Last year, while Mr. Fred Iwuoma was having a chat with some church members after a Sunday church service, he suddenly began to feel dizzy. He then lost consciousness and collapsed.

When he woke up two days later, his family members broke the news to him that he had suffered a stroke. Six years earlier, he had been diagnosed with hypertension and some medication was prescribed to reduce his blood pressure.
One year after his ordeal, Mr. Iwuoma still feels weak. “I still feel unexplained weakness,” he says. “I’m not able to walk well, I can’t use my left arm well and I can’t sing anymore.”

Mr Iwuoma said his doctor told him that his stroke was hemorrhagic, meaning that a blood vessel in his brain burst from excessive pressure. They are caused by a clot or other blockage of a blood vessel in the brain.

But according to a new study, the largest-ever of stroke patients in Africa, up to one-third of strokes in this area of the world are hemorrhagic. And while the survival rate for ischemic strokes is around 80 percent, for hemorrhagic strokes the odds of survival are only 50/50. Mr. Iwuoma is lucky to be alive after suffering hemorrhagic stroke.
Stroke at a glance

According to Dr. Gabriel Omonaiye, the burden of stroke is very high because stroke is a leading cause of death and disability all over the world. It is estimated that one in five women and one in six men all over the world will have a stroke in their lifetime.
Omonaiye said: “According to the World Health Organisation and data available from experts worldwide, about 17 million people suffer a stroke every year. Of these, at least 200,000 strokes occur in Nigeria alone.”

Stroke is the most common medical emergency in all the teaching hospitals across Nigeria, and certainly one of the top leading non-communicable causes of death. In fact, worldwide, stroke kills more people each year than AIDS, tuberculosis and malaria put together.
Stroke affects everyone – it occurs in children and adults, but beyond the directly affected persons, it can devastate families, friends, the workforce, and care givers.

Early signs of stroke
When it comes to stroke, the more time that passes, the more damage occurs in the brain. People who get to the emergency room for treatment within three hours of experiencing their first signs or symptoms are generally the ones with the best outcomes, Dr. Omonaiye said.

Here are some key facts about stroke:

Anyone can have a stroke. The risk for stroke increases with age, but it can occur at any time. More than a third of people hospitalized for stroke are younger than 65 years old.

Women have strokes more often than men. Each year, about 55,000 more women than men have a stroke. Race is also a factor in the risk for stroke. The risk for a first stroke is nearly double for blacks than whites. Black people are also more likely to die from a stroke.
Here are some tips to help you ‘BE FAST’ in detecting the symptoms of stroke:

B, Balance: A sudden loss of balance or coordination, such as not being able to walk a straight line or touch a finger to the nose.

E, Eyes: Sudden vision changes, such as double vision or blindness in one eye.

F, Face Drooping: Droopiness or numbness on one side of the face, such as an uneven smile.

A, Arm weakness: Weakness in one arm, such as not being able to raise both arms.

S, Speech difficulty: Slurred speech or speech that is difficult to understand.

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T, time to call for help: If any of the above symptoms are present, it’s important to call for help or rush to the hospital immediately, even if symptoms seem to disappear. Be sure to record the time when symptoms started.

Causes of stroke

According to Dr. Alex Nwobosi, human beings are born with genetic attributes that play out with the environment to determine the diseases they succumb to. In the case of stroke, these are termed non-modifiable or modifiable.

Nwobosi said: “The common cause is high blood pressure hypertension in 80 percent of cases, followed by diabetes mellitus, cholesterol abnormalities, sickle cell disease, heart diseases, sedentary lifestyle, old age, obesity, excessive alcohol consumption and cigarette smoking.”

Dr. Nwobosi stated that unfortunately, most victims of stroke are not aware of the above risk factors, which are largely preventable.
“If taken into context of the fact that stroke is the second leading cause of death and a major cause of disability globally, control of these factors is smarter and cheaper, Nwobosi added.”

Consequences of stroke
Dr. Nwobosi revealed that about 23 to 30 percent of stroke victims die in the first 30 days of the ictus. About 40 per cent will go home and be independent, 20 per cent will need some form of assistance for activities of daily living and 20 per cent will need institutional care. So, the consequences of stroke are devastating, particularly in low-income countries.

How to prevent stroke
Dr. Nwobosi says that majority of strokes can be prevented by making individual changes based on the risk factors, making healthier choices with respect to our diet and exercise, and having regular medical checkups to detect and treat any risk factor.
“Even when someone has survived a stroke, it is important to intensify these preventive measures to reduce the likelihood of recurrence, he noted.”

In the same vein, Dr. Omonaiye added that “in line with the global world stroke campaign recommendations, beyond individual changes, everyone must become involved in advocating globally and locally for policies that will ensure that we are altogether healthier.”

Possible stroke treatments
Stroke treatment is a multidisciplinary endeavour that involves many specialists, who apply their expertise and treatments that are based on evidence of being effective from research and experience, revealed Dr. Omonaiye.

He added that; “The most important thing is that when a stroke is suspected, the person must be taken to a hospital immediately. This will ensure that more accurate diagnosis is made and treatment started.”

Doctors must all stay abreast of the warning signs and be able to quickly recognize and diagnose stroke, and refer patients appropriately if the expertise is not available in their own practice noted Dr. Nwobosi.

“In the acute stage, survival partly depends upon time lapse from event to hospital (‘door to hospital’ time.) Medical technology can now restore blood supply to dying brain tissue (penumbra,) if the stroke victim reaches hospital within three to four and a half hours of the event, added Nwobosi.”

This is where the rudimentary or non-existent medical emergency service in low-income countries poses a serious challenge. As a result, many patients die before reaching hospital re vealed Dr. OmonaiyeDr. Nwobosi said that if a patient survives the acute stage, then rehabilitative physiotherapy plays a crucial role in restoring the patient to normal function, as much as possible.

“The degree of disability anchors on activities of daily living that some people take so for granted. Such actions as turning in bed, getting out of bed and going to the toilet that people do on reflex without thinking become very important, when they are unable to perform them. Relatives and spouses of stroke victims know this very well.