Stroke can begin in the heart, not just the brain: do not ignore symptoms on waking, says Pune neurosurgeon

Pune: A person goes to sleep without any trouble at night. On waking, they suddenly cannot speak, their face droops to one side or their arms and legs feel weak. Many people do not understand what has happened. These can be symptoms of a stroke.

Notably, a stroke often begins not in the brain but with a blood clot formed in the heart. When a stroke occurs during sleep and the symptoms are noticed in the morning, it is called a "wake-up stroke" in medical terms.

Dr Rakesh Ranjan, senior director of neurosciences and neurosurgeon at Aditya Birla Memorial Hospital in Pune, shared important information on the subject. "Many people believe a stroke is only a disease of the brain. In fact, some heart diseases also raise the risk of stroke. Often these heart conditions show no clear symptoms. So even if you find stroke symptoms on waking in the morning, do not assume it is too late for treatment. If the patient is admitted to hospital immediately, they can get the right treatment," he said.

An irregular heartbeat is called atrial fibrillation. In it, blood can pool and form a clot in the upper chambers of the heart. If the clot travels with the blood flow to the brain, it blocks a vessel and can cause a stroke. Atrial fibrillation can raise the risk of stroke about five times. Heart valve diseases and some other heart conditions can also be a cause.

The biggest difficulty with a wake-up stroke is that it is not known when the stroke occurred. It is hard to estimate how much time passed between going to sleep and noticing the symptoms in the morning. Even so, today's CT scan and MRI tests give information about the condition of the brain's vessels and the affected part of the brain. On that basis, selected patients can be given clot-dissolving drugs, or the clot can be removed through a "mechanical thrombectomy".

The "BE FAST" method helps in recognising stroke symptoms. Sudden loss of balance, blurred vision, a drooping face, weakness in an arm or difficulty speaking are the main symptoms of a stroke. As soon as such symptoms appear, an ambulance should be called and the patient taken to a hospital that has treatment facilities.

Even if the symptoms ease after some time, they should not be taken lightly. They could be a warning of a more serious stroke to come. Do not give medicines such as aspirin without a doctor's advice. Do not give the patient anything to eat or drink either.

To reduce the risk of stroke, it is essential to keep blood pressure, diabetes and cholesterol under control, exercise daily, stay away from tobacco and get the heart checked regularly. If the heartbeat is irregular, it is important to get proper treatment on a doctor's advice.

Dr Ranjan made clear that although a stroke may come suddenly, the risk behind it is often present beforehand. Understanding the link between the heart and the brain, recognising symptoms in time and seeking treatment at once can save the patient's life and also reduce the risk of permanent disability.