STROKE

What is stroke?

A stroke occurs when blood supply to a part of the brain is cut off, and the cells in that part of the brain dies. When this happens, the functions that are controlled by that part of the brain are lost. Depending on which part of the brain is affected, a person may have different symptoms. Blood is brought to the brain by blood vessels called arteries. A stroke happens when an artery to the brain is blocked or bursts. This may be due to high blood pressure or a weak artery wall from birth.

Causes & risk factors

Some risk factors for stroke are unchangeable (e.g. age and family history).

Others are related to our lifestyle. They include:

Smoking

Being overweight increases your chances of getting other stroke risk factors like high blood pressure, heart disease, high blood cholesterol, atherosclerosis and diabetes.

Eating foods which have excess salt and are high in saturated fat can lead to high blood pressure and thus increase your risk of stroke.

Sedentary lifestyle. Being inactive increases your risk of being overweight and having other stroke risk factors.

Alcohol. Drinking too much alcohol increases your risk of stroke.

Stress; if not managed properly, can lead to high blood pressure.

Some medical conditions if poorly controlled can increase risk of stroke. These include:

  • High blood pressure
  • Atrial Fibrillation (a heart rhythm disorder)
  • High LDL cholesterol
  • Diabetes

Signs & symptoms

One or more of the following symptoms may be present:

•Sudden numbness or weakness usually on one side of the body

•Sudden confusion or a fit

•Difficulty speaking or understanding

•Sudden difficulty seeing in one or both eyes

•Sudden difficulty in walking

•Difficulty in swallowing

•Sudden severe giddiness, loss of balance or coordination

•Sudden severe headache with no known cause

•Loss of concentration and memory

•Loss of control of passing urine or passing motion

Screening & diagnosis

If you have the signs and symptoms of stroke such as weakness or numbness of the limbs, you will undergo some tests which may include:

•blood tests (e.g. to detect diabetes and high blood cholesterol)

•brain scan – usually a CT or MRI scan to confirm the type of stroke (whether it is due to a blood clot or burst blood vessel) and where it has occurred

•ECG (electrocardiogram) – to look for heart disease

•Ultrasound scans (e.g. of the blood vessels to the brain to look for abnormalities)

•Angiogram – an x-ray text in which a small tube inserted via a blood vessel in the groin to reach the blood vessels to the brain. A dye injected through the tube then shows the degree of blockage of blood vessels or the location of the bleeding in the brain.

Treatment

•Medication – the doctor may prescribe medication, for example, in the case of a stroke caused by a blood clot, “blood thinners” may be prescribed.

•Surgery – a stroke that is caused by a blood vessel that has burst may require urgent surgery to stop the bleeding. In other cases, surgery may be performed later, to reduce the risk of another stroke, for example if there is serious narrowing of the neck artery, an operation may be done to remove or open up the narrowed area.

•Rehabilitation – this is a very important part of treatment for stroke. See Post-Stroke Rehabilitation for more information.

Self-care

Lead a healthy lifestyle

Do not smoke.

Aim to maintain healthy weight range. Keep your BMI at 18.5- 22.9kg/m2s.

Have a healthy diet, which is low in fat, salt and sugar and high in fibre. And take at least 2 servings each of fruits and vegetables daily.

exercise for 30 minutes at least 5 days a week. If you have not been exercising regularly, check with your doctor before you start an exercise programme.

Limit alcohol intake to no more than 2 standard drinks per day. 2/3 small can of beer (220 ml), 1 glass of wine (100ml), or 1 nip of spirit (30ml)

Manage your stress.

Living with stroke

Post-Stroke rehabilitation

The aim of rehabilitation is to allow you to regain as much independence as possible. Rehabilitation will start as soon as your doctor feels it is possible and will continue after your discharge from hospital. Rehabilitation usually involves a group of specialists and depends on the type of stroke.

Rehabilitation includes:

•teaching of mobility skills (physiotherapy) – walking, moving from chair to bed, etc

•swallowing and speech therapy

•teaching of self-care skills (occupational therapy) like bathing, dressing and feeding independently.

Your doctor will refer you to the appropriate rehabilitation specialist (e.g. physiotherapists, speech therapists). Rehabilitation often continues on an outpatient basis after discharge from hospital.

Prevention

Watch out for a TIA

A transient ischaemic attack (TIA) is a warning sign of a stroke. However, not all who have a stroke get this warning sign. A TIA happens when blood supply to a part of the brain is temporarily cut off. It may last from a few seconds to up to 24 hours, after which there is complete recovery. Because symptoms of a TIA are often vague and temporary, people tend to ignore them. Early effective treatment of a TIA can help to prevent a stroke from occurring in the future.

Should you have any of the following warning signs, you should see a doctor immediately:

•Sudden, unexplained tingling and/or numbness on one side of the body

•Sudden weakness or paralysis of the face, arm or leg

•Sudden severe headache with no obvious cause

•Dizziness or fainting

•Blurred vision

•Difficulty talking

•Stumbling and/or sudden clumsiness.

Stroke is an emergency. The earlier the treatment, the better the recovery. The longer a stroke goes untreated, the greater the damage. Once a part of the brain dies, it cannot be repaired and the effects are permanent.

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