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Treatment within the first few hours is crucial when a stroke occurs.
Every STROKE on the Clock Counts
Knowing how to react in the event of someone suffering a stroke – Singapore’s fourth most common cause of death – can help save lives. “Every minute counts in a stroke,” said Clinical Associate Professor Lee Kim En, Senior Consultant & Head, Department of Neurology at the National Neuroscience Institute (located on the Tan Tock Seng Hospital Campus).
There are two types of stroke:
- Acute Ischaemic Stroke (caused by blockage of a blood vessel)
- Haemorrhagic Stroke (caused by the bursting of a blood vessel)
“For patients arriving within the first three hours of any stroke, a clot-busting agent may increase their chances of a good recovery,” Prof Lee said. Other treatment options for stroke victims include the use of devices to re-establish blood flow to areas deprived of oxygen and nutrients. Those with haemorrhagic strokes may require emergency surgery. The present use of a clot-busting agent within the first three hours of the attack is currently the only approved treatment for acute ischaemic stroke.
Recent studies have shown that the benefits of the treatment extend to four and a half hours after the onset of stroke symptoms, but Prof Lee warned that patients should not be complacent and think they have more time to react as the chances of a good recovery are reduced when treatment is delayed. Symptoms of stroke can come on with no prior warning. In 2007, Mrs Chia was in the bathroom when she fell as she was trying to stand. She managed to yell for her husband who called an ambulance. “I was completely paralysed on my right side and my speech was slurred,” she said.
 Luckily for Mrs Chia, she received treatment quickly. “When they discharged me four days later, I was already walking well. I was also able to talk again, but I had trouble adding and subtracting,” she added. A year before the attack, she had suffered a transient ischaemic attack, a milder form of a stroke that usually pre-empts a full-blown attack. “At about 3am, I realised I could not see with my right eye. Although my vision recovered in a few hours, I went to see my ophthalmologist the next day and he referred me to a neurologist who started me on blood-thinning treatments to prevent a full-blown stroke,” she said.
“Medications prescribed for strokes target risk factors such as hypertension and diabetes. In some patients, surgery may be able to re-open blocked vessels and prevent future strokes,” said Prof Lee. Patients must also get started on rehabilitation as soon as possible. Depending on the severity of the stroke, patients will be considered for programmes with varying intensities.
“Up to 55 per cent of patients with ischaemic strokes treated here go on to enjoy full recovery,” he added. As for Mrs Chia, her recovery is almost complete. She said: “I like to say that my right hand has a mind of its own, so I find it difficult to write sometimes. But apart from that I’m fine.”
Stroke and it's Symptoms
A stroke occurs when a clot or disturbance occurs to the blood supply in the brain. In an acute ischaemic stroke, part of the brain is deprived of oxygen and becomes irreversibly damaged. Brain tissues surrounding the damaged part will also be affected, but can potentially be saved with quick action.
If you suspect you are feeling the onset of a stroke, seek help immediately if one of the following symptoms occurs suddenly.
- Weakness or numbness on one side of the body
- Slurred speech or difficulty in speaking
- Loss of vision or double vision
- Unsteadiness in walking or uncoordinated movements
- Dizziness
- Excruciating Headache
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