Mount Alvernia Hospital was the first private hospital founded in 1961 by a group of sisters from the Franciscan Missionaries of the Divine Motherhood. What started as a mission to treat the scourge of tuberculosis and leprosy that was rampant among the fishing villages, the hospital has transformed over the decades to be one of the leading care facilities in Singapore. With the spirit of the care the sisters brought, Mount Alvernia Hospital has grown to be a 336-bed facility while maintaining their not-for-profit creed. By having nursing as the backbone of their healthcare system, the hospital is well known for their maternity ward and Neonatal ICU. But they also have specialised doctors like neurosurgeons to treat those who have suffered strokes. While a stroke is often perceived as a problem that comes with old age but in reality, even the young and sporty can be vulnerable. Post Plus spoke to Consultant Neurosurgeon Timothy Lee to understand the condition better.

A stroke can affect anyone. Case in point: Popular Singaporean radio DJ Rod Monteiro. Despite being relatively young at 44, and leading a sporty lifestyle including running marathons and cycling regularly, Mr Monteiro made the news recently when he suffered a stroke while at work.

Dr Lee’s youngest patient who suffered a stroke was just 12 years old. “He fainted and was found to be bleeding from a congenital blood vessel abnormality. We had to operate on him immediately,” said Dr Lee, who was originally from Hong Kong but has trained and worked in Singapore for over two decades.

While you may have little control over congenital problems, there are risk factors which can be moderated to prevent or reduce the chance of a stroke. Things you can do proactively include adopting a healthy diet, avoiding smoking, and controlling diabetes and hypertension if you have the conditions.

Stroke also need not be viewed as a permanently debilitating condition. About half of all patients who suffer a stroke make a good recovery, usually within the first three months.

Dr Lee’s young patient is one such success story. “He made an excellent recovery and returned to school. He even regained the top position in his class,” shared Dr Lee.

What is a stroke?

A stroke is a condition where blood flow to the brain is interrupted—either due to blockage or bleeding, starving brain cells of necessary oxygen and glucose, and leading to brain damage which can manifest in impairment to speech, movement, and memory.

According to Dr. Lee, in most cases (about 80%), the stroke is due to a blocked artery; while bleeding accounts for the rest. Both result in a lack of blood flow to the brain and a build-up of pressure in the brain, which leads to the death of brain cells.

How can I tell if someone is having a stroke?

The common signs are weakness or numbness of the limbs, and a sudden headache. Transient weakness or numbness is a possible warning sign of a blocked artery, while a sudden and unusual headache may be a sign of internal bleeding. Other tell-tale signs include slurring of speech or sudden blurred or double vision.

Does it help if you get to a doctor quickly?

Like most diseases, the earlier you get treated, the better. Prompt treatment can make all the difference in one’s prognosis for recovery.

Are all strokes the same?

Not all strokes are alike and they can be of different severity. The impact of a stroke depends on how much and which part of the brain is affected. Smaller strokes may result in weakness on one side of the body, difficulty in speaking, and incontinence. Larger strokes may results in paralysis. Some strokes can be fatal.

What risk factors should I look out for to prevent a stroke?

Dr Lee suggests that to manage the risk factors that can lead to a blocked artery, try and remember this acronym: Cholesterol DISH. ‘D’ is for Diabetes; ‘I’ for ‘I or myself’, which refers to your genetics; ‘S’ is for Smoking; and ‘H’ is for Hypertension. As for the other major cause of stroke—bleeding—the main risk factor to monitor is hypertension.

Can anything be done to mitigate the occurrence of a second stroke after a patient has suffered the first one?

You should first try to reduce the risk factors. While you may not be able to do anything about your genetics, you can help yourself by making lifestyle changes such as giving up smoking, and opting for a healthier diet. It is also imperative to receive proper medical attention and medication. For example, an anti-platelet agent may be prescribed by the doctor to open up the blocked artery. Regular medications may be needed to control diabetes, high cholesterol, or hypertension.

What is the treatment for stroke patients?

The primary goal is to restore brain function and prevent future strokes. Besides the use of an anti-platelet agent, surgery to remove a narrowing in the artery may sometimes be required. Post-stroke, rehabilitation may be necessary to help the patient recuperate and recover mobility.

Final words of advice

Listen to your doctors and therapists, and follow their instructions. It is important to control the risk factors, and don’t stop your medication without first discussing with your doctor.