World Stroke Day is observed annually on October 29th to raise awareness about stroke prevention and treatment. This year's theme is "support for life after stroke" to highlight the needs of stroke survivors and caregivers. Stroke is a leading cause of death and disability worldwide. Risk factors include high blood pressure, heart disease, diabetes, unhealthy diet, smoking, and excessive alcohol. Symptoms can include numbness, confusion, vision problems, trouble walking, and severe headache. Treatment focuses on early diagnosis and management to limit disability. Prevention strategies emphasize lifestyle changes like quitting smoking, healthy diet, exercise and controlling blood pressure and cholesterol.

1. Presentedby: Guidedby:
Dr.SadhanaMeena(resident) Dr.maheshverma(Asso.Proff.)
Dep.Ofcommunitymedicine Dep.Ofcommunitymedicine
S.M.Smedicalcollege&hospital S.M.Smedicalcollege&hospital
RECENT ADVANCES

2. WORLD STROKE DAY
• World Stroke Day is observed on October 29 to
underscore the serious nature and high rates of stroke,
raise awareness of the prevention and treatment of the
condition, and ensure better care and support for
survivors.
• The annual event was started in 2006 by the World
Stroke Organization(WSO)and the WSO declared stroke a
public health emergency in 2010.

3. Theme - #upagainafterstroke:support for
life after stroke

4. • In 2018, the theme of the campaign is ‘support’
and the focus of campaign is raising awareness
of key issues and needs of stroke survivors and
caregivers, in order to achieve the best possible
quality of life after stroke.

5. Previous themes:
• 2018- #upagainafterstroke :support for
life after stroke.
• 2017- stroke is avoidable- know your
health status.
• 2016- face the facts-stroke is treatable.
• 2015- I am women
• 2013- Brain, stroke and kidney
• 2012- Because I care..
• 2010- 1 in 6 campaign

6. Facts:
• In 2013 approximately 6.9 million people had an ischemic
stroke and 3.4 million people had a hemorrhagic stroke.
• In 2015 there were about 42.4 million people who had
previously had a stroke and were still alive.
• Between 1990 and 2010 the number of strokes which
occurred each year decreased by approximately 10% in
the developed world and increased by 10% in the
developing world.
• In 2015, stroke was the second most frequent cause of
death after coronary artery disease, accounting for
6.3 million deaths (11% of the total).

7. Facts contd..
• About 3.0 million deaths resulted from ischemic stroke
while 3.3 million deaths resulted from hemorrhagic
stroke. About half of people who have had a stroke live
less than one year.
• According to the WHO, stroke is the leading cause of
death for people above the age of 60 and the fifth
leading cause in people aged 15-59.
• In India, ICMR estimates in 2004 indicated that stroke
contributed 41% of deaths and 72% of disability adjusted
life years amongst the NCD.
• In India, about one-fifth of all strokes occur below the
age of 40(called “strokes in the young”)this attributed to
our “young population” and shorter life expectancy”.

8. Facts contd…
Everytwoseconds,someoneintheworldsuffersastroke.
Everysixseconds,someonediesofastroke.
Everysixseconds,someone'squalityoflifewillforeverbechanged–they
willpermanentlybephysicallydisabledduetostroke.

9. Mortality impacts of stroke and
others diseases:
• An estimated 17.3 million people died from CVDs in 2008,
representing 30% of all global deaths. Of these deaths, an
estimated 7.3 million were due to coronary heart disease
and 6.2 million were due to stroke.
• In 2008, AIDS-related deaths total 2.0 million.
• 1.8 million people died from TB in 2008.
• 247 million cases of malaria in 2006, causing nearly one
million deaths, mostly among African children.
As conclusion it has been observed that stroke kills more
people each year than AIDS, tuberculosis and malaria put
together.

