“Stroke is the fourth most common cause of death and the leading cause of disability in South Africa. The good news for stroke patients, however, is that much can be done to treat and prevent this condition. A dedicated national initiative is now addressing the needs of these patients.”
This is the view of Dr Patty Francis, one of three neurologists who manage a dedicated acute stroke centre at Netcare Umhlanga Hospital, in Durban. “It should be emphasised that the damage a stroke causes to the brain can often be minimised, substantially reducing disability and death among those who are affected, if it is identified and treated both appropriately and early on using thrombolysis, a process in which blood clots are broken down using medications,” she observes.
Early treatment can reverse effects
“South Africans should be aware of the fact that the effects of a stroke can often be reversed if it is treated within four-and-a-half hours of the onset of the condition,” she reiterates. “It has been shown that the sooner the patient receives appropriate emergency treatment at a dedicated centre, after the commencement of a stroke, the better their chances of survival and recovery.”
Dr Lynn Katsoulis, special projects manager at Boehringer Ingelheim, who is leading the ambitious initiative that aims to establish accredited stroke centres at all major cities around the country, agrees. She says that all too often people observe a stroke but do not recognise the symptoms and hope the affected individual will recover soon.
“Anyone who is suspected of having suffered a stroke should immediately be rushed to a treatment facility specialising in this life-threatening condition. A stroke is a medical emergency and every minute counts when it comes to managing patients.
“Knowing the symptoms of this condition can be lifesaving,” she argues. “It is critical that stroke patients are diagnosed and treated both speedily and correctly. This is why it is so important that we put in place more specialised facilities that have the necessary expertise and technology to deal with this condition, which is destroying so many lives in this country.”
The most common type of stroke occurs when a clot in a blood vessel disrupts the blood supply to a part of the brain. This causes the affected area to become starved of oxygen with rapid death of brain cells. A stroke may lead to an individual becoming disabled, unable to care for themselves, and may even result in death. A stroke can affect any area of the brain and impact on multiple areas with negative consequences for physical and cognitive functioning.
Says Dr Francis: “Stroke patients require a combination of treatments, from emergency treatment through to physiotherapy, occupational and speech therapy to ensure the best possible chance of recovery and optimise their quality of life. Each stroke patient is unique and each patient needs highly specialised, individualised treatment to give them the best possible outcome.”
“This is the reason, as it has been determined internationally, that it is best to treat this serious medical condition at a specialised multidisciplinary stroke centre, which can provide a comprehensive range of services to meet the needs of each individual patient,” she adds.
The specialised stroke centre at Netcare Umhlanga Hospital was established to provide the people of KwaZulu-Natal with just such a service. The hospital’s general manager, Marc van Heerden, says that the facility is one of only three that have so far been registered for accreditation as stroke centres of excellence in the province.
As soon as the national accreditation by the South African Stroke Society (SASS) is launched, Netcare Umhlanga Hospital will more than likely be one of the few hospitals that will meet the strict expertise and technology requirements set by SASS, says Dr Katsoulis.
The importance of an integrated approach
Dr Francis, who developed the stroke service with two other resident neurologists at the hospital, points out that the multidisciplinary team at Netcare Umhlanga Hospital treat stroke patients in strict accordance with SASS guidelines. “These guidelines affirm that treatment for patients with acute stroke should be managed through an integrated stroke service, working according to a strict set of scientifically-derived treatment protocols.”
The team at Netcare Umhlanga Hospital comprises emergency personnel, radiologists, neurologists, neurosurgeons, cardiologists, a vascular surgeon, physiotherapists, occupational therapists and a speech and swallowing therapist. This provides seamless treatment experience for the patient, from thrombolysis to rehabilitation.
What to watch for
Anyone who is experiencing or who witnesses the sudden onset of any of the following symptoms in a person should contact an emergency medical services provider or go to the nearest stroke centre immediately:
o Facial droop — the facial muscles become weak and one side of the face droops.
o Arm or leg weakness — the person may feel weak in one or more of their arms or legs and experience numbness down one side of their body.
o Speech difficulty — the patient may slur words, use words incorrectly or be completely unable to speak.
o The person may have problems with coordination, difficulty walking or standing up, and may appear drunk to the untrained eye.
o The person may experience sudden blindness in one or both eyes and a severe headache with no known cause.
It is thanks to the tireless efforts of the team members that this stroke facility has been made a reality. It is a great privilege to be able to bring this 24-hour life-saving service to the people of our province.