By: Thalia Kaylyn Averil
World Stroke Day 2023 is the global commemoration of Stroke Day, observed every year on October 29. It is held with the aim of increasing public understanding about stroke and also aims to convince the public that stroke can be avoided from an early age. Stroke is the first cause of disability and the second cause of death in the world after heart disease. In 2018, Riset Kesehatan Dasar (Riskesdas) Indonesia recorded that 10,9% of the population aged over 15 years in Indonesia experienced a stroke. Before discussing ways to prevent stroke, let’s find out more about what a stroke is! Stroke is a neurological syndrome caused by injury to blood vessels in the central nervous system, either blocked or ruptured blood vessels. Stroke can be classified into two based on its cause, ischemic stroke and hemorrhagic stroke. Around 85% of strokes in the world are caused by ischemic stroke, while the rest are caused by hemorrhagic stroke. Ischemic stroke occurs if the blood
vessels that supply blood to the brain narrow so that blood flow to the brain becomes limited. Hemorrhagic stroke is a stroke caused by a blood vessel in the brain bursting, resulting in bleeding. This is caused by several things, such as high blood pressure, weak blood vessel walls, or certain medications. Each part of the brain has its own function, so the symptoms of a stroke vary depending on the location of the blood vessels in the brain that are affected. For example, injury to the arteries in the front part of the brain can result in weakness on one side or speech disturbances, injury to the back part can cause visual abnormalities, injury to the cerebellum often leads to nausea and vomiting, and injury to the brainstem results in balance disorders. However, Kementerian Kesehatan Republik Indonesia (Kemenkes RI) has created an abbreviation for the common signs and symptoms of stroke, which is “SeGeRa Ke RS”. If you encounter any of the following signs
and symptoms, promptly consult with a doctor:
- Senyum tidak simetris, sulit menelan, atau tersedak tiba-tiba (Asymmetrical smile,
difficulty swallowing, or sudden choking) - Gerak separuh bagian tubuh tiba-tiba melemah (Sudden weakness on one side of the
body) - Bicara pelo, yaitu tidak mengerti kata-kata, tidak dapat bicara, atau bicara tidak
nyambung secara tiba-tiba (Slurred speech, not understanding words, inability to speak,
or sudden incoherent speech) - Rasa kebas, baal, atau kesemutan hanya di separuh bagian tubuh (Numbness, tingling,
or loss of sensation on one side of the body) - Rabun atau pandangan salah satu mata kabur tiba-tiba (Sudden blurriness in one eye)
- Tiba-tiba mengalami sakit kepala yang hebat atau gangguan keseimbangan (Sudden
intense headache or balance disturbances) One in four people will experience a stroke in their lifetime.. However, as many as 90% of stroke cases can be prevented with good risk factor management. One risk factor that can influence is age, the risk is higher in babies under one year old and the elderly although stroke can occur at any age. When young, the risk of stroke in men is higher than the risk in women, but women have a higher risk when they are older because women tend to live longer. The risk of having a stroke is higher if someone in the family has had a stroke. Strokes can also be influenced by the environment, for example stress or living in an environment with high air pollution can increase the risk of stroke. However, the main risk factors that significantly influence the occurrence of stroke are: - Hypertension or high blood pressure
- Obesity
- Smoking
- Poor diet
- Lack of physical activity
CERDIK is an abbreviation created by the Kementerian Kesehatan Republik Indonesia (Kemenkes RI) which consists of methods that can be used to prevent non-communicable diseases, such as stroke. CERDIK consists of:
- Cek kesehatan secara rutin (Check your health regularly)
Regular health checks are one of the most important and easy ways to prevent
hypertension. Routine health checks consist of measuring blood pressure, weighing,
measuring height, measuring abdominal circumference, counting pulse, and checking
cholesterol and blood sugar levels. - Enyahkan asap rokok (Get rid of cigarette smoke)
Smoking significantly increases the risk of experiencing a stroke. Moreover, smoking not
only affects active smokers but can also impact non-smokers through secondhand smoke.
