Every minute during a stroke, an estimated two million brain cells can die. 

To mark World Brain Day on 22 July, Health-e News asked  leading stroke neurologist, Dr Pradeep Rowji from the Neurological Association of South Africa to answer common questions about recognising a stroke, acting quickly, protecting brain health and improving access to care.

Did you know?

Up to 90% of strokes are linked to risk factors that can be prevented or better managed, including high blood pressure, diabetes, high cholesterol and smoking.

South Africa has fewer than 200 neurologists for more than 60 million people, and specialist services are unevenly distributed. 

According to Dr Rowji, patients may face long journeys, delayed referrals and limited access to diagnosis, treatment and rehabilitation.

What is a stroke?

A stroke happens when blood flow to part of the brain is interrupted. 

This may be caused by a blocked blood vessel, known as an ischaemic stroke, or a burst blood vessel that causes bleeding in or around the brain, known as a haemorrhagic stroke. 

Without oxygen-rich blood, brain cells begin to die, affecting functions such as movement, speech, vision and memory.

Why is a stroke a medical emergency?

The longer treatment is delayed, the greater the risk of permanent brain damage, disability or death. 

Some patients with an ischaemic stroke may qualify for clot-dissolving treatment within four-and-a-half hours of symptoms starting.

What are the warning signs of a stroke?

What should you do if someone shows signs of a stroke?

• Call emergency medical services immediately and say that you suspect a stroke. 

• Note when the symptoms began, or when the person was last known to be well, because this may guide treatment. 

• Help the person reach a health facility as quickly as possible.

Can strokes be prevented?

Dr Rowji says not all strokes can be prevented, but many risk factors can be treated or reduced.

How can people lower their risk?

Dr Rowji says people with conditions such as high blood pressure, diabetes or high cholesterol should take their medication as prescribed.

Other preventative measures include:

Why acting fast matters

Learn the BE FAST warning signs and act immediately. Fast medical attention can save a life and reduce the risk of permanent disability.