Materia Medica Malaysiana

Preventing stroke

An awareness campaign will be held to make Malaysians more aware of the dangers of stroke, reports MAJORIE CHIEW.

THE National Stroke Association of Malaysia (Nasam) will embark on a nationwide Stroke Awareness Week campaign from this Sunday till May 16. This year’s theme is Let’s Get Physical, because the association hopes to encourage more people to adopt a healthy and active lifestyle to reduce the risks of getting stroke.

Janet Yeo, founder and chairman of Nasam, says: “Exercise and a healthy living are the best preventive measures that anyone can take to prevent stroke. Prevention is the best defence because stroke recovery is a long and costly process.”

Nasam’s forthcoming Stroke Awareness Week campaign is the second, after its inaugural one in 2002. The association is taking stroke cases seriously because stroke is the third leading killer disease in Malaysia after heart attack and cancer.

Some people may even be unaware that they had minor strokes and may not even make it to the hospital. Instead, they may visit doctors in clinics or seek traditional treatment. Some recover and carry on with life, not realising that the next stroke may kill, if not debilitate them.


“With a heart attack, one feels the pain,” she says. “And one is likely to rush to the hospital. But in a stroke, one doesn’t feel anything except discomfort and dizziness.”

By learning about the warning signs and symptoms of stroke, one can take precautions to prevent a major stroke.

“It’s cheaper to prevent stroke by knowing the signs and symptoms of stroke and leading a healthy lifestyle,” she emphasises.

She debunks a myth about stroke – some people perceive it as a disease of the sickly and elderly. She warns that stroke can also strike young people!

Nasam was set up eight years ago with a dual mission – to provide stroke care and to educate the public about reducing the risk of stroke.

“We help stroke survivors to believe that there’s life after stroke,” says Yeo.

Only a small percentage of stroke cases have access to rehabilitation facilities. Hence, Nasam deems that public education on stroke prevention, especially in rural areas, is a crucial part of its work.

Nasam has grown from a small support grown set up in November 1996 to an association with over 1,000 members, who are stroke survivors. It provides group physio, occupational and speech therapies for its members. Group therapy sessions are from Mondays to Fridays. Counselling is also provided for stroke survivors and their caregivers.

The association’s long-term mission is to set up community-based Nasam centres in every state. Apart from Nasam House in Petaling Jaya, it also operates centres in Ampang, Penang and Malacca. Plans are underway to open a centre in Ipoh.

Alarming statistics


Nasam founder and chairman Janet Yeo is a stroke survivor.
Statistics on stroke are alarming, whether locally or globally. Stroke can kill and is also the largest cause of disability in most developed countries and in Malaysia.

Malaysia with a population of 20 million, is estimated to record 40,000 new stroke cases annually. Yeo expresses concern over the possibility of rising stroke cases in Malaysia with the spread of Western lifestyles, particularly the fast-food culture.

The World Health Organisation projects that 75% of all stroke deaths by 2020 will occur in developing countries. Yeo cites that 5.5 million people die from stroke each year while 22% to 25% patients die within a year of having their first stroke. Some 8.4% of men and 11% women die from strokes.

A six-month United States study on stroke survivors found that many of them suffered disabilities: 50% had paralysis on one side of the body; 35% had symptoms of depression; 30% couldn’t walk without assistance; 26% needed help with daily activities and 26% were living in nursing homes.

A stroke survivor herself, Yeo’s courage and determination saw her remarkable recovery from the paralysing effects of stroke, inspiring many Malaysian stroke survivors and their families, friends and volunteers.

She says: “If one survives a stroke, it’s a struggle to make it back to leading a normal life!”

Brain attack

Stroke is a brain attack and occurs when the blood supply to the brain is disrupted. Most strokes occur when a blood clot blocks an artery, which is carrying blood to the brain. Some strokes are caused by bleeding within or around the brain from a burst blood vessel. When the blood supply is disrupted, the brain cells are deprived of oxygen and other nutrients, causing some cells to become damaged and others to die.

Several factors of stroke include smoking, hypertension, diabetes, family history and heart disease. However, some patients who have stroke do not have any of these risk factors but probably only minor valve problems or abnormalities in the blood.

Stroke can strike without warning.

“It happens like the wind. That is why we called it (stroke) angin akmar in Malay. It’s a very sudden problem. One day, someone may be well and the next, he or she wakes up with a problem,” says Prof Goh Khean Jin, Associate Prof and consultant neurologist, Faculty of Medicine, Universiti Malaya.

He advises the person who just had a stroke to see a doctor or go to the hospital immediately (if possible within three hours). The medical experts will need to make a diagnosis, assess the severity of the stroke and prepare to monitor the patient. Some people can get worse as their condition deterioratesif they have diabetes.

“In the acute phase, the doctor needs to get a diagnosis and monitor the patient to ensure that his vital signs are stabilised. A lot of stroke patients have difficulty swallowing,” he says.

Prof Goh, who is also president of the Malaysian Society of Neurosciences and medical adviser for Nasam, says: “Neurologists view stroke as a medical emergency much like a heart attack.”

Mild strokes, he says, should be a warning. Those who have such attacks should prepare themselves not to get a second severe stroke.

Nasam House is at 12 Jalan 7/2, 46050 Petaling Jaya, Selangor (03-79564840 / fax: 03-79542275 / e-mail: nasam@po.jaring.my).