New Delhi: Hormonal changes caused due to pregnancy, or the use of oral contraceptives, and the longer life expectancy are some of the reasons that explain the higher incidences of strokes among women than men, said experts on World Stroke Day on Tuesday. 

Stroke is a major cause of disability and death for all people worldwide. But, it is the third leading cause of death in women and kills more females than males, according to the American Stroke Association.

Dr. Atul Prasad, Principal Director & HOD, Neurology, BLK – MAX Super Speciality Hospital, told IANS that longer life expectancy, hormonal factors that are influenced by pregnancy and childbirth, oral contraceptives, and menopause.

Hypertension and heart diseases like atrial fibrillation, an irregular heart rhythm, together with pollution are other major risk factors.

“Women with a history of migraine with aura have an increased risk for stroke, especially along with factors such as smoking or oral contraceptives. Another is preeclampsia — a complication of pregnancy — which doubles the risk of stroke after the fact but is rarely considered,” Dr. Sumit Singh, Chief-Neurology, Artemis Hospitals

The experts noted that women also often have atypical or less-recognised stroke symptoms, such as fatigue, general weakness, confusion or disorientation, nausea, or vomiting, which contributes to late diagnosis and treatment.

“Common symptoms such as slurred speech, sudden weakness, and facial drooping are established in both genders; however, the symptoms in women are more disguised in dizziness, fatigue, nausea, and even hiccups. Such uncommon symptoms often delay judgement or misdiagnosis and are critical in worsening the outcome,” Singh said.

While the treatment and prevention of ischemic stroke are generally similar for men and women, post-stroke rehabilitation programmes for women need to be more gender specific.

“Outcomes are worse, and depression and cognitive decline occur more frequently, with longer times to recover in women compared to men. Thus, stroke recovery must be approached more holistically with mental health support, social integration, and individualised physical rehabilitation,” the doctor said.

The core strategies for preventing ischemic stroke — controlling blood pressure, managing cholesterol, avoiding smoking, and maintaining a healthy lifestyle — are the same for both men and women.

However, Prasad stressed the need for women to regularly monitor for stroke risk if they are taking birth control pills, or undergoing Hormone replacement therapy (HRT). Women with a history of preeclampsia also need long-term follow-up.

Many view strokes as distant possibilities, yet stroke risk surrounds us daily. High blood pressure, heart issues, and other factors quietly contribute to this life-altering event, which can strike without warning. 

Dr. Gaurish Kenkre from Atharv Ability explains, “A stroke can stop life in its tracks, turning a routine moment into one of immobility, slurred speech, and confusion.” This sudden disruption underscores the need to understand both stroke risks and the road to recovery. Fortunately, advancements in neuro-rehabilitation now offer hope for stroke survivors to rebuild their strength and lives. 

On World Stroke Day, celebrated today i.e October 29, 2024, the focus shifts from crisis to recovery, highlighting the power of neuro-rehabilitation in helping survivors regain their resilience. 

Understanding Stroke Risks: What Are We Up Against? 

Stroke risks are heightened by factors such as high blood pressure, diabetes, obesity, and smoking. While these risks increase with age, lifestyle choices play a significant role, meaning anyone can be vulnerable. Preventive actions, such as regular blood pressure checks, are essential in lowering stroke risk. 

However, even with preventive measures, strokes remain unpredictable. Recovery after a stroke involves more than reclaiming physical abilities; it’s about rebuilding a fulfilling life. Modern neuro-rehabilitation provides promising solutions for stroke survivors, addressing physical, cognitive, and emotional needs through tailored treatment plans. 

Challenges in Neuro-Rehabilitation Access in India 

In India, the need for neuro-rehabilitation is urgent, but resources are limited. Stroke patients often face a lack of access to neuro-physiotherapists, specialized centers, and comprehensive, multidisciplinary care. Many survivors must travel between various facilities to receive necessary therapies—physical, speech, and cognitive—leading to fragmented care. 

