Stroke

Stroke

A stroke is a serious medical condition caused by a lack of blood flow to part of the brain. This is usually due to a blood clot preventing the blood from reaching the whole brain. Strokes need to be treated as soon as possible to try and limit the damage. The FAST campaign aims to help people recognise the symptoms of a stroke so early action can be taken.

There are three types of stroke:

  • Ischemic - the most common - where the blood supply is stopped due to a blood clot.
  • Haemorrhagic - caused by a burst blood vessel.
  • Transient Ischemic Attack (TIA) also known as a mini-stroke. There is only a temporary stop to the blood flow. This is often a warning that a full stroke is imminent.

Symptoms of a Stroke

  • Facial paralysis - one side of the face may have dropped and they may find it hard to smile.
  • Weakness in one arm or both arms - difficulty raising the arm and keeping it there.
  • Slurred speech or the inability to speak.

The UK health authorities have started a campaign to help people recognise the symptoms of a stroke: FAST - Face, Arms, Speech, Time to act - Call 999 immediately.

Other symptoms include:

  • Dizziness
  • Severe headaches
  • Numbness or paralysis on one side of the body.
  • Incoherence
  • Loss of sight
  • Difficulty swallowing
  • Blackouts

The symptoms of a TIA will be similar to the above, although maybe less severe and only temporary, lasting from a few minutes to a few hours.

Causes of a Stroke

There are numerous factors which contribute to an individual having a stroke. Here are some of the most common:

  • General health - those with a history of health problems such as heart attacks and CHD are more prone to strokes.
  • Family history - if a close relative has had a stroke then your chances are higher.
  • Age - those over 65 are at a higher risk (although it can also happen in those much younger than this)
  • Ethnicity - Strokes are more common in those of Asian, African or Caribbean ethnicity. This is likely to be due to higher rates of Diabetes and high blood pressure.
  • Overweight
  • High cholesterol
  • High blood pressure
  • Smoking
  • Coronary artery disease
  • Excessive alcohol intake
  • Cardiomyopathy
  • Hyperthyroidism
  • Stress

Diagnosis

Whilst it is usually fairly clear from the symptoms that a stroke has taken place, it is still important to undergo a range of tests as these will help to determine what type of stroke has occurred (they require different treatment), which part of the brain is affected and how severe the damage is.

The best tests for looking at the brain after a stroke are either CT scans or MRI scans.

Patients who have had a stroke are also asked to perform a swallow test to see if they can swallow ok. A stroke often affects the ability to swallow and difficulty in doing this can result in food reaching the lungs and causing infections.

Further tests may include echocardiograms and angiography to determine the cause of the stroke.

Treatment of Strokes

The aim of stroke treatment is to reduce the effects of the stroke, deal with any complications and to treat factors which may have caused the stroke, in an attempt to reduce the risk of further strokes.

The key to treatment of a stroke is the speed at which medical attention is sought. The sooner the patient receives treatment, the less damage is done. Brain cells start to die after just 4 minutes without blood/oxygen.

Once at the hospital, an emergency CT scan or MRI scan will be undertaken to determine the severity and location of the blockage or bleed.

Clot-busting drugs such as Tissue Plasminogen Activator (t-PA) may be given to help dissolve a blood clot and help restore the flow of blood to the brain. The patient may also be put on a drip to maintain body fluid levels. Other medications such as anticoagulants and cholesterol and blood pressure lowering drugs may also be given if necessary.

Recovery from a stroke can take time and everyone's treatment plan after the initial critical care stage varies, depending on their own symptoms. Usually, a multi-disciplinary team helps to treat and support the patient. This may include Doctors, nurses, physiotherapists, occupational therapists, speech therapists, and psychologists.

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