Mind your Brain Series: The Sensing Brain

“Stroke is the second leading cause of death in the Philippines. It has a prevalence of 0.9 per cent. Ischemic stroke comprises 70% while hemorrhagic stroke comprises 30%,” said Dr Peter Allan A. Quitasol, a vascular neurologist and medical specialist II from the Department of Neurology of Baguio General Hospital and Medical Center Philippines at the webinar titled “The Sensing Brain: Stroke: Diagnosis and Management”.

Held as part of the “Mind You Brain Series”, the webinar was organised by UTAR Centre for Corporate and Community Development in collaboration with Malaysia Mental Literacy Movement, Centre for Research on Non-Communicable Diseases under UTAR M. Kandiah Faculty of Medicine and Health Sciences (MK FMHS), and Faculty of Science on 9 November 2022 via Zoom and Facebook Live.

Dr Peter Allan A. Quitasol

According to Dr Peter, stroke is a clinical syndrome consisting of rapidly developing clinical signs of focal disturbance of cerebral function secondary to a vascular event. “Stroke constitutes a major contribution to morbidity and mortality in both developed and developing countries,” said Dr Peter. He then explained the risk factors and the subtypes of stroke, stroke recognition with BEFAST (Balance, Eyes, Face, Arms, Speech and Time) and Neuroimaging.

Risk factors of stroke

Stroke recognition with BEFAST

Besides explaining why stroke patients are rushed for treatment, Dr Peter also shared the three main principles of acute stroke care, which are to achieve timely recanalisation of the occluded artery and reperfusion of the ischemic tissue, optimise collateral flow and avoid secondary brain injury.

The ischemic penumbra

Speaking of Intravenous Thrombolysis, Dr Peter said, “IV thrombolysis with rtPA is proven to be effective in improving functional outcomes after an ischemic stroke up to 4.5 hours after symptom onset. IV thrombolysis should not be withheld because of advanced age and mild but disabling deficits.” He also shared about a useful tool for quantifying neurologic impairment which is known as The National Institutes of Health Stroke Scale, or NIH Stroke Scale (NIHSS). It enables the healthcare provider to rapidly determine the severity and possible location of the stroke.

The timeline for stroke treatment

He said, “The human brain recovers from stroke through adaptation, regeneration and neuroplasticity. Most stroke deficits will see the highest rate of recovery during the first three to six months after the stroke. We have a few types of therapy, namely physical therapy, occupational therapy and speech therapy. Rehabilitation is a process of stroke care that reduces disability and improves participation in therapy. Recovery is defined as improvements across a variety of outcomes.”

He concluded, “Acute ischemic stroke is a medical emergency in which every minute counts. Achievement of reperfusion can reverse neurologic deficits, even if it is severe and allow patients to regain function. There are two reperfusion strategies that are currently proven. They are IV rtPA and mechanical thrombectomy. Patient selection is crucial to optimise outcomes. The attitude of the clinician should be, treatment must be given unless a solid contraindication exists. Stroke is a ‘brain attack’; it is an emergency but it is treatable and preventable.”

To watch the full webinar, kindly click here.