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Ischemic stroke is one of the world’s most serious medical emergencies, frequently ending in long-term impairment or death. A stroke happens when blood flow to a specific area of the brain is interrupted, generally by a blood clot, depriving brain cells of the oxygen and nutrients they require to operate. Without quick medical attention, these cells will perish, potentially causing irreparable damage.
This article discusses the causes, treatment choices, physical repercussions, and prevention of ischemic stroke, with a particular emphasis on ischemic stroke treatment and prevention in Singapore.
Global Prevalence of Ischemic Stroke
Stroke is a global health concern that affects millions of individuals each year. According to the World Stroke Organization, 12.2 million people have their first stroke each year, with ischemic strokes accounting for around 87% of all cases. In 2020, stroke was the second biggest cause of death worldwide, accounting for around 6.6 million fatalities. The global burden of ischemic stroke is growing, particularly among younger populations in specific countries.
In Singapore, stroke is the fourth leading cause of death, with ischemic stroke accounting for over 80% of all strokes. According to the Singapore Stroke Registry, the stroke rate in Singapore was 157 per 100,000 people in 2018. Understanding the causes and prevention actions is crucial to addressing this increasing public health challenge.
Contributing Factors to Ischemic Stroke
Several risk factors increase the likelihood of suffering an ischemic stroke. These factors are classified into changeable and non-modifiable groups.
Non-modifiable risk factors:
- Age: The risk of a stroke rises with age. People over the age of 55 are at higher risk, but younger people are not immune.
- Gender: Although men are more likely to have a stroke than women, women have more severe strokes.
- Family History: A family history of stroke or cardiovascular disease enhances a person’s risk of having an ischemic stroke.
- Ethnicity: Certain ethnic groups, such as those of African, Hispanic, or South Asian heritage, are at a higher risk of stroke. In Singapore, racial differences reveal that Malays and Indians had a greater stroke rate than Chinese Singaporeans.
Modifiable Risk Factors:
- Hypertension: Also known as high blood pressure, this is the most major risk factor for ischemic stroke. Elevated blood pressure damages blood arteries, making them more susceptible to blockages.
- High Cholesterol: Excess cholesterol can build up in the arteries, producing atherosclerosis (artery hardening) and increasing the risk of clotting.
- Diabetes: Diabetics are more likely to develop cardiovascular problems, which can lead to ischemic strokes.
- Smoking: Smoking causes blood to thicken, which raises the risk of clot formation.
- Obesity and Sedentary Lifestyle: A lack of physical exercise, as well as being overweight, raise the chance of developing hypertension, diabetes, and high cholesterol, all of which contribute to the risk of stroke.
- Atrial Fibrillation: This irregular heartbeat raises the chance of clots developing in the heart and traveling to the brain and cause stroke.
Ischemic Stroke Treatment Options in Singapore
Singapore’s healthcare system is well-known for its cutting-edge medical facilities and highly qualified healthcare workers, making it ideal for ischemic stroke treatment and prevention. The primary goal of ischemic stroke treatment is to restore blood flow to the brain as early as possible in order to limit damage.
1. Intravenous Thrombolysis (IVT)
The most common treatment for ischemic stroke is the administration of tissue plasminogen activator (tPA), a clot-busting medication. To be effective, tPA must be delivered within 4.5 hours of the commencement of the symptoms. This medication works by breaking the clot that is preventing blood flow to the brain.
2. Endovascular Therapy (EVT)
Endovascular therapy is a more advanced therapeutic option for large vessel occlusions (LVO), a severe type of ischemic stroke. EVT includes mechanically extracting the clot from the occluded artery with a catheter placed via the groin. This surgery can be conducted up to 24 hours after the stroke has occurred, depending on the patient’s state. Singapore’s hospitals, including the National Neuroscience Institute and Singapore General Hospital, provide this cutting-edge treatment, which improves survival rates and outcomes.
3. Carotid Endarterectomy with Stenting
If the stroke is caused by a blockage in the carotid arteries, which feed blood to the brain, surgical procedures such as carotid endarterectomy or stenting may be performed. The surgeon performs a carotid endarterectomy to remove the fatty deposits that are obstructing the artery. In contrast, carotid stenting involves inserting a tiny, inflatable tube to keep the artery open.
4. Rehabilitation Services
Post-ischemic stroke treatment and prevention Singapore, allows patients to restore function and independence. In Singapore, rehabilitation is tailored to individual needs and may involve physiotherapy, occupational therapy, speech therapy, and psychiatric counseling. Many stroke centers in Singapore, including Tan Tock Seng Hospital and the Stroke Hub at Khoo Teck Puat Hospital, offer complete rehabilitation treatments.
Physical Changes After Suffering an Ischemic Stroke
The aftermath of an ischemic stroke varies according to its severity and the location of the brain affected. Recovery can be a lengthy process, typically necessitating rehabilitation to restore lost abilities.
1. Weakness or Paralysis
A typical complication is weakness or paralysis on one side of the body (hemiplegia). This happens because one hemisphere of the brain controls the other side of the body. For example, a stroke on the left side of the brain can result in right-sided weakness.
