Strokes: A Useful Guide

Strokes are serious life-threatening medical emergencies which require urgent medical attention. The earlier somebody suffering from a stroke receives medical treatment, the less damage is likely to be caused to their body.

Today’s blog post takes a closer look at strokes, including what causes them, the symptoms, treatment and recovery. We’ll also look at the best ways of lowering your chances of suffering from a stroke in the future.

Statistics of Strokes

Strokes occur when the blood supply to part of your brain is cut off. Blood supplies your brain with essential nutrients and oxygen and without your blood, your brain cells can be damaged or even die. A stroke can change the way your body works as well as how your feel, think and communicate.

The statistics for strokes here in the UK are quite concerning. Did you know that:

There are more than 100,000 strokes in the UK each year; that’s around one stroke every five minutes. In fact, having a stroke is the fourth single leading cause of death in the UK. – Stroke Association.

The average age for men in England, Wales and Northern Island to have a stroke is 74, a figure which drops to 71 in Scotland. For women, the average age in England, Wales and Northern Island is 80, a figure which drops to 76 in Scotland. Overall, people are more likely to suffer a stroke if they are over the age of 55.

Here are some more facts and figures:

Stroke is a leading cause of disability in the UK, with around two thirds of all survivors being left with a disability.
Stroke is the fourth largest cause of death in the UK.
Over 40,000 people died of a stroke in the UK in 2015.
There are over 400 childhood cases in the UK each year.
Black people are twice as likely to have a stroke, compared to white people.
Around one in four stroke survivors will experience another stroke within five years.
One in 20 stroke patients have another stroke whilst still in hospital.
A third of stroke survivors experience depression.
More people are surviving stroke than ever before, with over 1.2 million survivors in the UK.

Causes

There are two main types/causes of strokes:

Ischaemic – When blood supply is stopped because of a blood clot. This accounts for 85% of all cases.
Haemorrhagic – When a weakened blood vessel supplying the brain bursts and bleeds into and around the brain.

There are number of reasons why blockages can form and cause a ischaemic stroke. This normally occurs when the arteries have been narrowed and hardened by fatty deposits, caused by problems such as smoking, obesity, diabetes, hypertension and excessive alcohol intake.

Heart conditions such as atrial fibrillation (irregular heartbeat) can also trigger blood clots in your heart, which break-up, escape and become lodged in the blood vessels which supply your brain.

The main trigger for a haemorrhagic stroke is high blood pressure, which weakens the arteries in the brain and makes them prone to splitting. Again, lifestyle choices such as smoking, drinking, a lack of exercise and a bad diet can increase the risk of high blood pressure.

Other causes of haemorrhagic strokes include:

Aneurysms – A weak spot on an artery, where the walls have become thin and weak – meaning that they can burst easily.
Cerebral amyloid angiopathy – When a protein called amyloid builds up inside the blood vessels in the brain, causing damage and torn blood vessels.
Illegal Drugs – For example, cocaine which can irritate blood vessel walls. This causes them to become weaker and more likely to rupture.

Symptoms

The symptoms of a stroke will usually begin suddenly and the ones you experience will depend on the part of your brain which is affected, and the extent of the damage being caused. The main symptoms for strokes can be remembered by using the word F.A.S.T:

Face – The person affected may be unable to smile and their face may have dropped on one side, with their mouth or eye drooping.
Arms – The person affected may be unable to life both arms and keep them there due to weakness in one arm.
Speech – The person affected may suffer from slurred or garbled speech, or may be unable to talk at all.
Time – Don’t waste any time! Dial 999 immediately if you notice any of these symptoms.

Other symptoms that you should take seriously include a sudden weakness or numbness down one side of your body, sudden blurred vision or loss of sight in one or both eyes, a sudden, severe headache and sudden memory loss or confusion.

If your symptoms only last for a short period of time, no longer than 24 hours, it may be that you’re suffering from a transient ischaemic attack (TIA). A TIA is a mini-stroke and although the symptoms don’t last as long, you still need to seek medical attention. A mini-stroke is a warning that there is a problem with the blood supply to your brain and that you’re at an increased risk of having a stroke in the near future.

If you spot any of these signals you need to call for help straight away – Paramedics are trained on how to deal with strokes.

Diagnosis

Upon arrival at hospital it is likely that you’ll be admitted to an acute, or hyper-acute, stroke unit. Doctors will want to know as much as possible about the symptoms you suffered from and will carry out several tests to help confirm the diagnosis of a stroke.

Tests include:

Blood tests to determine your blood sugar and cholesterol levels.
Blood pressure measurement.
Checking your pulse for an irregular heartbeat.
Swallow tests.

