Stroke
What is a Stroke?
A stroke is a serious condition which occurs when blood supply to a part of the brain is cut off. This is a medical emergency and if you suspect someone is having a stroke, call 999 immediately and ask for an ambulance. The quicker someone receives medical treatment the less likely sever damage will occur. Strokes are the third largest cause of death following heart disease and cancer. Strokes can occur in anyone but those most at risk are people over 65; of African, Caribbean or south Asian descent; have high blood pressure; have diabetes or smoke.
What are the causes for a Stroke?
Stroke can divided into two types: ischaemic or haemorrhagic. Ischaemic (85% of cases): a thrombus (clot) forms in a blood vessel in the brain or an embolus (clot) which has travelled through the body and become stuck in a blood vessel in the brain. The clot blocks of oxygen and nutrients getting to parts of the brain and so it begins to die. Haemorrhagic (15% of cases): Strokes can also be due to a bleed in the brain. If the blood vessels supplying the brain burst, blood isn’t directed to the right parts of the brain and so these parts begin to die.
Sometimes people experience transient ischaemic attacks or mini-strokes which are when the blood flow to the brain is blocked temporarily. These should be treated seriously, even if a person seems ok after as they are a warning sign that the person is at risk of having a full stroke soon.
What are the symptoms of a Stroke?
Stroke symptoms can be remembered by the pneumonic FAST (FACE, ARMS, SPEECH, TIME).
Face – one side may be drooping and a person might not be able to smile. Arms – a person won’t be able to lift both their arms to the same height due to weakness in one side. Speech – their speech might be slurred or they might not be able to talk at all. Time – a stroke needs to be treated as soon as possible so call 999 if you suspect it
There are some other symptoms for strokes as well as FAST. These include total paralysis on one side the body, confusion, dizziness, difficulty balancing, severe sudden headache, loss of consciousness.
How is a Stroke treated?
If a stroke is treated early, long-term disability can be prevented and lives can be saved. There is different treatment depending on the type of stroke suffered.
Ischaemic strokes: Medication is given to treat the immediate condition and once the person is stable, there is other longer term medication given. Medication to break up the clot (thrombolysis) is given within the first 4 hours of symptoms appearing. Alteplase is often given and acts by dissolving the clot. After the initial clot has been dealt with, people will be given aspirin to reduce the chance of another clot forming or other anti-platelet medication such as Clopidogrel and Dipyrimadole. Some people might also be offered an anticoagulant such as Warfarin to reduce the risk of clots forming in the future. If you have risk factors for strokes such as high blood pressure, medication to treat that might also be given to you.
Haemorrhagic strokes: Medication to lower blood pressure such as ACE Inhibitors will be given and if you were taking anticoagulation medication, this might be reversed. Surgery might be performed to remove blood from the brain and repair blood vessels. The procedure is called craniotomy. During a craniotomy, a section of the skull is cut away to access the brain. Damage to blood vessels will be repaired and the piece of bone which was removed will often be replaced with an artificial metal plate.
