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26 October 2011

Stroke is country's third-biggest killer

Cassie was standing in the kitchen chatting to her oldest friend while enjoying a pre-dinner glass of wine when it hit her. It wasn't anything dramatic. Quite the opposite, really. Cassie just stopped talking in mid-sentence and her face went blank.

The second indication that something was amiss was when the glass slipped through Cassie's fingers and crashed to the floor. Even though Cassie's friend didn't recognise the symptoms, she had the good sense to realise something was seriously wrong and drove Cassie to the nearest hospital. Within minutes of seeing a doctor, Cassie's mini-stroke was diagnosed.

She was lucky. Of the more or less 240 South Africans who fall prey to strokes every day, 60 will die. It is the third biggest killer in the country. And as a testament to our appallingly unhealthy lifestyle -- marked by obesity, smoking, lack of exercise and high alcohol consumption -- the fatalities are growing. Moreover, it's also the leading cause of adult disability.

So what exactly is a stroke and what causes it? The majority of strokes happen in one of two ways. A blood vessel leading to the brain either ruptures or leaks, resulting in blood loss. This is called a haemorrhagic stroke and accounts for roughly 20% of all strokes, although it is associated with a higher death rate. The other type, which accounts for about 80% of strokes, is an ischemic stroke. This occurs when a blood vessel either in or leading to the brain is blocked by a clot or other particles. The sudden loss of oxygenated blood and nutrients incurs a potentially devastating loss of function as brain cells die.

Because a stroke largely does to the brain what a heart attack does to the heart, some neurologists refer to them as "brain attacks" -- an apt title considering that strokes attack an increasing number of South Africans. Even youthfulness isn't a barrier. Between 13% and 30% of stroke patients are young adults aged between 15 and 49 years.

Quick intervention is crucial. Medical treatment with­in three hours will reduce the area of brain tissue damaged, which is a major factor in the patient's recovery. The simple rule is that the quicker the treatment, the less brain function is lost. In fact, immediate treatment by medical practitioners has been shown to give the sufferer a 70% better survival rate.

Symptoms of a stroke can include sudden numbness or weakness of the muscles in the face, arm or leg, especially on one side of the body; sudden confusion; blurred or double vision; a sudden severe headache; dizziness; and sudden speech difficulties.

As for the causes of strokes, high blood pressure is the leading culprit. A smoker has a 50% higher chance of suffering a stroke. Cardiovascular disease also exacts a heavy toll, as does diabetes and having high cholesterol levels. A poor diet coupled with lack of exercise is also a major cause, along with stress and depression. Birth-control pills and migraines are also known to increase the risk of strokes.

Cassie was released from hospital five days later after the lameness on the one side of her body had disappeared. The only symptom that persisted for a few days was a slight drooling as the result of weakened facial muscles.

Within two weeks, she was back at work. And the only reminder of the stroke was blood-clot-busting medication and regular check-ups. She also started a moderate exercise regime and changed her diet to more healthy alternatives.

Cassie was determined not to be part of the statistics that claim that 30% of those who get mini-strokes will later suffer a full stroke, between 12% and 18% will be unable to talk properly, 22% will experience difficulty in walking, 32% will be clinically depressed, 48% will be paralysed on the one side of the body, and between 24% and 53% will need help from caregivers.

Strokes will be the topic of Bonitas House Call on October 29 at 9am on SABC2

This article originally appeared in the Mail & Guardian newspaper as a sponsored feature