10. Insightintothisyear’sthemerationale:
The Global Stroke Bill of Rights, published in 2016 identified key
aspects of recovery to be included in this important advocacy tool.
identified the following support as being most important to
recovery:
Be provided with hope for the best possible recovery.
Receive psychological and emotional support.
Be included in all aspects of society regardless of any disability.
Receive support (financial or otherwise) to ensure surviour
cared for in the longer term.
Be supported to return to work and/or other activities.
Get access to formal and informal advocacy.
Be connected to other stroke survivors and caregivers.

11. Stroke research programs in
India:
1. WHO STEPS Program -The Global Stroke Initiative launched in
2004 by the WHO provides guidance through its STEPS program
to generate population-based data on burden of stroke and to
use such data to develop strategies for prevention and
management.
2. INTER STROKE - This is a large, international case-control
study(2008) .
3. INSPIRE( Indian Stroke Prospective Registry)- INSPIRE is a
large, multi-center prospective pilot registry whose objective is
to determine etiologies, clinical practice patterns and outcomes
of stroke in India.(2009)

12. Contd..
4.PURE(Prospective Urban Rural Epidemiology) is a large-
scale epidemiological study that plans to recruit
approximately 140,000 individuals residing in >600
communities in 17 low-,middle-, and high-income
countries around the world.
5. NPCDCS (National program on Prevention and Control of
cardio vascular disease, diabetes and Stroke.)(2008)

13. Stroke:

14. Types of stroke:

15. Major Risk factors:
1. Atherosclerosis.
2. Increased tendency of the blood to clot, due to a
genetic condition.
3. High blood pressure.
4. Heart disease.
5. Diabetes.
6. Unhealthy diet.
7. Lack of exercise, which can cause obesity and lead to
diabetes, high blood pressure, and atherosclerosis
8. Tobacco use, as it damages the blood vessels
9. Drinking too much alcohol.

16. Stroke symptoms:

17. Stroke Warning Signs
• Sudden numbness or weakness of the face, arm or leg,
especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or
coordination
• Sudden, severe headache with no known cause

18. Signs contd..

19. Treatment:
• Early recognition and diagnosis of stroke using validated tools
outside hospital environment can help save life and limit disability .
Specifically the FAST test is a lay approach to diagnose stroke and is
widely used to raise awareness about early recognition of stroke
among the public in developed countries
• Acute management of acute thrombotic stroke include intravenous
thrombolysis within 3 hours of onset of symptoms, use of aspirin
within 48 hours and decompressive surgery for malignant middle
cerebral artery infarction. Thrombolysed patient are usually
transferred to specialized acute stroke units where screening for
swallowing and nutrition are done. Early mobilization is considered a
priority in order to prevent disabilities and promote function.
• Post-acute management of stroke patients depends on the severity
and site of lesion

20. Disorders after stroke:
1. Pain
2. Depression
3. Cognitive decline
4. Spasticity
All of these disorders can be diagnosed and there are
treatments available for most of them.

21. prevention
• Primary prevention interventions are expected to target at behavior
modification such as reduced smoking, alcohol and salt consumption
patterns and increased physical activity.
• Secondary prevention: Optimal medical therapy that includes
antiplatelet therapy, statin therapy, and risk factor modification, is
recommended for all patients with carotid artery stenosis and TIA or
stroke as a secondary measure of Prevention.
• Tertiary prevention: rehabilitation
The WHO study showed that nearly three quarterly of all registered
stroke patients had associated diseases, mostly in the cardio vascular
system or of diabetes.

22. 6-point prevention plan:
1) Keep your blood pressure under control.
2) Exercise moderately for at least 150 min a week.
3) Eat a nutritious plant based diet.
4) Keep your cholesterol with in norms.
5) Don’t consume more than two standard alcoholic drinks per
day.
6) Don’t smoke or quit if you do.
Ref:- harvard medical school

23. The WHO study showed that nearly three
quarterly of all registered stroke patients had
associated diseases, mostly in the cardio
vascular system or of diabetes.

24. Thank you