Thursday, 06 October 2022

Is side-lining stroke treatment amidst COVID-19 too dangerous?

17 February 2022 | Views

While the rest of the diseases affect patients over time, stroke patients can incur a sudden impact and potentially have life-long paralysis

With the emergence of the pandemic, the healthcare service, medical staff and infrastructure have been weighed down with innumerable challenges that they have not faced before. The medical safety of the frontline workers has been risked because their work was necessary to combat the disease. If they stopped working the entire nation’s situation would have deteriorated.

The current state of the healthcare industry has neglected and side-lined the presence of other non-communicable and lifestyle diseases like hypertension, diabetes, colon cancer, heart problems and
stroke. These diseases contribute to around 60 per cent of deaths in India. We must not overlook the fact that as time has passed, SARS-CoV-2 has begun having a bi-directional impact on the people
suffering from it.

While the rest of the diseases affect patients over time, stroke patients can incur a sudden impact and potentially have life-long paralysis. It kills about 2 million brain cells in under a minute. Due to this, the brain ages by 3.6 years as an hour pass.

Stroke is the second leading cause of death and comes fourth on the list of causes of disability worldwide. Currently, the neural effects of the virus are apparent. It is mostly because of the lack of oxygen to the brain. The others cover increased immune response, clots and the virus invading the brain. As a result, the condition needs precise treatment and prompt decision-making.

As per reports, about 3 per cent of the global population are at the risk of developing a brain aneurysm. Furthermore, five in every 100,000 people worldwide experience a ruptured intracranial aneurysm. In India, around 76,500 to 204,100 cases of subarachnoid haemorrhage (SAH), which involves slight bleeding in the membrane occur every year. These circumstances arise because of high blood pressure and trauma.

It is high time that we educate the masses about Aneurysms and change or alter policies around this issue., which would result in a reduced stroke burden on the country. There is an immediate necessity
to legislate schemes and frameworks regarding stroke care. Healthcare facilities across the country should be capable enough to form a regional task force including nurses, stroke coordinators, neurologists, neuro-interventionalists, EMS personnel, community physicians and hospital administrators who are experienced to deal with a high volume of stroke cases.

The brain requires 20 per cent of the body’s blood supply to flow to it exclusively. Having a blockage or a rupture in even a small blood vessel leads to irreversible changes like paralysis, speech issues, visual impairment, losing control of bladder and bowel movement, coma and loss of life. A common cause of this disease is abnormally ballooning of the vessel, also called an aneurysm. This condition makes the blood vessels’ walls thin and makes them more likely to burst.

Until recently, all the treatments were done by open surgery. But currently, Endovascular interventions are commonly being used for managing aneurysms. These are non-surgical procedures. The treatment is done through an artery present in the thighs called the femoral artery.

This novel method has reduced death rates and complications. Unfortunately, being only available in developed countries, Indians are deprived of this revolutionary cure.

“Better three hours too soon than a minute too late” – This saying deems fit here as every second counts. A slight delay in treatment can lead to 30,000 brain cell death. The rising cases of brain aneurysms in one of the most populous countries have highlighted the lack of equipment and awareness. If we pay requisite attention to this, we would be able to deliver better results.

 

Dr Kalpesh Shah, Neurosurgery, Fellowship in Endovascular, Neurointervention (Japan) 

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