Strokes: Timeous treatment can make a difference

Stroke is a leading cause of death and disability in South Africa, and it is critical
for people to have greater awareness of the condition and its signs and symptoms, so that a victim of a
stroke can be treated promptly and at an appropriate stroke care facility.
This is the view of Dr Biancha Mentoor, clinical improvement lead at Netcare, who was speaking during
World Stroke Day on 29 October and during National Stroke Week, 28 October to 3 November. Dr Mentoor
pointed out that many South Africans are not aware that strokes can often be successfully treated.
“Studies have shown that if a person who has had a stroke receives timeous treatment at a hospital or
stroke facility that is trained in, and appropriately equipped to, handle this complex condition which
requires specialised treatment, then the risk of mortality and long-term disability can be substantially
reduced, ” added Dr Mentoor.
“If this can be achieved, the damage caused to the brain can often be minimised, and lives can be saved.
South Africans should be aware that the adoption of healthier lifestyle choices can assist in reducing the
risk of an individual suffering a stroke,” she added.
According to the World Stroke Campaign, the organisers of World Stroke Day, this potentially dangerous
medical condition results in the deaths of some six million people every year and is the leading cause of
permanent disability globally. The South African Stroke Society (SASS) meanwhile observes that strokes are
also a leading cause of death and disability in South Africa.
Dr Mentoor says that some of the Netcare Group’s Medicross medical and dental centres and Akeso
psychiatric hospitals will be undertaking special awareness and educational drives to educate South
Africans on the causes and warning signs of strokes, as well as on possible ways of reducing their risk of
developing this condition.
Medical emergency
Dr Patty Francis, one of three neurologists who treat patients who have had a stroke at Netcare uMhlanga
Hospital near Durban, warns that a stroke should be considered a medical emergency and can potentially
occur in anyone at any age. She points out that this condition often not only impacts those who have
suffered a stroke, but also on families, workplaces and communities.
Dr Francis says that signs and symptoms may include the sudden onset of the following:
• Numbness or weakness of the face, arm or leg, especially on one side of the body
• Confusion, trouble speaking or understanding
• Trouble seeing with one or both eyes
• Trouble walking, dizziness, loss of balance or coordination
• Severe headache with no known cause.
She explains that a stroke occurs when a clot or a rupture in a blood vessel disrupts the blood supply to a
part of the brain. The affected area of the brain becomes starved of blood and oxygen, causing brain cells
to die. A stroke can cause damage to the functioning of the brain, which may result in disability and even
be fatal. Many people are disabled to the extent that they are no longer able to care for themselves and
may also require long-term rehabilitation.
There are two main types of strokes: haemorrhagic and ischaemic strokes. The former is caused by a
haemorrhage in the blood vessels of the brain while the latter results from a disruption in the supply of
blood to the brain as a result of a thrombus (blood clot) or embolism.
“The effects of a stroke can vary greatly and will depend upon the area of the brain that was affected and
the degree to which it was damaged. Some individuals may be severely affected, suffering physical and
mental impairment while others may recover fully.”
Individuals who are over the age of 55 are at greater risk of stroke. Other risk factors include high blood
pressure, diabetes, male gender, family history of stroke, high cholesterol levels, smoking and an unhealthy
lifestyle. Younger people may be at risk of stroke too, particularly some at-risk women on the contractive
pill and individuals using certain recreational drugs. By addressing these risk factors everyone can take
positive action to reduce their risk of suffering a stroke.
Strengthening stroke care
“The South African Stroke Society is in the process of developing a comprehensive accreditation system for
all stroke treatment facilities nationally in order to strengthen stroke care throughout South Africa. This
aims to enable healthcare and emergency workers to be aware of the levels of treatment that stroke
treatment facilities offer, so that they can get a patient to the facility that is best placed to treat the patient
concerned,” says Dr Mentoor.
“Netcare is fully supportive of this critical initiative, and are actively preparing our facilities based on the
personnel and material resources available within each. We have undertaken extensive stroke-specific
nursing staff training in our hospitals across the country, to ensure that comprehensive nursing care can be
offered to affected patients.”
“This is one part of an extensive project within the Group that spans from Netcare 911 emergency medical
services and our Medicross centres, where the focus is on awareness, prompt recognition of symptoms and
prompt transfer to an appropriate facility such as Netcare acute care hospitals, where we are collaborating
with our specialists and members of the allied disciplines to facilitate timeous, acute, multi-disciplinary
management of affected patients and the early commencement of in-patient rehabilitation to improve
clinical outcomes,” explains Dr Mentoor.
“The Group’s acute physical rehabilitation and sub-acute facilities also plays a key role in the case of stroke
patients who no longer need acute treatment but do require on-going in-patient rehabilitation, while our
Akeso facilities can provide psychological and psychiatric help for patients and their family members facing
the potential challenges of adjusting to life with a new neurological impairment.”
“By participating in the international World Stroke Day campaign, Netcare’s facilities aim to support the
international initiative to improve global stroke care and do our part to make South Africans more aware of
their potential risk factors and to take the necessary steps to reduce these,” concludes Dr Mentoor.