Friday, May 13, 2016

How to identify symptoms of a stroke

Would you know what to do if your friend collapses shortly after complaining of dizziness or a severe headache? 
When someone suffers from a stroke, time is of the essence. For each minute the stroke goes untreated, the person is at a higher risk of suffering from brain damage. It is essential to recognise the symptoms of a stroke and to ensure that the person seeks medical attention immediately. 
The symptoms of a stroke are diverse. A simple way you can recognise these symptoms and to know how to react is through the acronym FAST. 
If you observe:
- Facial drooping or paralysis,
Arm weakness or
Slurred speech,
- Time to call an ambulance at 995 
It is also important to note the time of the first symptom as it can affect treatment decisions. 
Knowing these symptoms and getting the person medical attention immediately is essential and it can help to save a life.

What is a brain aneurysm?
When an artery supplying blood to the brain becomes weak, the blood vessel will swell and form an aneurysm. Brain aneurysms are typically found in the blood vessels located at the base of the brain known as the circle of Willis. If ruptured, the brain aneurysm may cause stroke, brain damage and even death. A ruptured aneurysm is fatal nearly 40 per cent of the time.


A person may develop aneurysms as they become older because their arteries may harden up. Although it is uncertain to tell if a person has a brain aneurysm, there are some factors that may increases the risks of having an aneurysm or rupturing it. On occasion, brain aneurysm may be heredity and as such, people whose family members have aneurysms may develop it. Women are also more likely to develop aneurysms compared to men, with the ratio being 3:2.

People with existing high blood pressure may also have a likelihood of having aneurysm. In addition, smoking may also greatly increase the chances of an aneurysm rupture.

Brain aneurysms are more likely to develop between the ages of 35 to 60 and people over 50 have a high chance of getting a hemorrhagic stroke when an aneurysm ruptures.

Some brain aneurysms may not have symptoms and can go unnoticed for years. Certain warning signs include constant severe headaches, blurry vision and neck pains. Other symptoms might include sensitivity to light, fainting, seizures and pain in the surrounding areas of the eye.

Surgery will have to be done in order to repair the blood vessel damaged by the aneurysms. The two treatment options are clipping and coiling.

For clipping, the surgeon places a clip across the aneurysm to prevent blood from entering the aneurysm and making it bigger.

Similarly, coiling is done by threading a tube through the arteries, filling the aneurysm with coils made from wire or latex to prevent blood from entering the aneurysm.

It is important to detect the symptoms of an aneurysm before it is too late as if left untreated, the aneurysm can kill. Fifty per cent of people who have an untreated brain aneurysm die within a month.

Trend in Stroke In Singapore
There are two types of stroke: ischaemic and haemorrhagic stroke. Ischaemic stroke is more common (about 80% of all strokes in Singapore) and occurs when a blood vessel becomes blocked, usually by a blood clot. Haemorrhagic stroke occurs when a blood vessel in the brain bursts or breaks, causing bleeding in or around the brain.

Overall, the crude incidence rates have remained stable while the age-standardised incidence rates (ASIR) decreased then stabilised. But the age-specific rates among males in age group 40-44 and 45-49 increased from 2005 to 2013. The age-standardised mortality rate (ASMR) has declined from 2005 to 2013 with small variations in between. The ratio of stroke episodes among men as compared to women was approximately 1.36:1 from 2005 to 2013. The ASMR was higher among males than females and has declined significantly from 2005 to 2013 in both genders. Malays had the highest ASIR for stroke from 2005 onwards, followed by Indians and Chinese, whose rates were similar. The ASIR for Chinese has fallen significantly over the 9-year period; the ASIR for Indians has also fallen but not significantly, while the ASIR for Malays has been increasing significantly. The crude mortality rates (CMRs) among the various ethnicities have remained stable while there was a decrease in ASMR among the Malays after 2005 and also among Chinese. The ASIRs of ischaemic stroke have fallen over the 9-year period and those for haemorrhagic stroke have remained stable . The overall crude 30-day case-fatality rates (CFR) have remained stable, ranging from 8.4% to 10.4% in 2005 - 2013. Similar to CMRs, the CFR for females was greater than that for males. Hypertension and hyperlipidaemia were the two most common risk factors among the stroke patients. The proportion of first-ever stroke patients with hyperlipidaemia has increased over time while that of other risk factors has remained stable. The percentage of ischaemic stroke patients taking anticoagulants upon arrival and upon discharge had increased between 2009 and 2012 while the percentage of ischaemic stroke patients given antiplatelets upon arrival had increased by 12.0%from 2009 to 2012. The percentage of ischaemic stroke patients given antiplatelets during hospitalisation has exceeded 90% since 2009). The two most common complications seen in stroke cases included urinary tract infections (UTI) and pneumonia. The percentage of stroke patients with no common complications has remained above 80% since 2005.

Click Here for Tables and Charts on Trends In Stroke In Singapore

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