World Stroke Day 2025: Every Minute Counts
World Stroke Day is observed on 29th of October every year, a day dedicated to spread awareness about this disease with profound morbidity and mortality , huge social and financial burden on families in particular and impact on health care system in general. First observed in 2006 by WHO considering the rising incidence of Stroke World over. Globally , stroke is the second leading cause of death and the third leading cause of disability. The World Health Organisation estimates that 15 million people suffer a stroke each year, of these nearly 5 million die and another 5 million are left permanently disabled. Despite advances in treatment , stroke’s impact remains huge and uneven, especially in low- and middle-income countries where awareness and access to timely care lag behind.
What is a Stroke?
It is an acute medical condition wherein blood supply to a part of brain is hampered due to either occlusion or rupture of a vessel supplying particular part of brain leading to development of neurological defecit. 85% of the strokes are ischemic wherein the vessel is occluded and remaining 15% are hemorrhagic – occurring due to a ruptured vessel.
Who gets a Stroke?
Mostly a disease of elderly in whom the underlying risk factors for Stroke are present for a long time whether known or unknown. These risk factors include Hypertension, Diabetes mellitus, smoking, Cardiac diseases like Atrial fibrillation which connotes an abnormal irregular rhythm usually seen in elderly population or a manifestation of myocardial disease like heart failure, cardiomyopathies etc. Pertinent to mention about the role of diet and lifestyle in development of stroke, a diet containing high fat, oil and salt content accelerates the process of atherosclerosis which underlies the pathology of ischemic strokes. A sedentary lifestyle promotes the development of obesity which is a risk factor for Stroke.
The etiology of Stroke in young population is different , it may be due to underlying genetic factors, connective tissue disorders, hypercoagulable states, vasculitis , structural heart diseases etc.
How to identify a Stroke?
It is an acute event and its recognition is of utmost importance considering the essential and fixed time window when appropriate treatment may be instituted to decrease or avoid the neurological defecit after the stroke. The acronym “FAST” may should be remembered where in F-Face droop or numb feeling on one side of face, A-Arm weakness, the person may not be able to lift one arm, S-Speech difficulty, the speech may become slurred or incomprehensible, T-Time to intervene immediately, the person should be rushed to nearby health facility immediately.
Never wait for the defecit to improve on its own, EVERY MINUTE COUNTS as the theme of this year’s World Stroke Day rightly suggests. In case of an ischemic stroke where a blood vessel is occluded, the same occlusion may be relieved by injecting a thrombolytic agent which breaks the clot and restores the blood supply of the affected part of the brain, however this technique can be utilised in a fixed time period after the onset of first symptom, the so called Window period which is 4.5 hours beyond which it cannot be used , so timely identification and intervention are of paramount importance to lessen the burden of morbidity and mortality.
How to treat a stroke?
Once a person develops stroke , he/she should immediately shifted to a hospital and investigations like ECG, CBC, Blood sugar, PT/INR, Non-contrast CT scan of brain should be done. These investigations broadly rule out stroke mimics. If CT scan of brain rules out hemorrhagic stroke then urgent thrombolysis should be planned whether CT scan is normal or suggests an early ischemic stroke. Blood pressure should be <185/110mmHg and contraindications to thrombolysis should be ruled out. Once done with the above work up thrombolysis should be done with intravenous thrombolytic agent, hemodynamic parameters and sensorium should be monitored closely. In case of a hemorrhagic stroke , a neurosurgeon should be called in if the bleed is amenable to surgery otherwise treatment should focus on decreasing intracranial pressure and maintaining blood pressure .
How to decrease the stroke burden in the community?
Primary focus should be on prevention: the power we have-
While rapid treatment matters enormously, avoiding stroke is even better. Numerous risk factors are modifiable which include high blood pressure (hypertension), smoking, diabetes, high cholesterol, obesity, poor diet and inactivity and atrial fibrillation (irregular heart rhythm). Monitor blood pressure regularly, quit smoking, control diabetes and cholesterol, eat healthy diet and do regular physical activity. Routine checkups allow for monitoring and managing risk factors. Early identification of arrhythmias, carotid artery disease and other warning signs can result in preventive action before stroke occurs. It is estimated that up to 80 % of strokes could be prevented by addressing these modifiable risk factors. Here in India and specifically in Kashmir, awareness about stroke remains inadequate. Many patients arrive late, at centres not equipped for stroke management. If you suspect a stroke—go to the hospital immediately. Do not delay thinking it will improve on its own. Hospitals must ensure stroke-ready facilities, and public education must reach rural and urban populations alike.
The journey after initial treatment: recovery matters
Even when the stroke is treated promptly, recovery varies widely. Surviving a stroke is the beginning of a long journey. Recovery depends on the severity and location of brain damage, age, overall health and speed of treatment. Rehabilitation plays a crucial role. Physical therapy, speech therapy and occupational therapy form the backbone of post-stroke recovery. The sooner rehabilitation begins, the better the outcome. The importance of emotional and social support can not be ignored. Stroke survivors and their famalies often grapple with anxiety, depression and social isolation. Local support groups, counselling and family education play a critical role in emotional well being of the survivors.
Preventing recurrence:
Managing risk factors, strict adherence to medication and healthy lifestyle choices cannot be overlooked. After an initial episode, the risk of recurrence is high , making continued vigilance mandatory.
Role of AI in stroke?
Artificial intelligence (AI) is revolutionizing healthcare, especially in stroke medicine where quick diagnosis and treatment are vital. The integration of AI technologies across the stroke care continuum, from initial diagnosis to outcome prediction, represents a significant advancement in our ability to deliver precise, personalized care in a timely manner. Recent years have witnessed an exponential increase in publications exploring AI applications in stroke medicine, with studies ranging from automated imaging analysis to prediction models for patient outcomes. The increase in research activity, especially since 2019, highlights the advancement of AI technologies and their acknowledged potential to address significant challenges in stroke care.
Role of Public Health Campaigns:-
Global and regional campaigns significantly improve stroke awareness and reduce delays in seeking timely care. Tools such as mobile apps, leaflets, social media and community meetings have been shown to increase recognition of stroke symptoms and promote preventive care. Innovative campaigns target schools, work places and health care settings, engaging people of all ages. In this regard Department of Neurology Government Superspeciality Hospital is not behind, we have been organising CMEs, public place events like “Run for Stroke” and delivering this crucial message to the masses via print and social media.
Challenges ahead:
Despite progress, many populations remain under-informed or underserved. In rural areas or developing nations, limited access to emergency care and specialists continues to hamper outcomes.
There is also a growing need for culturally and linguistically adapted educational materials to bridge gaps among diverse populations. Addressing gender, economic and geographic disparities remains a public health priority.
Author is Professor and Head, Department of Neurology, Govt Superspeciality Hospital, Srinagar
