Acute Stroke: A Matter of Life or Death

Dr. TSUI To Shing, Alex

Resident Medical Officer

Specialist in Emergency Medicine

According to the latest figures, around 3,000 people die from stroke each year in Hong Kong, making it the fourth leading cause of death. It is also on the rise in the younger population. The physical and psychological complications of stroke, though severe, are preventable with early diagnosis and treatment.

Acute stroke can be classified into 2 main types, namely ischaemic stroke and haemorrhagic stroke. Nearly 80% of acute stroke cases are ischaemic, in which brain tissues are deprived of blood and oxygen supply due to the blockage of cerebral arteries. Haemorrhagic stroke occurs when blood vessels burst and bleed into the brain, causing damage to brain cells.

Acute stroke treatment is time-critical. At Hong Kong Sanatorium & Hospital, triage nurses and doctors are always on high alert for emergency stroke management. A multidisciplinary acute stroke team will swing into action upon arrival of patients with suspected stroke. The Resident Medical Officer will help determine the time of symptom onset, assess patient’s consciousness level, maintain patient’s airway, control blood pressure, conduct examinations  (blood test, echocardiogram, computed tomography scan) and perform necessary procedures (intravenous infusion,  placement of urinary catheter). He/she will also work hand in hand with other specialists to arrange proper tests and treatments as soon as possible.

Causes of Stroke

While the risk of stroke increases with age, certain risk factors can be controlled. The primary risk factors of stroke include the 3 highs (high blood pressure, high cholesterol and diabetes), obesity, smoking, drinking alcohol, lack of exercise, drug abuse, coronary heart disease, atrial fibrillation, sleep apnoea, cerebrovascular malformations, cerebral aneurysm, and family history of stroke etc. People who have a past history of stroke, mini-stroke (transient ischaemic attack) or myocardial infarction also belong to the high-risk group.

The risk factors above can be alleviated by lifestyle modification and disease control. With diagnosis and treatment by family physicians and specialists, the risk of stroke can be reduced.

Lifestyle Modification Prevents Stroke

The risk of stroke can be reduced with regular check-ups by family physicians, good diabetic and blood pressure control, and the following lifestyle modifications: 

• Quit smoking and drinking alcohol.
• Keep healthy weight and waistline: according to WHO, the ideal BMI for Asians is 18.5 - 23.0, and the waistline should be below 90 cm for male and below 80 cm forfemale.
• Maintain a balanced diet: eat more vegetable and fiber, and avoid high-salt, high-fat and high-sugar food.
• Do moderate exercise. Do not sit all the time.
• Keep ideal blood pressure, blood sugar and blood cholesterol levels.