Never Too Young To Die

STROKE IS ANOTHER LEADING CAUSE OF DEATH AMONGST TANZANIANS.

Juma 43 years old, father of two children had first episode of stroke when he was 39. He claimed himself to be a healthy man and hardly visited doctor before stroke. He worked as a consultant and made comfortable living for his family. On January 7, 2005 at a meeting after lunch Juma started a throbbing headache that didn’t get better after taking pain killer. He ignored and continued with meeting and finished his work. At home he tried to rest but felt uncomfortable with weakness in right side of his body. He made it through the night and managed to report to work the next morning. Juma felt better so he changed his mind to see the doctor due to the fact that hospitals are busy and the services are often slow. Life went smoothly until after one year when Juma got same symptoms but he thought he will get better after 24 hours but instead his condition got worse to the extent that he completely lost sensation in his right side of the body. Colleagues rushed him to the hospital but unfortunately Juma’s brain suffered from low oxygen far too long. Juma was diagnosed as having a stroke that resulted in complete paralysis. Juma stays at home now and his wife works as a school teacher. They never thought life would take a turn like this facing such disability and suffering before retirement.

Potential consequences of stroke can affect financial, social and psychological aspect of an individual or family. Stroke is the third largest cause of the death in the world. According to an article by RW Walker et al. in Lancet 2000 titled ‘stroke mortality in urban and rural Tanzania’, about 5.5% of total deaths in adults more than 15 years were attributed to cerebrovascular accident. This observational study was carried out over a 3 year period with 3 surveillance population of Dar-es-Salaam, Morogoro and Hai district. The author concluded that high mortality because of cerebrovascular accident in adults is most likely due to untreated hypertension.

WHAT IS STROKE? (CEREBROVASCULAR ACCIDENT)

A stroke occurs when the normal flow of blood to part of the brain is blocked or interrupted due to a clot or burst of a blood vessel. Blood carries oxygen to the brain therefore, due to this obstruction brain will not receive blood and oxygen and eventually brain cells will die causing stroke symptoms.

CLASSIFICATION:

Two types of stroke:
Ischemic Stroke
Hemorrhagic Stroke

Ischemic Stroke: (Brain Attack): It is an urgent medical situation just like a heart attack. 75 to 80 percent of strokes are Ischemic, caused by a clot or narrowing of an artery due to fatty deposits. Brain cells will not receive blood and oxygen thus will die causing stroke symptoms.

Hemorrhagic Stroke: Caused by bleeding in the brain resulting from head injury or a ruptured of weakening or bulge in an artery.

A Transient Ischemic Attack or TIA is a temporary interruption of blood flow to the brain. Stroke symptoms clear within 24 hours but without treatment the individual is at high risk to develop stroke during the following five years.

RISK FACTORS:

High blood pressure
Atherosclerosis (Thickening and hardening of the artery due to fatty deposits)
Diabetes Mellitus
Stress
Obesity
Anticoagulation Therapy
Oral Contraceptives

WARNING SIGNS: IMMEDIATELY RUSH TO THE HOSPITAL IF YOU HAVE ANY OF THESE SIGNS.

1. Sudden weakness or numbness of the face, arm or leg especially on one side of the body.
2. Sudden confusion, trouble speaking or understanding.
3. Sudden trouble seeing in one or both eyes.
4. Sudden loss of balance, trouble walking and dizziness.
5. Sudden, severe headache with no cause.

Ref: http://www.strokeassociation.org/

COMPLICATIONS:

If signs and symptoms of stroke are ignored, damage to brain will occur, causing paralysis, disability or even death. Stroke may cause problems with thinking, judgment, memorizing, and difficulty in understanding or forming speech. Depression and uncontrolled emotions may occur.