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Prevent the stroke of bad luck

Aneurysm, a weak area in a blood vessel wall, is the biggest cause of stroke among young people. Sadly, not many are aware of this fact. Sanchita Sharma reports. Can you spot a stroke?

health and fitness Updated: Oct 29, 2012 02:32 IST
Sanchita Sharma

In the two months leading up to its annual Dussehra Ramlila production in October, Shriram Bharatiya Kala Kendra director Shobha Deepak Singh, 70, practically lives at the iconic cultural centre, stepping out once a day just to go home to sleep.

Last year, when Singh suddenly developed double vision two weeks before Dussehra, she put it down to exhaustion. "I suddenly started seeing double for a few seconds before normal vision returned. When the problem stayed for a day, I went to an eye specialist, who referred me to a neurologist," she recalls.

An MRI (magnetic resonance imaging) followed by an MRA (magnetic resonance angiogram) scans of the brain showed Singh had an aneurysm - a weak area in a blood vessel wall that causes it to bulge and, sometimes burst.

The resultant bleeding in the brain (subarachnoid hemorrhage) or pooling of blood in the brain (hematoma) can cause a stroke.

"Most strokes or brain attacks are caused by sudden decrease in blood supply to the brain, which can cause reversible or permanent paralysis, depending on the injury to the brain. One in every 20 strokes is caused by an aneurysm rupturing, which usually strikes people at the early age of 40-50 years," says Dr Vipul Gupta, head of the Neuro-Intervention Centre at Medanta-the Medicity.

In any given population, 2-4% people have an aneurysm but they don't know about it, and this is the biggest cause of stroke among young people.

Gurgaon-based Aparna Adlakha, 28, is one such person, who was caught completely unawares.

Adlakha had the first inkling of trouble when she had a sudden excruciating headache that did not go even after popping painkillers.

"It was late at night in April, and when she kept crying in pain, we took her to a neighbourhood hospital where they diagnosed it as migraine and gave her a shot to treat it," says Adlakha's sister Sushma Nambiar.

But the pain just got worse, and Adlakha's family moved her to Max Gurgaon, where a CT-scan showed that the pain was caused by a ruptured blood vessel.

"Max Gurgaon said they were not equipped to deal with the sickness and referred her to Max Saket. But we decided to save on time and took her to Medanta in Gurgaon, where a new procedure called 'coiling' saved her life," says Nambiar.

"Watching her in the hospital bed for three weeks, we almost gave up, but now she has bounced back to health," says Nambiar.

Ruptured brain aneurysms kill two out of five people. Of those who survive, two in three suffer permanent neurological damage. For those who get treated on time, life goes on as usual.

"Six days after coming home from hospital, I developed a blister in my foot from walking around too much," laughs Singh, who is back to her 15-hour work schedule.

Conventional surgery involves clipping the base of the weak wall of the blood vessel after opening up the scalp, skull and the coverings of the brain under general anaesthesia.

For coiling, a catheter is guided through a small cut in the groin to an artery and then to the blood vessels in the brain where the aneurysm is located. Thin metal wires or glue are put into the aneurysm that then coil up into a mesh ball.

Blood clots that form around this coil prevent the aneurysm from breaking open and bleeding. Globally, more than half of all aneurysms are now treated using 'coiling'.

"The risk factors for ischemic strokes are the same as heart disease - smoking, high blood pressure, high cholesterol, family history - as it is also triggered by a blockages in the arteries that stop blood flow to the brain," says Dr Pushpendra Renjen, senior consultant neurologist, Apollo Hospitals.

"Newer techniques make it possible to treat patients even if they reach the hospital three hours after having a stroke. But it is advisable to get a check-up done because the sooner you get treated, the lower is the injury to the brain," adds Renjen.

Online quiz: Can you spot a stroke?