2. Speech and Language Difficulties
Damage to parts of the brain important for speech and language, such as Broca’s area, can cause aphasia, a disorder in which the patient fails to speak, understand, or construct words properly.
3. Cognitive Changes
Cognitive impairment, including memory, problem-solving, and attention issues, is frequent following a stroke. This may impair the individual’s ability to complete daily duties alone.
4. Sensory Disturbances
Individuals who have had a stroke may feel altered sensations such as numbness, tingling, or inability to sense warmth or discomfort.
5. Emotional and Behavioral Changes
Ischemic strokes can also result in emotional instability, such as depression, anxiety, or personality shifts. This has a substantial impact on a patient’s quality of life and necessitates psychological support which is why it is important to know the different ischemic stroke treatment and prevention Singapore.
Natural Ways to Prevent Ischemic Stroke
Prevention is usually preferable to treatment, especially for ischemic stroke. While medical therapies can dramatically reduce the risk of stroke, maintaining a healthy lifestyle is essential for prevention. Here are some natural approaches to prevent ischemic stroke, with a special emphasis on ischemic stroke treatment and prevention in Singapore.
1. Maintain Healthy Blood Pressure
High blood pressure is the most common cause of ischemic stroke. Regularly monitoring your blood pressure and implementing dietary changes, such as limiting salt intake and eating potassium-rich foods like bananas and leafy greens, can help you manage it naturally.
2. Adopt a Heart-healthy Diet
A diet high in fruits, vegetables, whole grains, and good fats (such as omega-3 fatty acids found in fish) may reduce the risk of stroke. Avoiding processed meals, saturated fats, and extra sweets can also help prevent diabetes and high cholesterol, both of which are stroke risk factors.
3. Exercise Regularly
At least 150 minutes of moderate physical activity per week, such as brisk walking, swimming, or cycling, can help you maintain a healthy weight, lower your blood pressure, and improve your cholesterol.
4. Quit Smoking
Smoking raises the risk of a stroke by harming blood vessels and increasing the possibility of clot development. Quitting smoking is one of the most critical measures toward avoiding an ischemic stroke.
5. Limit Your Alcohol Intake
Drinking too much alcohol can elevate blood pressure and lead to weight gain, both of which are risk factors for ischemic stroke. Limiting your alcohol usage to modest amounts (up to one drink per day for women and two for men) will help reduce your risk.
6. Manage Stress
Chronic stress is associated with high blood pressure and cardiovascular disease. Relaxation techniques such as meditation, deep breathing, and yoga can help to reduce stress and improve cardiovascular health.
7. Control Diabetes
Maintaining blood sugar levels within the acceptable range through food, exercise, and medication is critical for diabetics to reduce their risk of a stroke.
Frequently Asked Questions (FAQs)
1. What’s the distinction between ischemic and hemorrhagic strokes?
An ischemic stroke occurs when a clot blocks blood flow to the brain, but a hemorrhagic stroke occurs when a blood artery in the brain ruptures, resulting in hemorrhage.
2. What are the earliest indicators of an ischemic stroke?
Common symptoms include abrupt numbness or weakness, particularly on one side of the body, trouble speaking or understanding speech, loss of balance, and a sudden intense headache.
3. How are ischemic strokes handled in Singapore?
Treatment options in Singapore include intravenous thrombolysis, endovascular therapy, carotid artery surgery, and extensive rehabilitation services provided by premier institutions.
4. Is it possible to entirely prevent an ischemic stroke?
While risk cannot be totally eliminated, it can be greatly lowered by addressing modifiable risk factors such as hypertension, cholesterol, smoking, and nutrition.
5. What lifestyle modifications can help avoid an ischemic stroke?
Adopting a balanced diet, exercising frequently, stopping smoking, and controlling stress are all important lifestyle improvements to avoid ischemic stroke.
6. What are the long-term consequences of an ischemic stroke?
Long-term consequences may include physical disability, cognitive impairment, emotional disorders, and difficulties with speech or motor functioning.
7. Is recovery from an ischemic stroke possible?
Yes, with quick treatment and rehabilitation, many people can regain significant function following an ischemic stroke, while some may suffer permanent disability.
Conclusion
By understanding the ischemic stroke treatment and prevention Singapore, individuals can take proactive steps toward maintaining brain health and reducing their risk of stroke. Singapore offers world-class treatment options, and by incorporating natural lifestyle changes, the risk of ischemic stroke can be significantly lowered.
If you’re concerned about your heart health, it’s wise to speak with a doctor and explore the option of a cardiac biomarkers test in Singapore. Whether you have heart disease symptoms or simply want a routine heart check-up, acting quickly is essential. Reach out to the Harley Street Heart and Vascular Centre for a thorough evaluation. Call +65 6235 5300 to schedule a consultation with one of our renowned cardiologists. Safeguard your heart health today—your well-being is our highest priority!
Written by: Dr Michael MacDonald MB ChB, BSc (Hons), MRCP (UK), MD (Research), FESC (Europe). Dr MacDonald was trained in the UK and is a senior Consultant Cardiologist.