By Gilbert Kidimu

FIVE months ago, Rachael Nassali suffered a stroke which left part of her face paralysed. Her left eyelid drooped and she spoke with difficulty. Following medical treatment and progressions of physiotherapy, she became better.

A stroke occurs when blood supply to part of the brain is suddenly interrupted due to the presence of a blood clot or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding the brain cells.

Brain cells die without oxygen and nutrients from the blood or are damaged by sudden bleeding into, or around the brain, resulting in temporary or permanent neurological impairment.

Related complications
Dr. Godfrey Malemeko of Kadic Hospital, says paralysis of the arm, leg, face or any part of the body are signs of a stroke. Similarly, one could experience numbness, vision changes, difficulty in speaking or hearing.

Dr. Cornelius Azirawo, a physician at Bugolobi Nursing Home, says if not attended to quickly, a stroke can lead to brain damage which eventuates in loss of memory, heart failure and death.

Origins
Azirawo says more than 15 cases of stroke are reported in Mulago Hospital daily. It is caused by high blood pressure, high levels of cholesterol, smoking, diabetes, severe head injury (trauma) and the fact that it could be a strain in the family.

“HIV/AIDS patients normally get a number of infections and tumors in the brain such as herpes virus, small tumors and diseases of the blood vessels. This makes their immune system weak,” says Malemeko, These infections lead to a haemorrhage stroke.

Types
There are two clinical types of strokes; ischemic and hemorrhagic. High blood pressure, heart disease, cancer and high levels of cholesterol lead to ischemic stroke. Haemorrhage, on the other hand, results mainly from a weakness in the blood vessels.

The seriousness of the stroke highly depends on the location of the damage and the size and type of the stroke.
“If the damage covers a bigger part of the brain, the stroke is severe.

Haemorrhage, due to its progressive nature, is more intense than Ischemic,” explains Malemeko. The two types are just as common.

Diagnosis, treatment
Clinical check-ups to measure blood pressure, the eyes for traces of high pulse rate and exploring the patient’s history are done to determine the origin of the stroke.

“A Brain CT; a machine which helps to establish the size, type and location of the stroke is used to decide whether to use medical or surgical treatment,” says Malemeko. If the impact is serious, surgery is done, whereas minor cases are given medical treatment.

Drugs called diuretics are administered to restart the valves of the heart. If blood pressure is low, IV fluids are applied to reinstate it. The patient is put on a hydrocortisone drip.

Norton drugs are administered to restart the normal functioning of the lungs. This is followed by physiotherapy, which is maintained until the patient stabilises.
Physiotherapy is, for the most part, given to medical cases, although sometimes, it is applied to a few surgical ones.

Recovery
Recovering is a gradual process. Most people who suffer strokes regain normal composure if they are attended to early. Consistent physiotherapy quickens the recovery process.

Costs
Medical treatment is cheaper than surgery. Drugs like nurolobine cost about sh30,000 a doze, while a major operation in the private wing of Mulago costs sh500,000 for outpatients and rented rooms are priced between sh30,000 to 40,000 a day.

Preventive Measures
Regular medical check-up keep it in check
Exercise for 40 minutes a day, four times a week to reduce risks of high blood pressure

Include more leafy green vegetables, cereals and fruits in your diet
Avoid stress. It is responsible for a significant fraction of deadly strokes in Mulago Hospital

In case of a stroke, immediate medical attention should be sought to avoid further damage because strokes are progressive.