Stressful life may increase the risk of stroke

Stressful life may increase the risk of stroke

Maria Endah Hulupi, The Jakarta Post, Jakarta

Hendra, 35, was a very energetic, hard-working businessman. He
was a good tennis player and often played tennis with his friends
on Sunday mornings, a weekend activity which he said soothed his
stress.

Earlier this year, his parents and friends were shocked to
hear the news that Hendra had passed away after a sudden collapse
on the tennis court. A family doctor said that he died of a
stroke.

"A stressful lifestyle which includes heavy responsibility,
debts and targets one cannot cope with would increase one's risk
of stroke," said the chairman of the Indonesian Neurologists
Association (Perdossi), Samino.

"This situation would induce stress, increase the adrenaline
level, make one's heart beat faster and in turn would eventually
contribute to cardiovascular problems. This condition can
increase a person's risk of stroke or cardiac diseases," Samino
added.

A few decades ago, he claims, strokes generally occurred to
people aged 50 and older but now the disease also increasingly
attacks people in their mid-30s.

Samino explained that a stroke is a vascular problem, which
hinders blood flow to the brain depriving it of essential oxygen
and nutrients. "It happens spontaneously and persists for 24
hours," he said during a seminar on endovascular surgery at
Siloam Gleneagles Hospital recently.

He said strokes are a result of clogging and hemorrhaging in
the brain. "Usually a hemorrhage stroke occurs during an
activity, but the stroke due to clogging usually occur at night
or in the morning," while people are resting.

Clogging occurs when plaque builds up in blood vessels in or
leading to the brain that have already been damaged by
arteriosclerosis. However, a blood clot can also form in the
heart and travel along the vessel and finally, nest in the brain.

This clogging would block blood flow, carrying oxygen to the
brain, and leading to brain cell death within minutes. "When an
area of the brain doesn't function, body parts related to it
cannot function either," he said.

Hemorrhage stroke can be caused by several factors, including
head trauma, ruptured Arterio-Venous Malformation (AVM) or
defective arteries in the brain which leads to a ruptured
aneurysm. An aneurysm is a bulging blood vessel formed due to a
weak artery wall. Aneurysms generally are difficult to detect and
usually have no symptoms until it ruptures, and at that point it
is usually fatal in a very short time.

People at high risk for stroke are those with high blood
pressure (hypertension), cardiovascular diseases, diabetes
mellitus, dislipidemia, and infections such as syphilis. Prior
research indicates that 70 percent of stroke sufferers have
hypertension, 20 percent have cardiovascular problems and 20
percent diabetes.

"However, normal people with bad habits like smokers,
alcoholics, drug users and overweight people are also very high
risk," he said, adding that all these conditions can lead to
vascular problems.

Samino added that age also plays a role in the onset mainly
because the aging process can lead to arteriosclerosis.

He said common symptoms of a stroke can include coordination
problems, partial memory loss and some sensory loss. It may also
hinder the patient's ability to talk and swallow, depending on
the part of the brain damaged by the stroke.

The American Heart Association indicates that warning signs of
a stroke may be a sudden numbness or weakness in the face, arm or
leg, especially on one side of the body; sudden confusion,
trouble speaking or understanding; sudden trouble seeing in one
or both eyes; sudden trouble walking, dizziness, loss of balance
or coordination and sudden severe headaches with no known cause.

Among other neuro related diseases, Samino said, stroke is a
major cause for disability and once a person experiences a
stroke, he has a 30 percent chance to get the second attack
within the next 12 months.

Treatment for an acute stroke, he said, was aimed at
preventing death, minimizing brain defects and preventing the
onset of other illnesses due to prolonged immobilization, such as
pneumonia, bed sores and falling down.

Stroke can be treated by micro surgery, open surgery or both.

Micro or endovascular surgery -- a procedure that requires
inserting a micro catheter from the vessels on the femur or thigh
and directing it to the lesion area in the brain -- can be done
to release a coil and/or a small balloon to protect the aneurysms
against rupture and to insert stents to create space for the
artery. While, the open surgery can be performed for
decompression, hematome evacuation and to insert a metal clip
around the base of aneurysms to prevent it from bursting.

As for prevention, treating or managing hypertension, diabetes
mellitus and cardiovascular diseases with related internists are
very important.

It is also necessary to change bad habits and eat a healthy,
high-fiber, low-fat diet to reduce cholesterol and to become or
remain physically active.