What is a stroke?
ACCORDING to Dr Alvin Hong, consultant neurosurgeon at Mount Elizabeth Medical Centre and Gleneagles Medical Centre, there are two types of stroke.
‘One is caused by blockage in a blood vessel, so that blood cannot flow to the part of the brain that the vessel supplies.
The other is when a blood vessel within the brain bursts, causing blood to leak inside the brain. Mrs Lee suffered this type of stroke.”
What causes it?
Most haemorrhagic strokes are spontaneous, meaning there are no underlying causes, such as tumours or blood abnormalities. It often happens in older people due to degenerative changes in blood vessels.
In people in their 40s to 60s, the most common cause is high blood pressure.
Effects of stroke
Effects can vary. If the bleeding is in the brain stem, the damage can be serious.
If the stroke is in the left side of the brain, the person could be paralysed on the right of the body and also have problems communicating with others as speech is controlled in the left brain. This can be very disabling.
If the stroke is in the right side of the brain, language ability most probably won’t be affected.
Another factor is the size of the blood clot. A big blood clot will do more harm.
Swelling around the blood clot usually gets worse in the first 24 to 48 hours. Blood clots can threaten life by exerting so much pressure that the rest of the brain is also affected.
How to treat the condition
Sometimes, to save a life, doctors operate to remove the blood clot.
If the clot is not so big and the rest of the brain is less affected, doctors use medication to bring down the swelling in the brain.
If one waits long enough, all blood clots disappear. The problem is that one could die before a clot disappears.
Typically it takes five to seven days before a clot subsides significantly.
If a patient is quite stable after three to five days, he will probably remain so because swelling and bleeding are worst in the first two days.
In Mrs Lee’s case, the fact that she can recognise family members means the rest of the brain is working. The reason why it’s considered a serious condition is because it’s only the fourth day.
Recovery prospects
Doctors will have to first treat the complications of the stroke, of which a chest infection is the most common. Such patients often lie in bed and do not cough or breathe deeply enough. Secretions from the lungs are not cleared and they get a chest infection.
As the blood clot disappears and the pressure on the surrounding brain drops, the brain will begin to recover.
‘Once the danger period has passed, the patient will require intensive rehabilitation. It takes time, and patience,’ said Dr Hong.
Source : Straits Times - 16 May 2008
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