Is it possible for you to have stroke and not know it? Here's what you need to know

Stroke or in layman's term a "brain attack" is the second leading cause of death in the Philippines, next to heart attack.

Citing the World Health Organization, neurologist and Stroke Society of the Philippines board member Dr. Joyce Tenorio-Javier told GMA News Online that stroke is "a rapidly developing clinical signs of focal or global disturbance in the cerebral or brain function lasting for more than 24 hours with no apparent cause other than of vascular origin."

In layman's terms, Mayo Clinic said stroke "happens when the blood flow to an area of the brain is cut off."

"The brain cells are deprived of oxygen and brain cells begin to die. When this happens, the abilities that are controlled by those areas in the brain lose their function," it added.

Dr. Javier said there are two main types of stroke, the Ischemic and the Hemorrhagic.

Ischemic stroke — which she said is the most common with around 70% rate in the Philippines — "is when there is a blockage or blood clot in a certain part of a blood vessel or artery in the brain."

When this happens, Dr. Javier said there will be a "decrease in blood flow or blood supply through that area and decrease in oxygen level which can lead to weakness or numbness or loss of function of a particular body part."

Meanwhile, the second type which is called the Hemorrhagic is usually seen in patients with extreme or elevated blood pressures from 180 to 200 systolic BP and above.

Dr. Javier said this happens when "there is a rupture in blood vessels which causes leakage of blood and eventually leading to hemorrhage."

How would you know if you're suffering from a stroke?

To be able to tell if you're already suffering from a stroke, Dr. Javier said you should keep the acronym BE FAST in mind.

Dr. Javier said "B" is for balance. A sign of stroke is when a person has a loss of balance, or experiences problems in balance or dizziness.

E stands for "Eyes" or having problems with the vision. F is for "Face" or when there is facial asymmetry or crooked smile.

A stands for "Arm" when a person is having trouble with arms, and displays arm weakness or numbness. S meanwhile is for "Speech," when someone is having trouble speaking or is slurring.

Finally, "T" is for "time," to remind patients to immediately call for help and go  to the nearest hospital.

According to the American Heart Association (AHA), time is of the essence when one is suffering from stroke. Immediate treatment can minimize its long-term effects and even help reduce the risk of death from stroke.

AHA said the outcomes are the most optimal when patients immediately receive treatment within 60 minutes "Golden Hour" window following the onset of the symptoms.

Can you be suffering from stroke and not know it?

Dr. Javier said it is possible for you to have stroke and not know it. There is a thing called "silent stroke," where patients have mild symptoms.

"Sometimes it will depend on the blood supply or the blood vessel involved para masabi natin na magkakaroon ka ng symptoms kasi some of the patients have mild symptoms or 'yun nga nagre-resolve nga spontaneously," Dr. Javier explained.

She's had patients who only learned of having suffered from stroke after an MRI or CT scan. The patient might have not noticed since the blood vessel involved is "not too large to cause significant symptoms or impairment."

But even if the symptoms are mild or it's considered a silent stroke, Dr. Javier said it is still dangerous because once you suffer from it, you will have an "increased risk" to have a recurrent stroke in your life time.

"The more na mas fragile and mas let's say mas mahina yung wall or lining ng mga blood vessel natin, mas mataas yung risk na magra-rupture ito," Dr. Javier said.

"Let's say once you experience a stroke or let's say you have several silent stroke meaning even the small vessels that are involved na nawawalan ng blood supply if it becomes like more vessels are involved and then eventually it can lead to a greater problem which is a large vessel stroke," she added.

Does age have something to do with stroke?

Based on current studies and clinical trials, the elderly or those 50 and above are more susceptible to a stroke since their population are those who are most likely to have comorbidities such as hypertension, diabetes, dyslipidemia or increase in cholesterol.

However, Dr. Javier said the younger people are not exempted. In fact, she's had patients as young as 24 who have suffered from stroke.

She said there are modifiable and non-modifiable risk factors of stroke.

Non-modifiable is when a person has a strong family history of stroke, hypertension, diabetes which means one can have an increased risk of suffering from it.

Meanwhile, a modifiable risk factor is when a person suffers from hypertension, increased blood pressure, blood sugar, cholesterol levels.

Dr. Javier said obesity, stress, smoking, excessive alcohol, and drug use are also risk factors.

Lifestyle and diet changes

According to Dr. Javier, it all boils down to a person's lifestyle and diet.

However, Dr. Javier said the type of diet or food intake they advocate and emphasize are food with not too much salt.

"I'm not saying na yung food hindi na lalagyan ng salt or sodium kasi hindi rin maganda na wala tayogn sodium sa body so far we encourage natin na tignan natin diba yung mga nutrition facts kasi lalo na yung mga foods na may preservatives or msg, mga junk food," she said.

Dr. Javier these type of foods have excess salt, "lalo na tayong mga pilipino mahilig sa sawsawan sa patis sa bagoong or sa toyo na yun na din yung added salt we advise to lessen."

She said the AHA advocates less than 1500 mg of salt or 1/2 teaspoon to 2/3 of salt, "but of course it would vary lalo na sa mga patients na may comorbidity lalo na sa mga patient na may chronic kidney disease siyempre may certain amount na inaallow yung kanilang physician na intake."

Dr. Javier said it's also best to avoid food with trans fat, saturated fat, meat fat, and butter. She said the best source of fats are those high in omega-3 such as fish, fruits, and vegetables.

In terms of physical activity, Dr. Javier said 150 minutes of exercise a week or 30 minutes per day for 3-5 times a week is what they recommend.

If one has to try strenuous or extreme sports, Dr. Javier suggested they consult their physicians first, especially the elderly to be sure that you are fit enough to do it.

Despite stroke being a genetic disease, Dr. Javier said diet and lifestyle still has a big role

"Kumabaga if you would look at it nagsasama sama rin yung risk factors and yung diet it can affect your BP it can affect your blood sugar level your cholestrol level  or yung BMI po para ikaw ay maging obese o physically fit it all boils down to that pa din," she said.

Stroke is curable

As previously mentioned, time is of the essence when it comes to stroke, Dr. Javier said they are advocating to go to the nearest stroke-ready hospital if there is one available.

"Stroke is an emergency but it is treatable that's why we keep on emphasizing to our patients na once you've experienced these signs and symptoms of stroke then it is proper to go to the nearest hospital," Dr. Javier stressed.

"Siyempre merong mga criteria na mga cinoconsider natin for a patient to be illegible and once they reach the hospital that's why I emphasize on a stroke-ready hospital siyempre mas complete yung facilities and let's say yung mga equipment there when we stay a stroke-ready hospital there should be an available CT scan and laboratory procedures for 24 hours," she added.

Dr. Javier said there should be an access to a stroke unit, a stroke expert or neurologist.

"Most importantly we have certain or specific treatments na kasi or standard treatment for ischemic stroke we can give certain medication na what we call the IV thrombolysis which can help to let's say mabawasan yung pag-progress nung stroke," she added.

In the Philippines, the local Angels Team in partnership with the Stroke Soceity of the Philippines advocates #StrokeDOntStayAtHome campaign initated by the World Stroke Organization and the Angels Initiative at the global level.

This campaign "aims to encourage persons experiencing signs and symptoms of stroke (“BE FAST”) to seek emergency care regardless of the pandemic situation.

"Despite the pandemic, stroke remains to be a medical emergency so people with stroke should not just stay home but go to the emergency room/hospital to get appropriate and immediate treatment," it added. — LA, GMA News