According to the statistics department, stroke was the third most common cause of death in Malaysia last year. The health ministry also highlights stroke as a major cause of mortality in its Clinical Practice Guidelines 2020, with ischaemic stroke being the most prevalent form.
Ischaemic stroke occurs when the blood supply to parts of the brain is obstructed, preventing brain tissue from receiving oxygen and nutrients, and leading to cell death within minutes.
This could result in neurological complications such as muscle paralysis, speech difficulties, visual disturbances, gait imbalances, dizziness, and long-term muscle stiffness.
“Ischaemic strokes can result from various conditions, such as the build-up of fatty deposits in arteries, and other factors that promote blood-clot formation,” said Dr Kok Chin Yong, consultant neurologist from a medical centre in Sunway Velocity, Kuala Lumpur.
The critical time window from the onset of stroke symptoms to receiving treatment is known as “the golden hour”. During this period, timely medical intervention can significantly improve the chances of recovery and reduce the risk of long-term disability or death.
Medical interventions during the golden hour include two key treatments: thrombolysis and mechanical thrombectomy. Thrombolysis involves administering medication to dissolve small blood clots in the brain, and must be conducted within 4.5 hours of the stroke onset.
Mechanical thrombectomy involves using a device to physically remove larger blood clots. It is most effective within six hours of stroke onset but can still be beneficial if performed within 24 hours in certain cases.
Stroke patients who do not receive treatment within the golden hour face the risk of severe brain damage, increased mortality, and long-term disabilities. Delayed treatment reduces the effectiveness of interventions, making recovery more challenging and often resulting in permanent physical, cognitive, and speech impairments.
Rehabilitation and prevention
Kok advises that while it is important to accept the reality of a stroke, patients should remain committed to their recovery. “Rehabilitation can significantly improve the quality of life and independence, reducing the need for assistance in daily activities,” he said.
For stroke prevention, daily lifestyle choices and diet are crucial: according to Kok, being physically active and consuming foods rich in omega-3 can lower stroke risk by as much as 60%.
Key risk factors for stroke include hypertension and diabetes, which promote plaque buildup in blood vessels, potentially causing blockages in blood flow to the brian.
He also observes an increasing incidence of stroke among younger individuals, often linked to sedentary lifestyle, smoking, undiagnosed hypertension, and obstructive sleep apnoea, which is common in overweight individuals and frequently goes unnoticed.
All in all, effective stroke treatment within the golden hour can significantly improve patient outcomes and reduce long-term disabilities. Patients must seek immediate medical attention if they are experiencing symptoms, and continue rehabilitation post-treatment to enhance recovery.
Each stroke case requires a tailored treatment approach, so it’s important for loved ones and carers to consult trusted medical professionals and physiotherapists.