Stroke/apoplexy commonly occurs as a result of disorders of cerebral/brain circulation, called cerebral vascular accident (CVA). It results in unconsciousness, paralysis either of a part or one half of the body (hemiplegia), or loss of speech or vision or balance of the body. As described earlier, it can be very senous.

In this condition, there could be either thrombosis (clotting) or haemorrhage in one 6f the blood vessels of the brain, leading to the above-stated manifestations. This can be best checked by the same factors which are required for the prevention of coronary artery disease. This includes proper control of diabetes, hypertension, high blood cholesterol, high blood uric acid, and by taking a proper diet and exercise commensurate with any of the above disease(s) one is suffering from. In case one is overweight, reduction in weight is also essential for the prevention of stroke.

It should be known to all that sometimes there may be even warning signals before the occurrence of stroke. These are termed as 'transient ischaemic attacks (TIA)'. In these attacks, the flow of the blood is momentarily hampered in one of the blood vessels of the brain, causing transient spells of loss of vision/speech/paralysis of a part of the body/vertigo, etc., depending on the involvement of the vessel of the brain, supplying a particular part of the brain responsible for the above transient lesions.

Since the blood supply is only stopped/slowed for a while, the part of the body involved immediately returns to normal. If such attacks occur, especially in middle-aged persons, one should immediately report it to the physician/neurologist for proper diagnosis and prevention of a possible full-fledged stroke at a later stage. Such transient attacks may even occur repeatedly, in some cases, before the person gets a stroke causing complete paralysis. Once it occurs, i.e. complete paralysis, recovery is usually incomplete, and if brain haemorrhage occurs, it becomes a medical surgical emergency.

Hence a stroke should be given weightage comparable to a coronary artery disease or a heart attack. Both are dangerous and need equal attention, and they also have common factors for their prevention. And, if a person seriously controls the above-stated factors, like diabetes, hypertension, etc., he will certainly bear the least risk of suffering from these disorders. Public education in this respect is essential.

Caution: As soon as the stroke occurs, the patient should be immediately taken to the hospital for advice/treatment, as the first three hours from the occurrence of stroke are vital for treatment. In these three hours, is the time taken for transportation, urgent tests in the hospital, like computed tomographic (CT) scanning/magnetic resonance imaging (MRI), etc. Therefore, awareness of this limited period should be be known by all so that not a single minute is wasted in dealing with this emergency. It should be clearly understood that 'the therapeutic window' is ideally open in the first three hours only. It may be added that once a stroke occurs, it is very difficult to salvage the brain. Hence immediate recognition/ diagnosis of the condition and prompt treatment are very important. Undoubtedly, prevention is most vital.