By Abba Muhammad Tawfiq

Garsa is a sinister superstition label ubiquitously attached to stroke patients particularly in some Hausa-Fulani community. The conception of cerebrovascular accident as demon-ridden problems is continuously denying its victims the pleasure of urgent medical intervention. This delay in appropriate medical care inevitably complicates the patients’ condition and make it even difficult to treat after all the efforts of traditional treatments have proved abortive.

The vagueness over which the accident is traditionally considered as “being possessed” ailment is refuted and cleared by sophisticated medicinal sciences. This piece will help to comprehensively elucidate more on what cerebrovascular accident and its management entail.

Adequate life sustaining nutrients and oxygen necessitate the survival of the building blocks of life. Hence, the circulatory system is primarily programmed to efficiently execute the function of meeting the fundamental requirements of body tissues and cells. This however can successfully be achieved by the way of transporting nutrients and metabolic wastes to and away from the body. Also, establishing a stable homeostatic state in all the tissue fluids by transporting biological chemicals called hormones from the part of its synthesis to where its effect is necessary in order to ensure an optimally continuous survival and robust function of the body tissues and cells through the means of blood and blood vessels.

Physical and organic pathology that disorient the rudimentary pattern of circulation that shape various tissues give rise to life threatening complications. And this conceptualizes the basis of “STROKE” with regards to brain.

Stroke otherwise known as cerebrovascular accident occurs as a result of an interruption to or loss of blood supply to a part of the brain from an assault to the concerned arterial supply to the brain. The American Heart Association defined stroke as “a disease that affects the arteries leading to and within the brain.

Globally, stroke is said to be the leading cause of morbidity and mortality. It is the No. 5 cause of death and a leading cause of disability in the United States. The current prevalence of stroke in Nigeria is 1.14 per 1000 while the 30-day case fatality rate is as high as 40%.

On pathological ground, the disease lends itself to two categorical divisions, namely; Ischemic stroke and haemorrhagic stroke.

The former is the most common type of stroke and associated with blocked or narrowing of the brain’s blood vessel caused by fatty plagues which build up in the blood vessels or by blood clots or other debris that travel through the bloodstream, most often from the heart, and lodge in the blood vessels in the brain. This consequently leads to the death of brain tissue from poor nutrients and oxygen supply to the brain.

However, the latter occurs due to a rupture or leakage in blood vessel in the brain. This is mainly associated with atherosclerosis or a local dilation of the blood vessel (aneurysm) which leads to the burst of the blood vessel hence leading to hemorrhagic stroke

The predisposing factors that lead to cerebrovascular accident can be categorized into modifiable and non modifiable factors. And the major modifiable risk factor for stroke is sedentary lifestyle. People’s manner of living exerts impact on their state of well-being. Obesity caused by unhealthy diet, excessive alcohol consumption and smoking may result in high blood pressure or deposition of fatty droplets in the arterial wall causing arterial narrowing or bursting, thus consequently leading to stroke. Others include uncontrolled hypertension, gestational or pregnancy hypertension and diabetes.

The non modifiable risk encompasses factors such as family history and ageing. Although stroke does not wreck havoc on any age or age group exclusively, but older individuals are at higher risk of having stroke than other individuals. This is because the complications of ageing are mainly associated with arterial narrowing and loss of elasticity. Hence the susceptibility of the arteries to be damaged by fatty droplets and other debris in circulation, thus; resulting in stroke is high.

History of severe idiopathic headache, dizziness and vomiting are being clinically associated with haemorrhagic stroke. Facial, arm, or leg weakness on either or especially one side of the body denotes the onset of stroke. Other symptoms include confusion or trouble in understanding other people, difficulty speaking, visionary problems, trouble with walking and coordination.

Obesity and or weight control by the means of lifestyle/dietary modification and exercises are the mainstay for the prevention of stroke. The revelation of the aforementioned symptoms of stroke should urgently be reported to a close healthcare facility for immediate care and complications minimization. Notable blood pressure should be regulated through exercises and medications.

Multidisciplinary approach is essential for the effective management of stroke. This comprises a team of a well trained healthcare professionals and most precisely doctors, speech therapist, occupational therapist and physiotherapists. Surgical procedures can also be employed to repair vascular damage in the case of haemorrhagic stroke, while obstruction of adequate blood flow and oxygen supply to the brain by clogged garbage in the vessels can be flushed out through the use of medication.

The physiotherapy specialty covers a wide scope in the management of patients with neurological conditions such as stroke and their aftermath on the body function. Following stroke, patients show and suffer from multiple complications such as muscles flabbiness, accumulation of secretion in the lungs and loss of speech, loss of balance and coordination, which may not be or difficult to manage by medication.

Various physiotherapy techniques are applied to improve muscle physiology, prevent deformity, improve coordination, facilitate airways clearance by removal of accumulated secretions in lungs and improvement of overall quality of life. Physiotherapists therefore bridge this gap by playing restorative and preventive role in restoring the lost function and preventing post stroke complications.

Abba Muhammad Tawfiq, graduate of Medical Rehabilitation, University of Maiduguri, Borno State, Nigeria.

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