Brain scans (CT and/or MRI) will also be carried out to determine if the stroke has been caused by a blocked artery or a burst blood vessel, which part of the brain has been affected and how severe the stroke is. This brain scan will usually take place within an hour of arriving at the hospital.

Treatment

The quicker your stroke is diagnosed and treated, the better your recovery will be. The course of treatment given to you will depend on the type of stroke that you have suffered: an ischaemic stroke or a haemorrhagic stroke.

For the former, a combination of medication is used to treat the condition and prevent it from happening again. The most common type of treatment for this type of stroke is known as thrombolysis.

This involves the injection of alteplase, which dissolves blood clots and restores blood flow to your brain. The sooner this is started, the more effective it can be. It isn’t generally recommended if more than 4.5 hours have passed, as it’s not clear how beneficial it is when used after this time.

Some cases can be treated by using an emergency procedure known as thrombectomy, which removes blood clots and helps to restore blood flow to the brain. This is only effective at treating ischaemic strokes caused by a blood clot in a large artery in the brain.

Other treatment for an ischaemic stroke includes:

Antiplatelets – Used to reduce the chances of another clot forming.
Anticoagulants – Prevent blood clots by changing the chemical composition of your blood.
Antihypertensives – Used to lower your blood pressure if it is too high.
Statins – Used to reduce the level of cholesterol in your blood.
Carotid endarterectomy – Surgery carried out to unblock any blocked arteries.

For a haemorrhagic stroke, emergency surgery may be needed to remove any blood from the brain and to repair any burst blood vessels. This is usually done using a surgical procedure known as a craniotomy.

During this procedure, a section of the skull is cut away to allow the surgeon access to the cause of the bleeding. Any damaged blood vessels will be repaired, and the surgeon will ensure that there are no blood clots present. After the bleeding has been stopped, the piece of bone removed from the skull is replaced, often by an artificial metal plate.

Surgery may also be offered to treat a complication of this type of stroke, known as hydrocephalus. This occurs when the damaged caused from a stroke leads to a build-up of cerebrospinal fluid in the cavities of the brain.

As with ischaemic strokes, some people who have had a haemorrhagic stroke will also be offered medication to lower their blood pressure and prevent further strokes.

After immediate treatment is complete, it may be that you need further short-term treatment to help manage some of the problems caused by the stroke. Examples of such treatment include:

A feeding tube inserted into your stomach through your nose. This will provide nutrition if you have difficulty swallowing.
Fluids given directly into a vein if you’re at risk of dehydration.
Nutritional supplements if you’re malnourished.
Oxygen given through a nasal tube or face mask if you’re levels are low.
Compression stockings to prevent blood clots in your leg.

Recovering from a Stroke

Your recovery from a stroke will depend on the severity and the amount of damage which has been caused to your brain. Some people may recover quickly, whilst others may need long-term support and treatment to help them regain their independence.

As you move into a rehabilitation ward, your stroke team and family will work with you to determine and assess the effects of your stroke and what that means moving forward. Several assessments will take place, including:

Mobility
Swallowing.
Communication and Cognitive.
Nutritional and Hydration Status.
Pressure Area Risk.
Continence.

The team on your stroke unit will include different health professionals who all have specialist training and experience in stroke. Teams can include physiotherapists, psychologists, occupational therapists, speech and language therapists and dietitians.

You will have daily sessions with your therapists to help you to relearn any skills that you may have lost and to build up your confidence and self-belief.

Preventing Strokes

Living a healthy lifestyle is the best way of reducing your chances of a stroke. This includes following these simple suggestions:

Stop Smoking – Smoking narrows your arteries and makes your blood more likely to clot.
Cut down or quit alcohol – Excessive drinking can lead to high blood pressure and can trigger an irregular heartbeat.
Diet – An unhealthy diet can lead to high blood pressure and high levels of cholesterol. A low-fat, high-fibre diet is recommended.

You should also try and combine your healthy diet with regular exercise, as this will help you to maintain a healthy weight. The NHS suggest:

For most people, at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week is recommended.”

If you’re changing your lifestyle habits following a stroke, you should discuss any potential exercise plans with your rehabilitation team to ensure that you’re not pushing too hard, too soon. Regular exercise may not be possible in the first weeks or months after a stroke.

VAT Exemption

If you have suffered from a stroke you qualify for VAT Exemption when purchasing a personal alarm. HMRC state that a product which has been “designed or adapted for a disability” qualifies for VAT exemption.

For a person to qualify they must meet certain criteria set by HMRC. This criteria says that the customer must have a long-term illness, a terminal illness or a disability in order to qualify.

Personal Alarm Information

For more information about our life-saving personal alarm service, please get in touch with our friendly team on 0800 999 0400. Alternatively, complete our contact us form and we will get back to you as soon as possible.

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