Stroke – What is it and What Are My Insurance Options?

There are 8,000 to 10,000 people diagnosed with stroke in the UAE every year. According to a survey conducted by the World Health Organisation, there’s at least one person experiencing stroke every hour in the UAE. What makes matters worse is that the stroke patients in the UAE tend to be from a comparatively younger age group when compared to the western nations. More than 50% of people suffering from stroke or who already experienced an episode are below the age of 45 years. Read on to know more about stroke, risk factors, options to prevent it, treatment options available and insurance options to look for if needed. 

Types of Strokes 

• Ischemic Stroke: The most common kind of stroke, an ischemic stroke happens when the blood vessels in your brain get blocked by a blood clot or due to accumulation of plaque. Almost 80% of the strokes are ischemic strokes. The plaque that blocks the blood vessels is made by cholesterol or fatty deposit in the veins. 
• Haemorrhagic Stroke: Haemorrhagic stroke happens when a blood vessel bursts in the brain leading to a haemorrhage. The blood spills to nearby tissues in the brain causing further damage. Haemorrhagic strokes are deadlier than ischemic strokes. While all kinds of strokes require immediate medical attention, haemorrhagic strokes may need an even faster action plan. In most haemorrhagic strokes, an artery bursts in the brain. This is known as intracerebral haemorrhage. In less common kinds of strokes, i.e., the subarachnoid haemorrhage, bleeding occurs in the area that lies between the brain and the thin lining of tissues that cover it. 
• Transient Ischemic Stroke: This is not technically a stroke but a mini-stroke of a kind. In this kind of stroke, the blood flow is blocked, like in ischemic stroke, but only for a short duration. The blockage stays for no more than 5 minutes. It is a warning sign of a future stroke and has to be treated as urgently as a normal stroke. The symptoms of both ischemic stroke and transient ischemic stroke are similar so there is no way of identifying one beforehand. Diagnostic tests are the only way to identify the type of stroke. 

Symptoms of Stroke 

Strokes as well as their symptoms are very sudden. On top of it, symptoms may vary from one person to the other. Here’s a list of some of the most common stroke symptoms:

• Feeling of numbness or weakness in the arms, legs or other body parts, especially if located to just one side of the body. 
• Facing troubles in comprehending simple sentences and in speaking as well.
• Loss of vision in one or both eyes. Also includes dimness in the vision in one or both eyes.
• Compromised consciousness, for example, dizziness, losing coordination, etc. 
• Having troubles in walking or moving around.
• Complete loss of consciousness such as fainting or seizures. 
• Headaches that are persistent and severe without a cause. 

A few of the less common stroke symptoms may include the following:

• Vomiting or nausea happening without any reason per se. 
• Blackouts or small episodes of fainting, loss of consciousness, seizures or even coma.
• Having a transient ischemic stroke aka, a mini-stroke

Note that a transient ischemic stroke will represent symptoms similar to that of a normal stroke. However, the mini stroke symptoms do not last for more than 24 hours in general. But as explained above, even mini stroke needs immediate medical attention. So, even if you can determine that a person is having a transient ischemic stroke, call for medical help immediately. 

