A stroke happens when blood flow to a part of the brain is cut off. Without blood, brain cells start dying within minutes. This makes the speed of treatment very important, so the most important thing that people can do is recognise the signs of a stroke and call for help quickly. Every year in the UK around 115,000 people have a stroke, and a further 30,000 have a recurrent stroke. Although strokes can occur at any age – even in the very young – the vast majority of cases are in the elderly. This means that in the UK about 1% of the over-75 population have a stroke every year.
To remember the signs of a stroke, think “F-A-S-T”. F stands for face (face droop), A stands for arm (weakness in one or both arms), S stands for speech (trouble in speaking), and T stands for time (immediately call the emergency number local to you, such as 999 in the UK).
Other symptoms of stroke can be sudden confusion, blurred vision in one or both eyes, seeing double, dizziness or loss of balance and coordination, and a severe headache.
Once you have recognised that someone you are with has symptoms of a stroke, call for help as soon as you can. While you wait, avoid giving them medication, food or anything to drink.
Once they arrive at hospital the medical team will carry out a series of tests to determine if this is a stroke. If a stroke is diagnosed, there are different treatment options available including medications and surgery, depending on the type of stroke.
Different parts of the brain can be affected by a stroke, and so this gives different symptoms and long term deficits. The whole of one side of the body may be affected, or just one arm, hand or leg. The anatomy of the brain is complex, and one side of the brain carries messages via nerves to muscles on the other of the body, so a stroke on the right side of the brain may affect movement or sensation of the left side of the body
A stroke at the back of the brain, over the occipital region, is more likely to affect visual function. If a stroke hits very specific areas of the brain, this may affect speech, either articulating sounds or understanding words.
Whilst in all strokes there is a loss of blood reaching a part of the brain, this can happen in two ways – ischaemic and haemorrhagic strokes.
An ischaemic stroke occurs in around 80% of cases and happens when an artery (a blood vessel taking blood away from the heart) is blocked by plaque or a blood clot, stopping blood from reaching a particular part of the brain. This clot often forms over time in the artery itself but can sometimes travel to the brain from another part of the body, such as can occur in the condition atrial fibrillation.
A haemorrhagic stroke occurs when a blood vessel in the brain breaks and bleeds into the brain tissue, and about 10-15% of strokes are of this type. This can be an intracerebral bleed, where the blood vessel bursts in the brain itself, or a subarachnoid haemorrhage where a blood vessel burts in the narrow gap between the brain and the skull.
There is a third type of stroke called a transient ischaemic attack (TIA), also sometimes referred to as a “mini-stoke”. This is where the blockage of blood flow to the brain is temporary, lasting anywhere from a few minutes up to 24 hours. The symptoms of a TIA are very similar to a stroke, but they then improve whereas a stroke often causes permanent damage. Anyone who has a TIA should be seen by a specialist within 24 hours of their symptoms developing.
Common risk factors for strokes include high blood pressure, smoking, a history of atrial fibrillation (a type of irregular heart beat), diabetes and high cholesterol levels - these are all cardiovascular disease risk factors.
Dietary changes such as reducing salt, cholesterol, saturated and trans-fat intake can reduce the overall risk of stroke. Exercising daily, even for small periods can help improve general health and further reduce the risk of stroke as can stopping smoking and drinking less than 14 units of alcohol a week.
Some risk factors such as high blood pressure, diabetes and high cholesterol can be treated with medication alongside lifestyle changes, so if you are concerned you have any of these, see your doctor for advice.
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