Early Intervention and the Role of Neuroplasticity 

The initial weeks post-stroke are crucial, as early intervention can enhance recovery through neuroplasticity, the brain’s ability to reorganize itself. Rehabilitation strategies like constraint-induced movement therapy (CIMT) and repetitive task training support this by helping to rebuild motor skills and establish new neural connections. Therapists use targeted exercises, while speech therapy focuses on language recovery for those affected by aphasia. 

Motor Skills and Cognitive Rehabilitation 

Stroke survivors often face challenges with mobility and cognitive functions. Advanced tools such as robotics and virtual reality (VR) have made rehabilitation more effective, offering immersive exercises to enhance motor skills. Cognitive rehabilitation helps restore memory and problem-solving abilities, involving engaging activities like games and practical simulations that aid survivors in relearning essential skills. 

Emotional and Psychological Support 

The emotional toll of a stroke can be profound, leading to anxiety, depression, and uncertainty about the future. Psychological counseling and support groups are essential in helping survivors cope emotionally, allowing them to navigate post-stroke life with renewed hope and resilience. 

Bridging the Gap in India: The Need for Comprehensive Care 

India’s rehabilitation infrastructure remains limited, with a shortage of multidisciplinary neuro-rehabilitation centers. According to the Stroke Association of India, one person experiences a stroke every 40 seconds, with 60% of cases resulting in lasting disability. The gap between the need for care and available resources highlights the importance of affordable, one-stop neuro-rehabilitation solutions, where trained professionals provide integrated therapy under one roof. 

Moving Forward: Accessible Care for Stroke Survivors 

While strokes can alter lives, they need not be life-ending. With the right rehabilitation, survivors can reclaim their independence and dignity. This World Stroke Day, the spotlight is on making neuro-rehabilitation accessible, particularly in regions like India, where demand far exceeds supply. By fostering collaboration between healthcare providers, policymakers, and communities, we can build a future where every stroke survivor receives the care they deserve. 

Through awareness and action, we can support stroke survivors in reclaiming their lives and restoring their strength. 

World Stroke Day 2024, celebrated today, October 29, serves as a global reminder of the pressing need to combat stroke—a silent yet severe health issue that stands as the second leading cause of death in India. Strokes occur suddenly, often with little warning, as a result of blocked arteries impeding blood flow to the brain or vessel ruptures causing brain hemorrhage. Symptoms can be life-altering, from weakness and slurred speech to paralysis and, in severe cases, death. Beyond the physical toll, strokes place a heavy emotional and logistical burden on families and caregivers. 

In the fast-paced modern workplace, organizations play a crucial role in stroke prevention. As Dr. Vikram Vora, Medical Director at International SOS, states, “In modern workplaces, where long hours of sitting and high-stress environments have become the norm, companies have a critical role to play in reducing stroke risk among employees.” He emphasizes that “creating a supportive office culture that promotes physical activity, stress management, and healthy lifestyle choices can significantly contribute to stroke prevention.” 

To foster a healthier workplace environment, companies can initiate wellness programs that encourage exercise, provide nutritious food options, and increase awareness about stroke risks such as high blood pressure and stress. “Flexibility in work schedules and fostering a work-life balance can also reduce stress, which is a key factor in both cardiovascular and cerebrovascular health,” Dr. Vora adds. By embracing these strategies, companies not only enhance employees’ health but also see improvements in productivity and job satisfaction. 

Stroke Prevention in India: Key Factors and Awareness 

In India, cardiovascular and cerebrovascular diseases are especially concerning due to common risk factors like hypertension, high cholesterol, diabetes, smoking, and obesity. These health challenges are prevalent, particularly in urban settings where sedentary lifestyles and job stress are widespread. Stroke awareness remains relatively low, despite its significant impact on individuals and families. 

World Stroke Day is an opportunity to spread awareness and promote lifestyle changes that reduce stroke risk. Simple adjustments such as regular physical activity, a balanced diet, and blood pressure management can go a long way in prevention. By encouraging a better understanding of stroke and its risk factors, World Stroke Day reminds us all of the importance of proactive health measures and wellness support in every aspect of life—from workplaces to communities.