Treating stroke with the latest technologies

September 06, 2021 08:42
The University of Hong Kong has collaborated with the Hospital Authority in using big data to study acute stroke cases. Photo: HKU

Quoting a global study, the Department of Health pointed out that there are an estimated 13.7 million new cases of stroke around the world every year. The number of cases has been rising in recent years, and there is a rising trend of strokes among young adults.

Similarly, data from the United States shows that the incidence of stroke for U.S. adults between 20 to 44 years of age increased by 64% from 17 per 100,000 American adults in 1993 to 28 per 100,000 in 2015. Taiwan also reported similar statistics. In 2015, the proportion of young people with strokes (strokes under the age of 45) doubled from about 5% ten years ago to more than 10%. Among the patients with hemorrhagic stroke, the majority were young patients, representing 50% of the total stroke cases; while elderly patients only accounted for 20%. What’s more, there were recent reports of young internet celebrities affected by strokes, they are only about 30 years old, which aroused hot discussion.

The physical deterioration caused by stroke can be very serious. In addition to damaging the brain, causing weakness or numbness in the face, hands or legs, symptoms such as speech, swallowing, vision, balance or cognitive impairment may also occur; even worse, there may be a chance of permanent disability, or even death. In 2017 alone, more than 6.16 million people worldwide died of stroke; stroke has become the second leading cause of death in the world. In Hong Kong, cerebrovascular disease is also one of the fourth most deadly diseases. Every year, more than 20,000 people are admitted to hospital because of stroke, about 3,000 people died of it. As a result, the demand for stroke treatment and rehabilitation follow-up services has increased significantly.

Every moment counts in treating stroke patients. Today's technology can speed up the diagnosis and greatly increase the chance of survival, especially for strokes due to large vessel occlusions, which is the most serious case of acute stroke, accounting for 13% of stroke cases, the mortality rate is as high as 40%. The patient must be treated within six hours of the onset of stroke. Early in 2017, the University of Hong Kong collaborated with the Hospital Authority in using big data to study 300 acute stroke cases, they used artificial intelligence to analyse patient records, radiological images, etc. As a result, the system can screen 95% of large vessel occlusions within 20 seconds. It shortens the diagnosis time by up to two hours. Advanced technology plays an important role in life-saving treatment.

At present, the risk of disability caused by stroke is still very high. The medical community believes that if rehabilitation and follow-up training can be done as quickly as possible, such as physical therapy of repeated hand training to revitalise the neural network of the brain, hence reconnecting the motor nerves of the brain, it has a good chance for the patient to resume normal life. To this end, the Hong Kong Polytechnic University and a medical product company have jointly developed the Hand of Hope device therapy used for neuromuscular rehabilitation of the hand and forearm. The device won the Grand Prix of the International Exhibition of Inventions Geneva in 2012. It functions as a biofeedback device that detects the electromyographic signal (EMG signal) of the stroke patient’s hand, and the robotic arm assists the patient in hand rehabilitation training, strengthening the brain’s ability to control the hand, so as to speed up the recovery of hand capability.

However, for stroke patients, it is also important to have the support and care from their families and the society. In view of this, the Sau Po Centre on Ageing of the University of Hong Kong initiated the WeRISE: Stroke Family Empowerment Project in partnership with five local hospitals and three non-governmental organisations to provide different types of stroke information, including detailed medical care, information of elderly homes, as well as practical tips and talks for caregivers. The project benefits not only stroke patients, but also the caregivers. It has a mobile application to conveniently record the patient's health index. The Q&A robot in the WeRISE application answers frequently asked stroke-related questions in real time, which helps ease the worries of the stroke families.

In fact, most diseases stem from long-term bad habits, and stroke is no exception. As long as you pay attention to your daily life and diet, maintain a balanced nutrition and regular exercise, you can reduce the chance of cerebrovascular diseases. During the COVID-19 epidemic, we inevitably get tired physically and mentally, we need to care more about our physical condition as well as the health of other people around us. In reducing the threat of a disease, prevention is better than cure.

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Adjunct Professor, Department of Computer Science, Faculty of Engineering; Department of Geography, Faculty of Social Sciences; and Faculty of Architecture, The University of Hong Kong