Brain strokes not an 'elderly people's disease', hitting those below 45 increasingly: Neurologists

Once an "elderly people's disease", brain strokes are now hitting an increasing number of people below the age of 45, neurologists say, primarily holding the perils of modern-day lifestyles and substance abuse responsible for the medical emergency.

And ahead of the World Stroke Day on October 29, they are calling for facilitating timely diagnosis by setting up at least one stroke unit in every district of the country to improve the situation.

In the West, reports say, the possibility of a brain stroke in young people is between 3.5 and 8 per cent. In India, one-fourth of the total occurs to those below 45, meaning one in every four persons suffers a brain stroke, said Dr Padma Srivastava, chief of AIIMS Neurosciences Centre.

The Indian Council for Medical Research estimates one person suffers a stroke every three seconds in the country and a death is reported every three minutes. Conventional risk factors such as diabetes and hypertension, smoking, tobacco use, obesity and sedentary modern-day lifestyles are leading to strokes among those below 45.

Air pollution could also act as a trigger for a stroke and neurology experts across the globe are looking into it.

There has been an increase in stroke cases in middle-income countries in Asia, especially India and China. But the countries in Europe have reported fewer incidences of brain stroke owing to timely health check-ups and healthier lifestyles.

Dr Pushpendra Nath Renjen, senior consultant, Neurology, at Indraprastha Apollo Hospitals, said more and more stroke incidences are being witnessed among young people who are into illegal drugs and substance abuse. There has been a 25-30 per cent reported increase in stroke cases among the younger generation in one year, he added.

Another senior doctor at AIIMS said there is a lack of awareness around brain strokes in India. Almost 75 per cent of the stroke burden of the world is in low-middle-income countries such as India and China mainly due to a lack of "recognition and action", he said.

Early symptoms of stroke can be recognised through BEFAST sudden onset of symptoms such as balance problem, eye problems, facial drooping, arm drift and slurred speech.

"What is more crucial to treating stroke is getting the patient treated within the golden hour. The 'golden hour' varies from patient to patient, depending on the severity of the stroke, which can range between one hour to four hours," Dr Renjen said.

While there have been many medical interventions to treat strokes, mechanical thrombectomy remains the crucial treatment and there have been cases where stroke patients above 80 years of age have been treated successfully through intravenous thrombolysis.

"The best way to prevent strokes is through regular blood pressure checks, blood sugar tests, and screening for doppler of the neck, said Dr Vinit Suri, senior consultant, Neurology, at Indraprastha Apollo Hospitals.

Suri explained, 80 per cent of strokes are preventable and require simple measures to control blood pressure, diabetes, high cholesterol, obesity and choose better life-style choices, including regular exercise, stopping smoking and tobacco chewing and drinking moderately.

"Everybody after 30 years should get their BP, blood sugar and cholesterol checked on regular intervals," he advised.

Considering the challenges in terms of communicable and non-communicable diseases in the country, local physicians must be trained to tackle emergency cases, Srivastava of AIIMS said.