World Stroke Day 2025: Every Minute Counts

World Stroke Day is observed on 29^th 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