Strokes and other neurological problems

Tuesday, May 12, 2009

After a slight technical hitch, Dr. Alidz Pambakian began a most interesting and possibly frightening talk on strokes. She is a Neurological consultant at the West Middlesex and Charing Cross Hospitals.

First of all, what is a stroke? There are different types, but generally blockage or bleeding occurs in the brain causing it to swell and, according to which parts are affected, incapacitates those facilities it controls. Strokes could be due to ruptured veins or arteries, which may be torn, traumatised or misshapen.  Blood vessels may haemorrhage or the blood supply may be cut off due to blockages. There are a variety of triggers, among them: infection, the result of an operation, extreme cold, mental stress such as divorce or rows, or hormones. Wrong dosage of Warfarin may be harmful.

One must be aware of the difference between a mini stroke ‘TIA’ which lasts for about 24 hours and may be the precursor of a major stroke, which may occur anything between 2 and 90 days later.

The Greek word ‘apoplexia’ to knock down suddenly, is the “hallmark of the stroke” the fact that all the disabilities present simultaneously. In no particular order, there may be severe speech impairment, the patient able to understand but not articulate, or vice versa, paralysis down one side, double vision or a partial loss of sight as if a curtain were descending, hearing may be distorted. In acute cases where the brainstem is affected, choking, tinnitus or deafness may ensue.

It is vital that the patient be given aspirin if possible and transferred to a hospital within 3 hours, to ensure the best chance of a successful outcome.  Immediate access to neurological rehab, usually on the stroke unit itself, is one of the most effective treatments for preserving as much function as possible following a stroke.

One of the ways in which one can help oneself if possible, is having a positive attitude and perhaps religious belief. Many patients make a perfectly good recovery, to which the Vicar of St. Mary’s Elmwood Road, testified. The magazine Stroke News is also most helpful.

As for risks, here the usual suspects appear: smoking, alcohol, obesity, high cholesterol , sugar, high blood pressure and stress. Take advantage of preventive medicine, and regular blood tests at the surgery.

Gender, age and ethnicity are constants, about which the individual can do nothing; after 75 women draw level with men in the incidence of strokes.

After many questions well answered, the meeting closed with a vote of thanks and presentation of wine.

Hans-W Danziger.

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