IS IT STROKE or a spiritual attack?
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IS IT STROKE or a spiritual attack?

Health Scenario: Strokes Mr. Uzo (not real name) came home this fateful evening, cheerful as usual. He had his meal and went to bed. An hour later, his wife goes in to the bedroom and finds him struggling to get up from the bed. He couldn't lift the limbs on his right side. His mouth was open as though he was trying to speak but he couldn't form the words. His eyes were bulging. His wife raised an alarm. The ambulance service is non-existent in Nigeria, so a neighbour had to improvise with his car. Mr. Uzo was rushed to the hospital.

The Locals' Perspective
Very quickly the news went round. The locals determined it was a spiritual attack. "His jealous business partners have bewitched him." Some say "He has been struck by the same spirit that killed his father years ago."

The Medic's Perspective
An MRI scan taken at the hospital indicates a huge bleed on the left cerebellum (left part of the brain). A blood vessel in Mr. Uzo's brain had ruptured. He suffered a hemorrhagic stroke. The medical team fought to save Mr. Uzo's life, unfortunately, he didn't make it. He passed on four days later.

What Exactly is a Stroke?
Stroke, sometimes called a "brain attack", occurs when blood flow to an area in the brain is cut off. Brain cells are deprived of the oxygen and glucose they need to survive, and as a result die. If not caught early, permanent brain damage can result and death can occur.

Uncontrolled high blood pressure increases a person's stroke risk by 4-6 times. Over time, hypertension leads to atherosclerosis and hardening of the large arteries. This in turn, can lead to blockage of small blood vessels in the brain. High blood pressure can also lead to weakening of the blood vessels in the brain, causing them to balloon and burst.
The risk of stroke is directly related to how high a person's blood pressure is.

How Does a Stroke Occur?
There are two types of stroke:

Ischemic Stroke is similar to a heart attack, except it occurs in the blood vessels of the brain. Clots can form either in the brain's blood vessels, in blood vessels leading to the brain, or even blood vessels elsewhere in the body which then travel to the brain. These clots block blood flow to the brain's cells. Ischemic stroke can also occur when too much plaque (fatty deposits and cholesterol) clogs the brain's blood vessels. About 80% of all strokes are Ischemic stroke.

Haemorrhagic Strokes occur when a blood vessel in the brain breaks or ruptures. The result is blood seeping into the brain tissue, causing damage to brain cells. The most common causes of haemorrhagic stroke are High Blood Pressure and Brain Aneurysms. An aneurysm is a weakness or thinness in the blood vessel wall that causes it to balloon outward.

Signs of Stroke
If you experience any of the following signs you or a loved one are having a stroke, call for immediate help!
- Sudden numbness of weakness in the face, arm, or leg (especially on one side of the body)
- Sudden blurred vision or decreased vision in one or both eyes
- Sudden inability to move part of the body (paralysis)
- Sudden dizziness or headache with nausea and vomiting
- Difficulty speaking or understanding words or simple sentences
- Difficulty swallowing
- Dizziness, loss of balance, or poor coordination
- Brief loss of consciousness
- Sudden confusion

A Transient Ischemic Attack (TIA) also known as a Mini Stroke, may be a warning of an impending stroke. It typically consists of the same signs and symptoms of stroke, but the symptoms are temporary. It occurs when blood flow to a certain part of the brain is cut off for a short period of time, usually 15minutes or less. A TIA can occur anywhere from a few minutes to several months before a stroke. A TIA is a painless episode, but it is a warning that something is wrong. It should be treated as seriously as a stroke.

How Is Stroke Diagnosed?
A doctor can usually diagnose a stroke by the typical symptoms and signs which develop suddenly (e.g, ones listed above). Tests which are commonly done include:

- A brain scan (CT scan or MRI scan) to determine the type of stroke (ischemic or haemorrhagic)
- Blood tests to check on certain things like blood sugar level and cholesterol level. High levels of these can increase the risk of further stroke
- Chest X-ray and ECG (tracing of the heart) to check for heart or lung conditions which may have contributed to stroke e.g atrial fibrillation

What Treatment Do Stroke Victims Get?
IF YOU SUSPECT THAT YOU (OR THE PERSON YOU ARE WITH) ARE HAVING A STROKE, CALL FOR IMMEDIATE HELP AS YOU SHOULD BE ADMITTED TO HOSPITAL.

Immediate Care: The doctor assesses you quickly and a brain scan is organised to confirm diagnosis and type of stroke (Ischemic or Hemorrhagic). It is very important to know as the initial treatment for the two differ.

Immediate Care for Ischemic Stroke:
If an ischemic stroke is diagnosed, and it has been less than four hours since symptoms started, you may be given a medicine directly into your vein. This is a clot-bursting medicine which will dissolve the blood clot. The medical name for this is thrombosis. If the blood clot that caused the stroke can be dissolved as soon as possible, it can improve the eventual outcome.

