Stroke can be treated without a head injury

 Stroke can be treated without a head injury

Statistics show that, ‘Every 40 seconds in the world, one person has a stroke.’ Similarly, one in every 4 people is seen to suffer from a stroke at some point.

Stroke is the second leading cause of death in the world after heart disease. Stroke is considered the first cause of long-term disability.

It sounds scary at first glance. However, if you treat the symptoms as soon as they appear, you can avoid a stroke. And, you can return to a normal life.

What is a stroke?

An emergency situation in which blood circulation in the brain is stopped or a blood vessel in the brain suddenly bursts is called a stroke. Generally, there are two types of stroke. One is ischemic stroke and the other is hemorrhagic stroke.

An ischemic stroke is when the blood circulation in the brain is suddenly stopped due to blockage of a blood vessel. In this case, the brain does not get oxygen and nutrition from the blood. Without these two, the brain cells gradually die.

Similarly, a sudden burst of a blood vessel in the brain is called a hemorrhagic stroke. The resulting excessive blood pressure damages the brain tissue. Most of these two strokes are ischemic strokes.

Who gets a stroke?

People over the age of 50, those with problems such as high blood pressure, diabetes, and cholesterol are at risk. Similarly, those who do not take their prescribed medications or stop taking them can also have a stroke. People who are overweight, do not exercise, and smoke can have a stroke.

People who have heart problems at a young age can develop a blood clot in the heart and gradually reach the brain vessels, causing a stroke.

These symptoms appear suddenly

The symptoms of a stroke appear quickly. The condition can become serious within a few moments of the onset of symptoms, which can last from an hour to a day.

1. Difficulty speaking, mouth twisting, and slurred speech

2. Sudden weakness in one part of the body

3. Sudden headache

4. Difficulty seeing with one or both eyes

5. Inability to walk, sit, or stand up, or loss of balance

Symptoms such as severe headache and fainting may occur before a blood vessel ruptures and bleeds.

If these symptoms appear suddenly, you should go to the hospital immediately. It is best to go to a hospital with equipment for opening blood vessels. This is because brain cells gradually die within 24 hours of the onset of symptoms. Even if nothing can be done to the dead tissue or vessels, the remaining blood vessels can be opened by opening the blockage in the vessels. This increases the patient's chances of survival.

How do you know?

CT scans, angiography, and MRI can show in detail whether there is bleeding in the brain or how much tissue and cells have been damaged. This can help determine how to proceed with the treatment.

What are the treatments?

In case of ischemic stroke, a small blood vessel in the brain is blocked, in which the clot can be dissolved by giving thrombolysis drugs. However, in case of a large blood vessel blockage, the drug cannot dissolve it. However, the drug is also given to those with large blood vessels. Of these, only 5 percent of people have a chance of dissolving it.

If there is no effect even after giving the drug, the only option left is the neurointerventional method. In this, without making an incision in the head, a wire is inserted from the vein to the brain and the blood is circulated. This is called 'mechanical thrombectomy'. If the treatment is done with wires, the patient can be discharged within seven days.

Similarly, in case of hemorrhagic stroke, both incision and wire can be treated. Of these two, the wire method is considered effective. In this, the surgery done by opening the head is not as complicated as the wire method and is also relatively easy for the patient.

Treatment of ‘mechanical thrombectomy’ in Nepal

Although most hospitals offer open-heart surgery, only a few hospitals offer non-open-heart mechanical thrombectomy.

The new technology of mechanical thrombectomy has been available in Nepal since 2019. This facility is not available in government hospitals.

Currently, only Kathmandu’s Grand City Hospital and Neuro Hospital in Basbari have this facility with state-of-the-art machines. If you don’t know which hospital has this treatment facility and don’t get treatment on time, there is a risk of paralysis and even death.

How much does the treatment cost?

The cost of this treatment is quite expensive. The cost of treatment has increased because the necessary equipment is very expensive.

However, if the government could bring such a machine and provide this facility in government hospitals, many people would be able to get non-surgical stroke treatment.

(Dr. Phuyal is the Head of Department at Upendra Devkota Memorial National Institute of Urological and Elite Sciences Hospital. He introduced the first thrombectomy treatment service in Nepal in 2019, which has made it possible to treat stroke without surgery.)