Like many people, I used to think having a stroke was an old person’s problem – until my then-polytechnic mate, Daniel (not his real name), experienced it at the age of 20.
READ: Reversing the damage of a stroke: How one patient rehabilitated himself through sheer determination
When I caught up with him months after his stroke many years ago, he looked his usual self, except for the slightly discernible droop on the right side of his face. “I remember someone telling a joke and we were all laughing,” he said. “But my face didn’t feel right, like I’d lost control of the right side of my face. The muscles weren’t moving.”
Daniel described a numbness spreading down from his neck to his right shoulder and arm – and a sudden incoherence when he tried to tell his friends what was happening to him. Whether it was shock or prescience, his friends rushed him to the A&E instead of the nearest clinic. The move turned out to save his life – and from a lifetime of immobility.
The incidence of stroke increases with age, with the incidence doubling for each decade after 55 years of age.
If his friends had brushed off his numbness as, “nah, it’s just pins and needles”, or wasted time making fun of the way he spoke, he might not have made a near-100 per cent successful recovery (save for some weakness in his right arm and a slight facial droop to this day).
And therein lies the importance of recognising the signs of stroke as well as knowing that it can happen to younger people.
STROKE CASES IN SINGAPORE
According to the World Stroke Organisation (WSO), one in four people will have a stroke in their lifetime. In Singapore, the National Registry of Diseases Office (NRDO) puts the number of stroke cases at 7,741 in 2017. The reason why stroke is a concern is that it is a leading cause of adult disability, highlighted the WSO. According to Healthhub.sg, it’s also the fourth leading cause of death in Singapore.
“The incidence of stroke increases with age, with the incidence doubling for each decade after 55 years of age,” said Associate Professor Deidre Anne De Silva, senior consultant neurologist from the Department of Neurology at the National Neuroscience Institute.
Although most of the cases are patients above the age of 50, the NRDO noted that 8.8 per cent of stroke admissions are below that age. The fact that young stroke cases are seen may “possibly be due to lifestyle-related risk factors such as hypertension, diabetes, hyperlipidemia, obesity, heavy alcohol intake and smoking,” said Assoc Prof De Silva, who also chairs Stroke Services Improvement, a national team appointed by the Ministry of Health to improve stroke care.
Many of my patients have told me that the reason they came quickly to the hospital and received acute treatments is because a family member, colleague or often a stranger, knew the right action to take by calling for an SCDF ambulance.
Essentially, there are two types of stroke: The more common ischaemic stroke, where blood flow to the brain is obstructed by a clot; and the less common haemorrhagic stroke, which occurs when bleeding in the brain is the result of a burst blood vessel.
Both types disrupt oxygen and nutrient flow to the brain. “The area of the brain that is deprived of blood is thus damaged, resulting in signs and symptoms of stroke,” explained Assoc Prof De Silva.
Regardless of age and stroke type, the symptoms are the same. Assoc Prof De Silva recommended using the acronym FAST to help recognise these and take action:
- Face drooping
- Arm weakness
- Speech difficulty
- Time to dial 995
Other possible signs of stroke include the sudden onset of:
- Difficulty in swallowing
- Visual impairment
- Uncoordinated movements or an unsteady gait
- Very severe headache
“It is important that everyone can recognise stroke symptoms and know what to do,” said Assoc Prof De Silva. “Many of my patients have told me that the reason they came quickly to the hospital and received acute treatments is because a family member, colleague or often a stranger, knew the right action to take by calling for an SCDF ambulance.”