Ethekwini Hospital and Heart Centre is a Stroke Centre of Excellence
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Ethekwini Hospital and Heart Centre is a Stroke Centre of Excellence. It is important for the community to be informed about Strokes, the importance of acting FAST and getting the patient to a facility that is able to deal with Strokes within the GOLDEN HOUR. We encourage you load our dedicated Stroke line number 086 13 44 237 on your phones, should the need arise…

What is a stroke?

A stroke occurs when the blood supply to a part of the brain is cut off or a blood vessel ruptures. In the first case part of the brain dies. In the latter case there is a brain haemorrhage. The commonly used term is CVA which stands for cerebrovascular accident.

Why are strokes important?

Strokes are the third leading cause of death. In South Africa there are 360 new strokes each day. Of these patients, 110 will die and 90 will be significantly disabled. The cost to the care givers, families and society in managing the disabled patients is large.

What factors predisposes to the development of stroke?

  1. The non-modifiable risk factors are age, gender and family history: The older you are, if you are a male or if you have a strong family history of stroke you are more likely to have a stroke.

  2. Diabetes Mellitus

  3. High Blood pressure

  4. Abnormal lipids – high cholesterol and triglycerides

  5. Smoking

  6. Excess alcohol

  7. Being overweight.

What are the features of a stroke?

This depends on which part of the brain is affected. The symptoms come on rapidly. Remember the pneumonic FAST : F is for facial asymmetry (face pulled to one side or drooping), A is for a drooping of an outstretched arm, S is for slurred speech and T is for time.

Why time?

When the stroke is due to a blocked artery, the best chances of recovery if the artery can be unblocked is in the first 4.5 hours. So a stroke such this type is medical emergency. If the patient presents to a hospital which has dedicated facilities within the 4.5 hour period, the artery can be unblocked by either using a drug to dissolve the clot or insert a catheter into the artery and pull the clot out.

What must I do if I suspect that I, a family member or a friend has had stroke?

Act fast. Contact the ambulance service to take the patient directly to a hospital that has the appropriate facilities. Such hospitals should have a “stroke hotline” eg the Ethekwini Hospital’s hotline number is 0861344237.

What happens at the hospital?

The hospital will be expecting you. As you enter the emergency unit you will be assessed by the doctors and nurses, have blood tests done and an emergency brain scan performed. You will also be assessed by a neurologist or specialist physician who has an interest in stroke. Provided that all the evaluation is done within 4.5 hours of the onset of the stroke, patient is assessed regarding suitability for clot dissolution (thrombolysis) or clot removal (mechanical thrombectomy). Not all strokes can be treated in this way. The specialist will advise you.

What happens after the emergency management?

The next step is rehabilitation and attention to the modifiable risk factors mentioned above.

How can I decrease my chances of getting another stroke?

With strict management of risk factors such as Diabetes, High blood pressure and the abnormal lipids. Lifestyle changes are essential – stopping smoking, weight control and exercise.

Information courtesy of Prof Ahmed Bhigjee

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