Risk Factors of Stroke 

• Hypertension: High blood pressure stretches the arteries and hence damage them over time. Damaged arteries are prone to burst and cause a stroke. High blood pressure may also cause blockage in the arteries which yet again causes ischemic stroke. Blood pressure higher than 140/90 hg/mm is considered to be problematic and must be treated. However, haemorrhagic strokes are more prone to happen due to high blood pressure. 
• Heart Conditions: Many heart conditions and brain strokes have the same kind of risk factors involved. For example, high blood pressure, cholesterol levels, plaque accumulation etc. Having a heart condition, especially related to the blood vessels, increases a person’s chances of having a stroke several folds. Heart conditions are the second most common risk factor of brain strokes. 
• Smoking: Not only strokes but heart conditions are also fuelled by smoking. Chemicals in the smoke that comes from products like cigars and cigarettes lead to the formation of plaque in the blood vessels. This causes a blockage which may lead to not only a stroke but heart conditions like coronary heart diseases. med
• High Blood Sugar Levels: Diabetes raises the level of glucose or sugar in the blood. Since the glucose in the blood cannot get processed in time due to lower levels of insulin production in the body, it starts to damage the blood vessels. As established above, damaged blood vessels lead to rapture and hence a brain stroke. 
• Hormone Therapies: People taking estrogen in hormone therapy or people with a naturally higher level of estrogen are more at risk of getting a stroke. Higher levels of estrogen increase the risk of blood clotting which in turn increases the risk of blockage in blood vessels. 
• History of Transient Ischemic Strokes: For someone who has already had a mini-stroke or a transient ischemic stroke, the chances of having a real brain stroke are very high. Having just one transient ischemic stroke increases your chances of having a real stroke by 10 times at least. 
• High RCB Count: For someone who has a high level of red blood cells, the chances of getting a brain stroke are fairly high. Red blood cells make the blood thicker and hence more prone to clotting.
• High Cholesterol: Cholesterol is the substance that leads to plaque formation in the blood vessels. LDL cholesterol is the kind of cholesterol that is responsible for plaque formation and blood vessel blockage for the most part. High cholesterol levels hence, effectively increase a person’s chances of having a stroke. 
• Low Physical Activity: Low physical activity and exercise lead to weight gain, diabetes and accumulation of plaque in the arteries. The plaque in turn may cause brain strokes by blocking the arteries as explained before. While lack of exercise is not a direct cause of stroke, it is a very significant indirect cause. 
• Alcohol Consumption: Consuming unhealthy amounts of alcohol is a known cause of high blood pressure. This can damage arteries in the long run. The damaged arteries are prone to get raptured leading to brain stroke. While a healthy dose of alcohol when and as advised by a doctor is good for the body, alcohol abuse always leads to several health problems and not just strokes or heart attacks. 
• Cardiac Structural Deformities: Valves located at the end of each of the four chambers of the heart. Damages caused to the valves leads to long-term damage to the cardiovascular system overall and leads to brain stroke in many cases. 
• Ethnicity: Some ethnic groups are more prone to get hypertension for example the African Americans. And as mentioned before. People who are more prone to have high blood pressure are equally more prone to stroke. 
• Age: Old age increases your chances of getting high blood pressure as well as other cardiovascular diseases including brain stroke. People older than 55-60 years of age have one of the highest chances of getting a stroke. 
• Genetics: Family history and genetics also play a huge role in increasing the risk factors of brain strokes. People with someone in their family who have had an experienced stroke or other cardiovascular diseases have a higher chance of getting it themselves as well. 

Stroke Diagnosis Procedures

• CT Scans: X-rays are used in a CT-Scan to bring out clear images of the brain and show which blood vessels are damaged or causing bleeding in the brain. CT-Scans are perfect to determine the place of rapture and damage in the brain and effectively cure the said damage. It is also the ideal way to find the type of brain stroke that the patient had or is having as well as other abnormalities. 
• MRI of the Brain: Radiofrequencies and magnetic rays are used to create images of the brain on a computer. Magnetic waves used in an MRI can determine even the smallest change in the tissues of the brain which can be beneficial to find out smaller, more defined raptures and blockages. 
• CTA: This test uses x-rays to get a detailed image of the blood vessels in the brain or elsewhere. A dye or a contrast material is injected into the veins and then the ex-rays are used to get a detailed picture of the vessels. The pictures can be used to identify the blockage and rapture in the brain and other parts of the body as well. 
• Doppler Sonography: This particular test is for the carotid arteries only. The test uses sound waves to determine whether there is a blockage of some kind in the carotid arteries. 
• MRA: The same as MRIs, MRA (magnetic resonance angiography) uses magnetic waves and radio frequencies to create pictures of blood vessels on a computer screen. Yet again, blockages can be found using an MRA test result. 
• ECG and Echocardiography: Both these tests are used to examine if there are any heart conditions the brain stroke patient is suffering from which may have led to the stroke. ECG uses electric waves to record the activity of the heart while sound waves are used in echocardiograms for the same purpose. 

Treatment Options for Stroke 

• Clot-Busting Medicines: A few drugs can be injected to burst the blood clots that may have caused the stroke. Thrombolytics and fibrinolytic are two of the most common drugs to be used in this therapy. The medicines dissolve the blood clots as well as repair the blood vessels being damaged by the stroke. Clot-busting medicines are only effective for ischemic strokes and only when given within 3 hours of having the brain stroke. 
• Medicines And Therapy for Brain Swelling: Haemorrhagic strokes lead to swelling in the brain. Medicines and therapies to reduce or control the swelling become one of the most important parts of the treatment plan here. These medicines are given using an IV aiming to tackle the swelling in the brain. 
• Neuroprotective Medicines: Blockage in the blood vessels lead to a lack of supply of blood as well as lack of oxygen. This is why cells of the nervous system begin to die. Medicines are used to make sure that brain cells are not damaged any further due to a lack of oxygen. 
• Craniotomy: This is a type of surgery that is used to remove any clots and blockages in the blood vessels of the brain. A craniotomy can also be used to release pressure on the brain as well as other matters like swelling. 
• Life Support: Life support equipment is also something that many brain stroke cases require. This may include ventilators, IV support etc. Nutrition and other treatment factors may also be combined with life support equipment. 

