Stroke, also known as brain attacks, are a leading cause of death and serious long-term disability worldwide. It happens when blood supply to part of the brain is blocked (ischemic stroke), or when a blood vessel bursts (haemorrhagic stroke).
The National Stroke Association has cautioned that stroke cases are on the rise among the young, with 15% of ischemic strokes occurring in young adults and adolescents. This highlights the importance of this demographic taking proactive measures to safeguard their health.
According to Dr Kok Chin Yong, consultant neurologist from a medical centre in Sunway Velocity, Kuala Lumpur, 40% of stroke cases nationwide in 2016 that required hospital admission happened in those aged below 60.
There are many risk factors for stroke, including smoking, physical inactivity, and hypertension. Young adults are more susceptible if they lead a sedentary lifestyle, practise unhealthy food habits, indulge in excessive screen time, or increase alcohol consumption.
“Vascular risk factors such as hypertension and diabetes, and environmental factors such as air pollution are among risk factors as well,” Kok said, adding that obstructive sleep apnoea and illicit drug use can also cause blood-vessel disturbances that lead to both types of stroke.
Stress, too, can lead to behaviours that could potentially result in stroke; for example, not getting enough sleep could impact on the immune system and cause blood and heart issues.
Furthermore, Kok shared that there are rare, acquired risk factors that could occur in the younger population. These include Moyamoya syndrome, a rare progressive cerebrovascular disorder caused by blocked arteries; antiphospholipid syndrome, which leads to abnormal blood clotting; as well as heart abnormalities.
To address these risks, young adults need to adopt healthy lifestyle habits like regular exercise and a well-balanced diet. Kok strongly discourages the use of recreational drugs, as misuse and overdose could lead to severe constriction of blood vessels and, in turn, stroke.
Signs and symptoms
Common features of stroke include facial drooping, arm weakness, and speech difficulties. Kok recommends remembering the term BE FAST, which stands for:
- B for balance issues or dizziness;
- E for eye or visual problems;
- F for facial drooping;
- A for arm or leg weakness or numbness; and
- S(T) for speech impediments.
For further assessment, the doctors will use a defined stroke scale like the National Institutes of Health Stroke Scale to determine the severity of the attack. The higher the score, the more serious the stroke.
When a stroke occurs, time is of the essence. Hence, when an individual notices something is not right, they should rush to their nearest hospital for timely assessment, which offers a higher chance of getting the best outcome from treatment.
Rehab and recovery
According to consultant rehabilitation medicine specialist Dr Foong Chee Choong, rehabilitation is an important part of the recovery process. However, recovery times and treatment types vary, with no two patients having the same progress.
Doctors will have to assess the patient’s condition and propose a suitable and effective treatment plan tailored to their needs.
Age is an important factor in stroke recovery. “Younger stroke survivors have a better outcome, as they regain mobility and recover much faster. However, older stroke survivors will also benefit from a proper rehab programme,” he said.
Foong explains that rehabilitation technology in Malaysia has improved, with one of the most widely investigated and adopted approaches being an exoskeleton gait trainer that helps improve mobility of a stroke survivor.
The EksoNR device is very versatile and benefits not only stroke patients but those with conditions such as spinal cord injury, paraplegia (paralysis of the lower half of the body), traumatic brain injury, joint replacement, osteoarthritis, Parkinson’s disease, and cerebral palsy.
The benefit of using robotics is that it provides intensive training with highly accurate feedback, as well as various levels of assistance for different severity levels. With the help of robotic technology, it generally takes between one and three months to see any improvement in walking among stroke patients.
“It is important for the patient and their family to have a functional goal, be motivated, and be patient,” Foong concluded, “as any rehabilitation process takes time and effort.”