Brain Attack and Brain Angina

    Most people are aware that severe chest pain, especially after excretion may be a symptom of a heart attack or angina. Many who suffer this seek medical help. It is also widely known that heart attacks can be prevented by medication,angioplasty & stenting or by coronary artery bypass.

    Majority of people are not aware that most paralytic strokes have a similar cause as a heart attack i.e. a blocked or narrowed artery! In fact the term Brain attack is an apt way of describing this. It is not common knowledge that strokes can, like heart attacks, be prevented by medication, surgery or sometimes angioplasty.

    Many of us would have had a relative, acquaintance or friend who has unfortunately had a stroke and no treatment other than medicines and physiotherapy was offered! Many of those who suffer a stroke usually would have suffered from a "mini stroke" (temporary loss of the use of an arm or leg or slurring of speech or temporary sudden blindness in one eye).This is a warning sign for an impending stroke and is equivalent to angina when comparing stroke to a heart attack. If surgery to unblock the blocked artery is done at the time of the first warning sign many of these disabling or fatal strokes can be prevented.

    India unfortunately has one of the worst records in the world for the prevention of stroke. This is because of a depressing lack of awareness among the public as well as the doctor community. The situation was similar in the United Kingdom till a few years ago when a massive stroke awareness campaign was launched. This has lead to big drop in the number of strokes.

    The surgery done to prevent a major stroke can, unlike a cardiac bypass,be done under a local anesthetic and the patient is usually fully fit for discharge in a day or two. The cost implications for this surgery is also low, compared to a cardiac bypass, and when compared to looking after somebody with paralysis!


    How do I know if somebody is having a stroke or mini stroke?

    It is very easy to make out is somebody is developing a stroke or mini stroke. Just remember FAST.

    • F : Has their face fallen to one side? Can they smile?
    • A : Arms, can they raise both arm and keep them there?
    • S : Speech, is their speech slurred?
    • T : Time to seek urgent medical help

    Sometimes sudden blindness in one eye that recovers soon can also be a sign of a mini stroke.


    When is the best time to do stroke prevention surgery?

    The best time to do a carotid endarterectomy is within 2 weeks of a mini stroke. This is because the patient is at the highest risk of having another stroke in this period.