Treatments that may be further considered include anti-platelet medicine such as Aspirin or Clopidogrel. Anti-platelets are advised if you have had an ischemic stroke (due to blood clot) as they help prevent blood clots forming in the arteries. They are usually are usually prescribed for a long term after initial treatment.

If you are unable to swallow (this is common) you will be given food and fluids via a tube that is passed into your stomach.

Medication may be advised to reduce any risk factors for having a further stroke - these include medicines to lower blood pressure, sugar level or cholesterol level.

If you have atrial fibrillation (diagnosed irregular heart beats) you are at risk of a blood clot forming in your heart chamber and as a result of the irregular heart beats, this clot may travel to your brain and cause a stroke. Therefore, an anticoagulant should be prescribed.

Immediate Care for Haemorrhagic Stroke:

If you have a haemorrhagic stroke and are taking an anticoagulant, treatment to reverse anticoagulation should be given.
If the stroke is caused by a subarachnoid haemorrhage, an operation to fix the leaking artery is sometimes an option.
Other operations are occasionally done.

As soon as possible after having a stroke, rehabilitation should commence to maximise activity and quality of life following stroke. Hospitals which deal with stroke patients have physiotherapists, speech therapists, psychologists, specialist nurses and doctors, occupational therapists whose jobs are to help in rehabilitation. Good quality rehabilitation can make a great difference.

Who Is At Risk Of Having A Stroke & How Do We Prevent it?
There are risk factors you cant modify for example If you have a family history of Cardiovascular Disease just like Mr. Uzo, whose father died of a suspected Cardiovascuar event, You need to take your health seriously. Briefly Risk factors that you can be modify include:
Smoking: The chemicals in tobacco, cigarettes or anything you smoke is carried in your bloodstream and can damage your arteries.
High Blood Pressure: Make sure your BP is checked at least once a year. High BP show no symptoms usually. If you have High BP, take your treatment seriously.
Obesity: Lose weight if you are overweight. It is not a sign of good living.
High Cholesterol: This also can and should be treated.
Inactivity: Moderate physical activity for at least 30minutes on most days of the week.
Diet: Aim to eat a healthy diet, include 2-3 portions of fish per week. Nigerians generally believe fishes are for impoverished people, NO!!! Portions of fish are healthier. Cut down on salt. If you eat red meat, it is best to eat lean red meat or poultry such as chicken. Avoid fatty foods and eat fruits and vegetables
Alchohol: Some Nigerians brag about how much alcohol they can consume. NO!!!! Do not drink more than the recommended units. Not more than 21 units/week (3 units a day) for men and 14 units/week for women (2 units a day)
Diabetes: If you have diabetes, you are at risk of having a stroke if you do not adhere to treatments and regulate your blood sugar level.

Facts About Stroke in Nigeria
The population of Nigerians that suffer stroke is on the increase, though there is no national statistics on the number of sufferers.
The current prevalence of stroke in Nigeria is 1.14 per 1000 while the 30-day case fatality rate is as high as 40%. It is a leading cause of death and a major cause of long-term disability. (Wahab KW, The burden of stroke in Nigeria, Intl J Stroke Nov. 2008 )

Hypertension (high blood pressure) is the most prevalent risk factor for stroke. There is a continuous and graded relationship between high blood pressure and stroke risk in many population. One fifth of a cohort study of hypertensive patients had been unaware of their condition before they had stroke. (Alkali NH, Baal SA, Amano AO, Osi-Ogbu O, Alabi P, Ayeni OA. stroke risk factors, subtypes and 30-day case fatality in Abuja Nigeria. (Niger Med J 2013).

Majority of Nigerians who have high bp, high cholesterol, diabetes and diseases that predispose them to stroke do not even know they have these conditions. Most stroke cases can prevented if these 'at risk' patients identify and manage their conditions.

Myths About Stroke
A prevailing factor why stroke patients do not survive is the myth associated with the disease. Certain percentage of Nigerians who suffer stroke seek medical help from unqualified persons. The belief that stroke is a spiritual attack will not make an individual who has just suffered go to hospital, rather they go to spiritual homes. This calls for a need for increased public health education to increase the awareness of stroke and its contributing factors.

As stroke is increasingly becoming a common neurological condition in Nigeria, it is recommended that sustainable, community friendly intervention programmes are incorporated into the healthcare system for early prevention, recognition and modification of risk factors in persons prone to the disease. In other words, ENCOURAGING HEALTH PROMOTION IN THE POPULATION IS A KEY MEANS OF PRIMARY PREVENTION OF STROKE

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. While compiling this information, Drkay used all reasonable care but makes no warranty as to its accuracy.

Comments

Interesting post!

I couldn't resist commenting. Very well written!

I couldn't resist commenting. Very well written!

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