.S.T acronym to teach the public how to recognise and respond to the signs of a stroke:-
· F – Face: Does their face droop on one side, due to loss of feeling or weakness?
· A – Arms: Does this weakness and loss of movement extend down that side of the body to their arms or legs? If they are unable to raise both arms, that is an indication of a stroke.
· S – Speech: Can they speak, or are they having difficulty speaking or appear confused?
· T – Time: If you notice these signs, call an ambulance quickly because timely treatment is crucial.
RSH Consultant Neurosurgeon Dr. Ashraf Sharifuddin also highlights strokes that result from an intracranial haemorrhage or brain bleed. These bleeds are considered a life-threatening subset of strokes, “A brain bleed can occur either inside the skull but outside of the brain tissue, or inside the brain tissue.
“When there is a leaky or burst vessel that causes a brain bleed, oxygen may not be able to reach the brain tissue. Within three to four minutes, the brain cells start dying with no possibility of regeneration. This can result in severe physical, mental, and task-based disability. Any bleeding in the brain is a medical emergency that needs immediate treatment in the form of surgery or medication, to limit damage and improve the chances of recovery,” Dr. Ashraf said.