TIME is of the essence when a stroke strikes. How fast a stroke victim is taken to hospital will determine the likelihood of him surviving the stroke and recovering from any resulting disabilities.
More importantly, during a stroke, it's crucial to reach the nearest stroke-ready hospital as soon as possible.
A stroke-ready hospital would be better prepared to manage and handle an acute stroke and ensure the patient gets the right treatment.
In Malaysia, there are about 90 stroke-ready hospitals and these include public and private hospitals.
These facilities, called essential stroke centres, can administer clot-dissolving medication immediately to patients in need, ensuring a swift response to those suffering an ischemic stroke.
The earlier this crucial medication is administered, the better the outcome for the patient.
Two stroke facilities — Hospital Canselor Tuanku Muhriz (HCTM) and Hospital Sultan Abdul Aziz Shah (HSAAH) — were awarded the Advanced Stroke Centre certification by the World Stroke Organisation on Aug 22.
As an advanced stroke centre, HCTM takes a comprehensive approach to stroke management, with a full-fledged multidisciplinary team of medical experts, including an emergency physician, neurologist, radiologist, interventional radiologist and an anaesthesiology team on standby 24 hours a day to diagnose and treat stroke cases.
HCTM consultant neurologist and physician Associate Professor Dr Wan Asyraf Wan Zaidi says: "From the minute a suspected stroke case is brought in, our team works within 60 minutes to stabilise the patient."
There is a strict protocol that is followed, he adds. The patient will be immediately assessed and sent for a CT scan so doctors can decide on the course of treatment.
Depending on the case, the patient may require the administration of clot-busting medication.
Dr Wan Asyraf says in about 20 per cent of cases, this may be required, but not for all cases.
In some cases, a mechanical thrombectomy to remove the clot may be necessary.
If both these procedures are not suitable, a neurosurgeon may be referred to for surgical treatment, especially in the bleeding subtype stroke.
"Once the patient is stable, we get the rehabilitation team on board. The process is smooth and seamless, and it ensures the patient gets rapid but comprehensive stroke treatment and management."
Dr Wan Asyraf, who is also Malaysia Stroke Council vice-president and a lecturer at the faculty of medicine Universiti Kebangsaan Malaysia, says stroke intervention will be a crucial component of healthcare in the years to come as Malaysia becomes an ageing society.
Even more worryingly, stroke is affecting younger people, he adds.
"About 50,000 stroke cases are reported a year in Malaysia when data indicated about 30,000 cases a year previously.
"While we must continue efforts to promote stroke prevention, we must also work on improving our approach to stroke intervention."
Stroke prevention campaigns should not only address lifestyle habits related to the risk of stroke and common signs of a stroke, but also stress on the need for speed when it comes to seeking treatment.
Previously, people were advised that 4.5 hours was the "golden period" for stroke and that patients should seek medical treatment within 4.5 hours of a stroke.
Dr Wan Asyraf says patients should be brought to hospitals within one hour after a stroke for the best possible outcome.
Earlier would be even better, so being aware of the signs of a stroke is important.
More importantly, they should know where stroke centres are in their vicinity so they can seek help at facilities that are equipped to manage a stroke.
"Every minute that a large vessel is blocked, about two million neurons die in the brain and for every hour of blockage, the brain ages by 3.6 years."
It is for these reasons that patients in the midst of an acute stroke need swift and timely intervention.
Arriving at the "wrong door" delays a time-sensitive process and ultimately, does more harm than good.
To find out about stroke-ready hospitals near you, go to mystrokehospital.my.
TYPES OF STROKE
Ischemic Stroke
The vessel gets clogged within.
Haemorrhagic Stroke
The vessel ruptures, causing bleeding into the brain.
STROKE PREVALENCE
Six cases are reported every hour in Malaysia and around 52,000 cases annually, according to the Malaysia Stroke Council and Malaysia Society of Neurosciences.