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​Stroke: What is it

Stroke is a brain attack. It occurs when the blood supply to the brain is interrupted causing brain cells to lose their function thus leading to the symptoms and signs of stroke.

Stroke is the leading cause of adult disability – 63 percent of stroke patients have some disability at three months. It is the fourth most common cause of death, accounting for more than 10 percent of all deaths.

In Singapore, 3.65 percent of the resident population has had a stroke in the past. There are 26 new stroke cases every day. The burden of stroke will rise with our ageing population.

Types of Stroke

  • Ischaemic stroke: This is due to blockage of a blood vessel limiting blood flow to the brain. It is the most common cause, accounting for 74 percent of strokes in Singapore.
  • Haemorrhagic stroke: This is due to rupture of a blood vessel causing bleeding into the brain. This makes up 24 percent of stroke cases in Singapore.
  • There are some other rarer forms of stroke.

Symptoms of Stroke

The symptoms of stroke depend on the part of brain which loses its function due to the interruption of blood supply. An easy way to remember these symptoms is to think of FAST- Face, Arm, Speech and Time.

Face- Ask the person to smile. Does one side of the face droop?

Arm- Ask the person to raise both arms? Does one arm drift downwards?

Speech- Ask the person to repeat a phrase. Does the speech sound slurred or strange?

Time- If you see or experience any of these signs, call for an ambulance and go to a hospital immediately. There are some beneficial stroke treatments that can only be given in the first few hours after the onset of the stroke. Therefore, it is vital that stroke patients go to a hospital as soon as possible.

Other symptoms of stroke include:

  • Sudden weakness or numbness of the face, arm or leg, especially on one side of the body
  • Sudden trouble walking, dizziness, loss of balance or incoordination
  • Sudden severe headache with no known cause
  • Sudden trouble seeing in one or both eyes

Risk Factors of Stroke

There are some stroke risk factors which one cannot change such as older age, race, family and past history of stroke. However, there are many stroke risk factors that are modifiable, meaning you can do something to reduce the risk of stroke. These include high blood pressure, cholesterol problems, smoking, diabetes, obesity, sedentary lifestyle as well as certain blood and heart conditions.

Reducing The Risk Of Stroke

Stroke risk can be reduced. Remember, prevention is better than cure. These measures reduce the risk of first stroke (if you have never had one) and recurrent stroke (if you are a stroke patient).

Control blood pressure
High blood pressure is the most important risk factor in stroke prevention. Uncontrolled blood pressure increases the risk of stroke by four times. High blood pressure should be treated if it is repeatedly above 140/90 mmHg. If you have diabetes, your blood pressure should be below 130/80 mmHg. In addition to medication, lifestyle plays an important role in controlling blood pressure. Having a healthy diet, reducing your intake of alcohol and salt and exercising regularly are some lifestyle measures that reduce blood pressure.

Control blood sugar levels
Diabetes causes high blood sugar levels in the body. Uncontrolled diabetes over a long period of time can cause damage to your blood vessels and nerves. The risk of stroke is 1.5 times more in diabetics. Good control of blood sugar in diabetics reduces the risk of stroke. A healthy diet, taking medication as ordered by your doctors and regular monitoring is crucial in controlling blood sugar levels.

Control cholesterol levels
High cholesterol levels can cause the narrowing of blood vessels in your body. This can lead to blockage of the blood flow to your vital organs including the brain, increasing the risk of stroke. Diet control that includes reducing the intake of foods high in cholesterol and saturated fats, such as coconut milk, deep-fried foods and seafood, as well as medications can control cholesterol levels.

Don’t smoke
Smoking increases the risk of stroke by 1.5 to 2.5 times for you and your family. The risk is reduced as soon as you stop smoking. Your risk of stroke will be the same as that of a nonsmoker within five years of stopping. So stop smoking today. Consult your doctor who can help you to stop smoking.

Maintain an ideal body weight
Obesity is the accumulation of excess body fat. It is associated with various stroke risk factors such as diabetes, high blood pressure and high cholesterol levels. Stroke risk is particularly high with deposition of fat around the tummy. You can calculate your body mass index (BMI) by using your height and weight. To obtain your BMI, simply divide your weight (in kilograms) by your height x height (in metres). The ideal range for an Asian body frame is 18.5 to 22.9. An ideal body weight is maintained by having a healthy diet and exercising regularly.

Have a healthy diet
An unhealthy diet increases the risk of stroke, as well as high blood pressure, diabetes and high cholesterol. Excessive salt and alcohol consumption contributes to high blood pressure. Start today with a healthier diet – an appropriate calorie intake, high in fibre, low in cholesterol and reduce salt intake.

Adopt a healthy lifestyle to prevent stroke - NNI

Exercise regularly
Stroke risk is higher with a sedentary lifestyle. Exercise at least three to five times a week, 30-60 minutes each time. Find an exercise regime that can suit your lifestyle and personality. Regular exercise helps to reduce obesity and also aids in the prevention and management of high blood pressure, diabetes and high cholesterol.

Take your medication as instructed
If you are diagnosed with high blood pressure, diabetes and high cholesterol, it is important to take your medication as instructed by your doctor, even if you feel fine. High blood pressure, diabetes and high cholesterol can be controlled with medications. If you have suffered a prior stroke or have certain blood and heart conditions that increases your risk of a stroke, your doctor may advise you to take certain specific medications for stroke prevention.

Have regular health screening
Have yearly health checks to monitor your blood pressure, cholesterol and blood sugar levels once you are over 40 years old. By adopting a regular health screening regime, these stroke risk factors can be detected early.

Please consult your Family Doctor if you have any concerns about your health.

Specialist services available at the following SingHealth institution:

National Neuroscience Institute
Tel: 6357 7095