STROKE: THE PREVENTABLE SILENT KILLER

Stroke has been identified as a major killer and cause of disability among Malaysians. Despite the sudden nature of this disease, it is actually preventable if symptoms are identified early and treatment given within the crucial period.

According to medical experts, strokes happen when blood flow to the brain is hindered, either due to a blocked or broken blood vessel. Without sufficient oxygen and nutrients, brain cells die within minutes. The damage this incurs leads to paralysis, loss of speech and in extreme cases, death.

 

Types of Stroke

Generally, stroke can be differentiated into two main types.

1. Ischemic stroke
   This is the most common, making up 85 to 90 percent of cases. This is caused by blockage of the artery leading to the brain by blood clots or the development of fatty plaque on artery walls. Hence, incidences that may lead to a stroke are artherosclerosis (plaque formation), embolism (blood clot from the heart that lodges itself in the brain) and thrombosis (clotting that arise inside the brain itself).
2. Haemorrhegic stroke
   This type of stroke happens when blood vessels in the brain burst, causing bleeding and build up of pressure inside the brain. Uncontrolled high blood pressure, aneurism (weakening and bulging) of blood vessels and arteriovenous malformation (AVM) has been identified as the main causes.

 

Additionally, mini-strokes can also occur when blood supply disruptions to the brain happen for short durations. These are also known as Transient Ischemic Attacks (TIA). While mini-stroke symptoms disappear quickly, they serve as grave warning of an impending full-blown stroke in the near future.

 

Early Warning Signs to Know

Recognizing early signs of a stroke is paramount because every minute after an attack determines how much brain tissue is damaged as a result.

The Malaysian Ministry of Health (MoH) urges the public to use this guide to enable fast identification of stroke victims:

B (Balance): Loss of balance when walking or standing.
E (Eyes): Blurred or double vision.
F (Face): Partially sagging face or a lopsided smile.
A (Arms): Weaker arm on one side or numbness.
S (Speech): Slurred speech that is difficult to comprehend.
T (Time): Get medical attention fast if any of these symptoms are observed.

Other symptoms may include sudden severe headache, dizziness, confusion and hemiplegia or one-sided body paralysis. MoH guidelines state that proper treatment within four hours of symptom onset is crucial to ensure the best recovery.

 

Causes and Risk Factors

Strokes do not happen suddenly, out of the blue. It is triggered by many risk factors that can be controlled and even prevented.

Some main factors include:

• High blood pressure (hypertension)
• High cholesterol and atherosclerosis
• Diabetes
• Smoking and high alcohol intake
• Atrial fibrillation (irregular heartbeat)
• Inactive lifestyle and obesity
• Age and genetics

 

"Unhealthy modern lifestyles, with frequent high fat diet, barely exercising and smoking are the biggest contributors to the rise of stroke cases in this country", quipped a local vascular neurologist.

 

Treatment and Rehabilitation

When someone is suspected of having a stroke, urgent investigation in the form of brain CT scan or MRI is done to determine if it is an ischemic or hemorrhagic type. Other tests may include blood work, electrocardiogram (ECG) and angiography which will be used to evaluate the condition of the heart and blood vessels.

With ischemic stroke the main treatment is a clot dissolving medication, tissue plasminogen activator (tPA). This must be given within the first four hours of a stroke. In some cases, a mechanical thrombectomy may be necessary. This is when a fine tube is introduced via an artery to remove the clot blockage.

Treatment for hemorrhagic stroke in centered on controlling blood pressure, reducing brain swelling and potentially surgery to stop the bleed.

After the emergency is over, patients face an intensive recovery period which involves physiotherapy, speech therapy and psychological support. This process is necessary to help patients recover physically and mentally.

 

Prevention

These easy yet effective steps may help prevent the occurrence of stroke. Some expert advice are:

1. Regular monitoring of blood pressure and sugar level.
2. Stop smoking and limit alcohol intake.
3. Enjoy a balanced diet – high in fruits, vegetables and whole grains.
4. Exercise at least 30 minutes daily, five times a week.
5. Maintain an ideal body weight with adequate sleep.
6. Handle stress well with leisure activities or exercise.
7. Go for regular medical checkups, especially for those above 40’s.

 

Conclusion

Stroke is called the "silent killer" because they usually happen without warning. Despite this, the disease can be prevented and treated provided we have proper awareness and act fast. Being able to spot tell-tale early signs should be common knowledge among the general public. When they appear, medical attention must be sought fast. Where stroke is concerned, every minute matters. Each delayed minute may be the difference between life and permanent disability.

Dr. Melati Khalid
Expertise: Neurosains
Department of Biomedical Sciences
Faculty of Medicine and Health Sciences
Universiti Putra Malaysia

Date of Input: 27/10/2025 | Updated: 27/10/2025 | nadia_rahman