By Dr Sheikh Hilal Ahmad

On World Stroke Day, I often pause to think about the word faaleg, our Kashmiri name for stroke.

It's a word we hear too casually, used for all kinds of neurological issues. But for those who've truly seen a stroke unfold, faaleg is a terrifying moment that can alter a life within seconds.

As a neurologist, I've witnessed this countless times in hospital corridors, where every passing minute decides how much of a person's mind and memory we can save.

This year's theme,“Every Minute Counts – Act FAST,” could not be more urgent. Science tells us that 1.9 million neurons die every minute a stroke is left untreated.

That is what we mean when we say time is brain.

In the first hour after a stroke, the brain's architecture begins to collapse. A delay in treatment means a lifetime of paralysis, speech loss, or worse: death.

Each year, an estimated 12 million people worldwide suffer a new stroke, and more than 6.5 million die as a result of stroke-related complications, making it one of the leading causes of death and disability across the globe.

In India, one person suffers a stroke every 40 seconds and one dies every four minutes. These statistics play out daily in our hospitals.

The valley, with its rising cases of hypertension and diabetes, is no exception.

I've seen men in their fifties, including shopkeepers, teachers, and farmers brought in with half their body paralyzed, their speech gone, and families surrounding them in panic.

Many reach us too late. They first try home remedies or rush to lower blood pressure, believing that the problem lies there.

That misconception alone costs us precious time. A stroke is not simply“kamzoori” or weakness. It is a medical emergency that needs immediate hospital care.

So what exactly happens during a stroke?

The brain, which depends on a steady flow of oxygen and nutrients, suddenly gets cut off. When the blood supply stops, brain cells start dying.

Sometimes, a vessel is blocked, and this is called an ischemic stroke. Other times, it bursts, causing a hemorrhagic stroke. In both cases, minutes matter.

The signs are simple to remember through the acronym BE FAST:

B for balance loss, E for eyesight changes, F for face drooping, A for arm weakness, S for speech problems, and T for time.

In our local language, I often tell people to remember Bachav: Baazu, Aawaz, Chehra, Vakt.

Once these signs appear, don't wait. Don't give home medicine or try to lower blood pressure. Go straight to a hospital with a CT scan facility. Only a doctor can confirm the type of stroke and start the right treatment.

Reducing blood pressure too early can actually worsen the damage. The goal is to identify if the stroke is due to a clot or bleeding, and act accordingly.

If it's an ischemic stroke, the more common type, there is a narrow window of 4.5 hours in which we can give a clot-busting drug such as tenecteplase or alteplase.

In some cases, we can remove the clot mechanically through a procedure called thrombectomy.

In Srinagar's Superspeciality Hospital, we have begun diagnostic angiography and are working to make emergency mechanical thrombectomy a regular service.

These are promising steps, but the best results still depend on how fast a patient reaches us.

Recovery doesn't end in the hospital. Physiotherapy and speech therapy must begin within the first 24 hours. It helps the brain rewire itself, forming new connections that compensate for the damaged ones.

I've seen patients lift their arms again, relearn speech, and return to life with persistence and guided care.

That, to me, is the most rewarding part of medicine.

The encouraging truth is that stroke can be prevented.

Nearly 90 percent of cases are linked to just ten modifiable risk factors: hypertension, diabetes, smoking, high cholesterol, obesity, and physical inactivity among them.

Awareness and lifestyle changes can go a long way in Kashmir, where winters make many of us sedentary and diets are often rich in salt and oil.

Even small shifts, like brisk walking, balanced meals, and regular checkups can save lives.

Policy also plays a crucial role. Stroke care should not be confined to tertiary hospitals. Every district facility must have clot-busting drugs and a basic stroke response system.

School curricula and media campaigns can teach the BE FAST signs early. Our Department of Neurology at Superspeciality Hospital runs a weekly stroke clinic and organizes awareness programs, but round-the-clock neurointerventionists remain unavailable in most hospitals. That gap still costs lives.

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