The treatment one receives for stroke strongly depends on more than just a few factors. Given below are some of the factors that can decide what kind of treatment a brain stroke patient would need:

• Age, vitals, overall health and medical history of the patient
• The type of stroke
• The severity of the stroke
• The location of the stroke in the brain
• The main causes of the stroke
• The way certain medicines affect the patient
• The opinion of the patient or the type of treatment the patient prefers

First Point of Action for Strokes

When someone is having a stroke in front of you, it becomes incredibly important that you take swift, calculated actions. The first step of the way is to identify if the person is actually having a stroke and then get them emergency medical help. F.A.S.T. is an acronym that can help you remember how to help someone having a brain stroke. Following are details for the same:

• F - Face Drooping: When you doubt if someone is having a stroke, ask them to smile and see if one or both sides of their face keep dropping or if they simply cannot smile. 
• A - Arm Weakness: Next ask the person to raise both their arms in the air. If one arm keeps dropping or the person is unable to raise it, note that down. 
• S - Speech Difficulty: Ask the person to say a few simple sentences. Tell them to repeat after you. Speech impairment is a huge sign of a stroke. 
• T - Time to Call Medical Help: If the person concerned shows even one of the above-mentioned symptoms, call emergency medical help immediately. Get the person to a hospital and let the doctor know about the timing and appearance of the symptoms. 

Stroke Prevention Steps

Strokes can be easily prevented just like cardiovascular diseases. However, there are a few concrete things one has to do to not only prevent strokes but also to lead a healthy and happy life after getting one. Given below are some things one can practice for the same:

• Lifestyle Changes: Embracing healthy lifestyle habits is the first thing you need to do to ensure that brain strokes are prevented in the future. From smoking to eating unhealthy diets, there is a lot to manage and change when it comes to lifestyle. Following are some things you can do to make sure strokes either does not happen at all or are prevented from happening again:
  • If you smoke, stop immediately and never look back. Smoking causes a lot more diseases than just strokes. From cardiovascular diseases of all kinds to cancers and respiratory diseases, a lot can be prevented if smoking is not a part of your lifestyle. 
  • Eating healthy is of utmost importance when it comes to preventing diseases like brain stroke. Reduce unhealthy fats like trans fats in your diet while increasing proteins, vitamins and dietary fibres. Include a lot of fruits, vegetables, lean proteins, lentils and fluids in the diet. If the doctor has prescribed something specific, be sure to follow it. 
  • Add exercise to your routine. Workout at least 4 days a week for an hour or so. If the doctor has prescribed a certain workout routine, ensure that you follow it precisely. 
  • In addition to stopping smoking, limit your alcohol intake as well. If you are a troke patient, make sure that you ask the doctor about alcohol intake if they already have not prescribed anything. 
• Medications: Several medicines can be used to ensure that people at the risk of having a stroke do not have it. These medicines can also be prescribed to current stroke patients to prevent any further episodes. These medicines can include blood-thinning drugs, antiplatelet drugs, medicines for hypertension, cholesterol medicines, heart and diabetes medicines. 
• Surgery: Several preventive surgeries can be opted for to prevent a brain stroke from happening. These surgeries generally target the blood vessels and damages that may already be at hand. For example, carotid endarterectomy, surgery to repair aneurysms or carotid stenting and PFO closure. 

Health Insurance for Stroke 

Critical health insurance plans are the ones that you can seek to have strokes covered by health insurance. A critical health insurance plan is designed to offer the policyholder a lump sum amount as compensation if they are diagnosed with a critical illness. A survival period of 15-30 days has to be covered after being diagnosed with the illness before the plan can provide the compensation. In case of a stroke, the patient has to survive the survival period as subjected in the insurance agreement. The compensation received from critical illness can be used to cover the expenses of the brain troke treatment that the patient receives. People who have already had a stroke can also get health insurance with the close of pre-existing disease. A waiting period of 6 months to 2 years may apply here. 

In a Nutshell 

Even when strokes make up a huge problem in the UAE, preventing them is simply a matter of lifestyle for the most part. Avoiding things like smoking and alcohol abuse, adopting a healthy diet and exercising are some of the many ways to manage brain strokes and many other critical illnesses. However, also ensure to have a good health insurance plan in place if you are at an increased risk of having a stroke. Make sure that you also understand the F.A.S.T. method to help someone else have one. Swift action and preventions are enough to ensure that stroke stays at bay.