Labour MP Karl Chircop is in intensive care after suffering a haemorrhagic stroke. As people await news about the young parliamentarian's health, Cynthia Busuttil looks at the incidence, causes and ways to lower the risk of cerebrovascular disease.
Every year some 400 people are admitted to hospital in Malta suffering from a stroke - the second most common cause of death following heart disease.
Dubbed the 'silent killer' because it creeps up on patients without warning, strokes are not solely reserved for the elderly.
Figures obtained from the Department of Health Information and Research department show that four young people in their 20s as well as a child under five died from stroke between 2003 and 2007. A staggering 1,667 people died of cerebrovascular disease between 2003 and 2007.
However, Neurology Department head Anthony Galea Debono said that while strokes can take place at any age, they are definitely more common in the elderly, and are often fatal in the very old.
"Younger people and those who do not have many other medical problems tend to have a much better outcome," he pointed out.
The figures show that the highest number of deaths was among the 80 to 84-year-old age bracket, followed by those in their late 80s.
Dr Galea Debono explained that mortality depends on the cause of the stroke, which is divided into two major types: An ischemic stroke is when an artery in the brain is blocked either because the artery is diseased or because a blood clot interrupts the brain's blood supply. On the other hand, a haemorrhagic stroke is when a blood vessel in or around the brain bursts and leaks blood. There are also few occasions where a stroke is caused due to a congenital malformation of arteries and veins, which have a tendency to bleed unexpectedly.
The good news is that there are people who recover completely; others gain their strength and are able to walk again, while speech may improve or even return to normal.
Improvement after a stroke is possible through rehabilitation, which is usually started immediately if the patient is conscious. Rehabilitation is easier in younger people, who can put up a better fight and have more motivation. Dr Galea Debono said that if the stroke causes the patient to lose his ability to speak and comprehend, he would not be able to benefit much from rehabilitation.
Asked whether there are any health conditions that make a person more susceptible to suffering a stroke, Dr Galea Debono said at least 80 per cent of strokes are due to disease of the blood vessels, with the same risk factors as heart disease and Peripheral Vascular Disease - including hypertension, smoking, poorly controlled diabetes and elevated cholesterol levels.
"In cerebrovascular disease, hypertension tends to be the more sinister risk factor."
Some lifestyle changes can help reduce the risk of a stroke. These involve cutting out smoking, regularly exercising to help maintain healthy blood circulation, a healthy diet which limits salt, fat and sugar, avoiding excessive alcohol intake, regular blood pressure checks and seeking medical advice as soon as changes in heartbeat are felt.
Karl Chircop's condition
Cerebrovascular disease was catapulted into the public eye last week when it struck Dr Chircop, just days before his 43rd birthday. In regular updates, the Health Division and the Labour Party said the MP was in a deep coma, with his condition deemed very serious and a cause for concern.
His situation yesterday remained the same, with the division saying there has been no improvement, as medical tests to determine his condition continue.
Messages of support for the father of four have poured in on timesofmalta.com over the past week, with many describing him as a gentleman and a capable politician.
Dr Chircop, who was appointed Labour health spokesman by party leader Joseph Muscat last month, has been involved in politics since 1996, when he was elected to Parliament at the age of 31.