Therefore, quitting smoking is very important to reduce the risk of stroke for yourself and
those around you. - Rajin aktivitas fisik (Have regular physical activity)
Physical activity can help maintain a normal body weight and reduce cholesterol levels
and blood pressure. For adults, the recommended physical activity is 150 minutes of
moderate intensity physical activity every week. While children and teenagers should get
one hour of physical activity every day. - Diet seimbang (Balanced diet)
- Healthy foods and snacks can help prevent stroke, especially fruit and vegetables. Eating
foods low in sugar, low in fat, and high in fiber can help prevent cholesterol levels in the
body. Limiting salt levels in food can also help in maintaining blood pressure. Keeping
cholesterol and blood pressure at normal levels can reduce the chance of having a stroke. - Istirahat cukup (Get enough rest)
For adults, adequate rest is to sleep for seven to eight hours a day. - Kelola stres (Manage stress)
Stress is also one of the risk factors for stroke and should be well-managed. Things that
can be done to prevent stress include maintaining a positive mindset, engaging in
recreational activities, practicing relaxation techniques, and socializing with others.
In addition to risk factor management, early detection is also important through regular health
check-ups, especially if you have the mentioned risk factors. Apart from stroke, routine health
check-ups are also crucial to identify the presence of other degenerative diseases that may occur.
Commonly performed health check-ups include: - Physical examination by a doctor
The doctor will conduct a series of tests for vital signs, such as checking the heartbeat
and blood pressure. Additionally, a neurological examination will be performed to assess
the potential impact of stroke on the nervous system. - Computerized Tomography Scan (CT Scan)
CT Scan uses a series of X-rays to create images of the brain. It can reveal brain
hemorrhage, ischemic stroke, tumors, or other conditions. - Magnetic Resonance Imaging (MRI)
MRI uses strong radio waves and a magnetic field to provide detailed images of the brain.
MRI can detect damaged brain tissue due to ischemic stroke and brain hemorrhage
Resources
- Kementerian Kesehatan Republik Indonesia. World stroke day 2023, greater than stroke, kenali dan kendalikan stroke [Internet]. Jakarta: Kementerian Kesehatan Republik Indonesia; 2023 Oct 29 [cited 2023 Oct 31]. Available from: https://yankes.kemkes.go.id/read/1443/world-stroke-day-2023-greater-than-stroke-kenali-dan-kendalikan-stroke
- Murphy SJ, Werring DJ. Stroke: causes and clinical features. Medicine (Abingdon) [Internet]. 2020 Sep [cited 2023 Oct 31];48(9):561-6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409792/
- World Stroke Organization. World stroke day 2023 [Internet]. Geneva: World Stroke Organization; date of publication unknown [cited 2023 Oct 31]. Available from: https://www.world-stroke.org/world-stroke-day-campaign/world-stroke-day-2023
- Kementerian Kesehatan Republik Indonesia. Cegah hipertensi dengan CERDIK [Internet]. Jakarta: Kementerian Kesehatan Republik Indonesia; 2019 Jan 22 [cited 2023 Oct 31]. Available from: https://p2ptm.kemkes.go.id/infographic-p2ptm/hipertensi-penyakit-jantung-dan-pembuluh-darah/cegah-hipertensi-dengan-cerdik
- Center for Disease Control and Prevention. Prevent stroke: what you can do [Internet]. Georgia: Center for Disease Control and Prevention; date of publication unknown [reviewed 2022 Apr 5] [cited 2023 Oct 31]. Available from: https://www.cdc.gov/stroke/prevention.htm
- Kementerian Kesehatan Republik Indonesia. Kenali gejala dan tanda-tanda stroke, SeGeRa ke RS [Internet]. Jakarta: Kementerian Kesehatan Republik Indonesia; 2020 Des 18 [cited 2023 Oct 31]. Available from: https://p2ptm.kemkes.go.id/infographic-p2ptm/stroke/page/surveilan.pptm.kemkes.go.id/kenali-gejala-dan-tanda-tanda-stroke-segera-ke-rs
- Mayo Clinic. Stroke [Internet]. Rochester: Mayo Clinic; date of publication unknown [cited 2023 Nov 4]. Available from: https://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/drc-20350119
