When former prime minister Patrick Manning suffered a stroke last month, it brought to light a serious condition which many take for granted. The fact is that anyone can suffer a stroke. Once thought of as a condition that occurs in the elderly, younger people are now becoming more at risk for developing this potentially fatal disease, said Dr Varma Deyalsingh.

"While modern medicine has advanced over the years, patients must understand that doctors are not magicians," he added.

"A stroke or brain attack is a condition where a blood clot or ruptured artery or blood vessel that carries oxygen and nutrients to the brain interrupts blood flow to an area of the brain. When this happens, part of the brain cannot get the blood and oxygen it needs and so it dies. This in turn can lead to brain damage often resulting in impairment in speech, movement and memory," he said.

"There are two main types of stroke, ischemic and haemorrhagic. Ischemic strokes accounts for about 83 per cent of all stroke cases and occurs when a blood clot, or thrombus, develops and blocks blood flow to that part of the brain. Not to be mistaken for an embolism which occurs when a blood clot forms somewhere in the body and ends up in the brain causing damage. A haemorrhagic stroke, though not as common as ischemic strokes are far more lethal and occurs when a blood vessel ruptures in the brain. It is important to note, aneurysms are weak points that may occur in blood vessels that can rupture causing strokes in younger people," he said.

According to Dr Deyalsingh the symptoms of a stroke include:

• Sudden weakness or numbness of the face, arm and leg usually on one side of the body.

• Difficulty talking or understanding speech

• Sudden loss of vision in one or both eyes

• Unexplained dizziness or unsteadiness or falls

• Sudden onset of severe headache

He said, "A stroke is a medical emergency and anyone suspected of having a stroke should be taken to the hospital immediately as prompt treatment is crucial to the patient's recovery. In most cases when a person has a stroke there is a level of confusion that can occur making it difficult for them to explain to those around them what is going on. We often refer to it as a brain attack because that is what it is – an assault on the brain that hinders speech, movement and memory."

According to Dr Deyalsingh, there are numerous risk factors for a stroke that are out of our control but there are several that can be kept in line through proper nutrition and medical care. Risk factors for stroke include the following:

• Over age 55

• A family history of stroke

• High blood pressure

• High cholesterol

• Smoking cigarettes

• Diabetes

• Obesity and overweight

• Cardiovascular disease

• A previous stroke or transient ischemic attack (TIA)

• High levels of homocysteine (an amino acid in blood)

• Birth control use or other hormone therapy

• Cocaine use

• Heavy use of alcohol

How is a stroke diagnosed?

Physicians have several tools available to screen for stroke risk and diagnose an active stroke. These include:

• Physical assessment – blood pressure tests and blood tests to see cholesterol levels, blood sugar levels, and amino acid levels

• Ultrasound – a wand waved over the carotid arteries in the neck can provide a picture that indicates any narrowing or clotting

• Arteriography – a catheter is inserted into the arteries to inject a dye that can be picked up by X-rays

• Computerised tomography (CT) scan – a scanning device that creates a 3-D image that can show aneurysms, bleeding, or abnormal vessels within the brain

• Magnetic resonance imaging (MRI) – a magnetic field generates a 3-D view of the brain to see tissue damaged by stroke

• CT and MRI with angiography –scans that are aided by a dye that is injected into the blood vessels in order to provide clearer and more detailed images

• Echocardiography – an ultrasound that makes images of the heart to check for embolus

Dr Deyalsingh said, "In our present health care system in Trinidad, it is difficult to get a CT scan or an MRI within an hour and places the doctor in a dilemma of trying to figure out if the patient is having a haemorrhagic or ischemic stroke. The guideline from the National Institute of Neurological Disorders and Strokes (NINDS) showed that treatment within three hours may reduce significantly the mortality of the patient. Ideally the doctor should do a MRI or CT scan to determine if one can institute blood thinners. In the case of ischemic strokes, blood thinners will help but will be detrimental in a hemorrhagic stroke making the person bleed more."

How is stroke treated?

According to Dr Deyalsingh treating ischemic stroke is all about restoring blood flow to the brain. This is done by using blood clot-busting drugs such as aspirin, heparin, or tissue plasminogen activators that must be administered within three hours of the