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Dr Sudhir Kumar MD DM Profile picture
@hyderabaddoctor
Jun 17 • 10 tweets • 3 min read Twitter logo Read on Twitter
10 commonly asked questions about stroke answered

1. Stroke affects heart
No.
#stroke affects brain and causes paralysis.
#heart attack is known by the term myocardial infarction.
#MedTwitter #NeuroTwitter twitter.com/i/web/status/1…
2. Common symptoms of stroke:
SUDDEN ONSET
*Weakness of arm, leg or face, usually on one side
*Inability to understand spoken words or to speak
*Imbalance while walking
*Reduced vision on one half or in one eye
*Sudden onset severe headache
3. Risk factors for stroke
*High blood pressure
*Diabetes
*High total and LDL cholesterol or high triglycerides and low HDL
*High homocysteine
*Heart diseases
*Smoking
*Alcohol consumption
*Lack of sleep
*Stress
Overweight or obesity
*Older age
*Family history of stroke
4. People with normal body weight can't get stroke.
Wrong.
There are many other risk factors of stroke, as mentioned in point 3 above. So, a normal weight person with other risk factors can suffer from stroke.
5. Young people with no (modifiable) risk factors can not get a stroke.
Wrong.
Genetic factors play an important role. So, a person with history of stroke among family members can suffer from stroke.
6. Some patients with stroke symptoms recover within a few minutes on their own.
TRUE.
These are called transient ischemic attacks (TIAs) or mini-strokes.
But one should not ignore them, as many people with TIAs can suffer from major strokes in the future.
7. Aspirin should be given to all patients with suspected stroke even before doing CT scan.
NO.
We need to identify the type of stroke- ischemic (due to lack of blood flow to brain) or hemorrhagic (due to bleeding in brain). Aspirin is useful in ischemic, but harmful in bleeding.
8. What is the golden hour for stroke treatment?
Treatments to dissolve blood clot in brain work best in the first 4.5 hours after stroke onset.
Agents approved for clot buster therapy are alteplase and tenecteplase.
9. Can aspirin dissolve clot?
NO
Blood thinners such as aspirin or clopidogrel can not dissolve clot.
Refer to point 8 to know more about clot buster drugs
10. Medicines for stroke prevention can be stopped after some time.
NO
People who have suffered TIA or stroke once need lifelong medicines to prevent recurrence of stroke.
In addition, risk factors also need to be controlled.

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM Profile picture
Jun 17
Patients with Inflammatory bowel diseases (IBD) have a higher risk of suffering a stroke

1. Persons with Crohn's disease or ulcerative colitis have an increased risk of developing thrombo-embolic events. A recently published study looked at the association between IBD & stroke. twitter.com/i/web/status/1…
2. >85,000 patients with IBD were followed up long-term (1969-2019), and the risk of stroke in them was compared to those without IBD.
Patients with IBD had 14% higher risk of suffering from ischemic stroke during follow up.
#MedTwitter #stroke #IBD
3. The elevated risk of stroke remained increased even 25 years after diagnosis, corresponding to one additional stroke case per 93 IBD patients until then.
Read 5 tweets
Dr Sudhir Kumar MD DM Profile picture
Jun 14
Investment tips for doctors

It is a fact that most of us lack the basics of managing our finances. It is not unusual to come across doctors who have little awareness about their income, expenses & future goals (for which money is needed). Here are some tips that could help. twitter.com/i/web/status/1…
1. Life insurance: If you have dependents (children, spouse), life insurance is a must to safeguard their future in case of any unexpected incidents. Life #insurance is to protect the risk, and not an investment to get returns. Term plans are good.
2. Medical insurance: Medical care is expensive and we would have to bear the expenses if we or our family members fall sick. Family floater schemes are the best as premiums work out to be lower.
Read 15 tweets
Dr Sudhir Kumar MD DM Profile picture
Jun 13
1. Mr Hari to his wife Mrs. Rani: "Have you lost all shame? Why are you changing dress in the living room, where our driver is waiting?"

Mr Hari had noted instances of mood swings in his 55-year old wife for the past six months but today's incident was shocking.
#MedTwitter twitter.com/i/web/status/1…
2. Mrs Rani was otherwise a pleasant woman, however, she had become irritable for the past few months. She would get agitated over small issues and go into a shell (for several hours) on many occasions. She would refuse to talk to her husband and even refuse food.
3. Mr Hari attributed these changes in her personality to post-menopausal symptoms and tried to ignore them, and hoped she would get back to her previous self soon.
He had noted inappropriate behavior in his wife on a few occasions, when she would crack jokes with strangers.
Read 12 tweets
Dr Sudhir Kumar MD DM Profile picture
Jun 12
Lower resting HR and its benefits

1. Today's resting HR was in 30s (39 bpm) again (usually it is 40-42 bpm). My original resting HR (in Nov 2020) was 72 bpm (prior to taking up running). With consistent running, resting HR dropped by about 30 bpm in about two years.
#Heartbeat twitter.com/i/web/status/1… Image
2. In the general population without known coronary artery disease and heart rate lowering medication, elevated resting HR (RHR) is an independent risk marker for all-cause mortality (death).
Reference
doi.org/10.1007/s00392…
3. Several studies have indicated that low resting heart rate (RHR) is associated with health and longevity, and conversely, a high resting heart to be associated with disease and adverse events.
Reference:
doi.org/10.1080/003655…
Read 6 tweets
Dr Sudhir Kumar MD DM Profile picture
Jun 9
Ten lesser-known symptoms that could point towards a diagnosis of brain tumor

June 8th is celebrated as “World brain tumor day” to raise awareness about brain tumors. I would like to focus on the symptoms, presence of which, can make one suspect the presence of brain tumor. twitter.com/i/web/status/1…
Common symptoms of brain tumor include headache, vomiting, reduced alertness, fits & paralysis. However, in several cases, these classical symptoms may be missing. It is important to know the lesser-known symptoms of brain tumors so that they can be diagnosed & treated early.
1. Increase in hat and shoe size over time- A tumor of pituitary gland of brain producing excess growth hormone (GH) causes a condition known as acromegaly, which can result in increasing head and feet size, necessitating a need for larger hats and bigger shoes.
Read 13 tweets
Dr Sudhir Kumar MD DM Profile picture
Jun 8
Litchi encephalitis (chamki bukhar): Facts and Myths

1. Lychee (or litchi) is a fruit, mostly grown in China, India and rest of Southeast Asia. Fruit ripening coincides with Indian summer (May-June).
There is a concern that eating litchi can cause brain fever and death.
2. Litchi does not cause "encephalitis" (brain fever).
No infective agent (virus or other pathogen) has been isolated from CSF or blood of any victim of litchi encephalitis.
Also, it does not spread from person-to-person (what is expected in an infection).
3. How is litchi associated with litchi encephalitis?
Hypoglycin A and Methylene cyclo propyl glycine (MCPG), more commonly found in unripe litchi and depletes glucose reserves in the body. More fatal for under- or malnourished children, who eat unripe litchi on empty stomach.
Read 11 tweets

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