What is a Stroke?

Strokes are the third commonest cause of death and the single most common cause of disability in the UK. They're commonest in the elderly, but can affect young adults, children and even babies.

A Stroke is a Brain Attack

Heart attacks happen when blood supply to the heart muscle is cut off. Similarly, strokes can be seen as brain attacks, as they occur when blood supply to part of the brain is interrupted, either due to a blocked blood vessel, or a bleed in the brain. The brain cells need oxygen and nutrients that the blood brings, and they start to die off soon after the blood supply stops.

What Causes Stroke?

• Up to 85 % of strokes are ischemic, where a brain blood vessel gets blocked by a blood clot, which may have formed right there, or been carried from a blood vessel elsewhere(embolus).
• Haemorrhaghic strokes occur when a blood vessel bleeds into the brain. This type of stroke, though rarer, is more deadly, accounting for more than 30% of stroke deaths.

A Stroke is a Medical Emergency

The sooner that a patient with a stroke gets medical help, the better the chances are of recovery. Some treatments can have dramatic effects, but need to be started as soon as possible, to limit the extent of brain cell death. Most people know that it's important to get someone with a heart attack to hospital as soon as possible. In recent years there's been a lot of effort made to improve public recognition that strokes are brain attacks, and as such, are medical emergencies too.

What Are The Symptoms Of Stroke?

When brain cells die, whatever abilities that part of the brain controlled are lost. Abilities affected include movement, speech, memory, sensation, vision and coordination. Common symptoms include sudden onset of:

• Weakness, paralysis or numbness and tingling in one leg, arm, or side of the face, usually on one side of the body
• Speech difficulties, like slurring, or problems with understanding and speaking
• Loss of vision or blurred vision in one or both eyes
• Dizziness, difficulty walking
• Severe headache

The Fast Test

A simple system to help people recognize a stroke is called the Face-Arm-Speech-Test (FAST)

• F – Facial weakness - Ask the person to smile – Does one side of the mouth or one eye droop?
• A – Arm weakness – Does one arm drift downwards if you ask them to lift both arms?
• S –Speech problems – Ask them to repeat a simple sentence. Is speech slurred or odd?
• T – Time is of the essence!! Call 999 if any of these symptoms are present

What Determines the Effects of a Stroke?

How a patient is affected by a stroke depends on which brain area was damaged, how extensive the damage is, and what overall state of health he was in before the stroke. The brain is divided into two halves, with the left brain controlling much of the right side of the body and vice versa. So the side of the body affected in a stroke is often opposite to the side of the brain affected. Language problems are commonest if the left brain is affected, and perceptual and spatial problems are commoner in right brain strokes

Some Risk Factors for Stroke are Out of Your Control

• Age – Most strokes happen in people over age 55, and risk continues to rise with age.
• Family History – If a close relation had a stroke, your risk is raised.
• Gender – Below age 75, strokes are commoner in men than in women.
• Ethnic background – strokes are commoner in people of African –Caribbean, African and Asian background.

Some Risk Factors For Stroke Can Be Controlled

• Medical conditions – Stroke risk is raised if you have diabetes, hypertension, heart disease or arrhythmias (irregular heart beat) But proper treatment and control of these chronic conditions can greatly reduce stroke risk.
• Diet – If you eat a lot of junk food that's salty and high in saturated fats, your weight, cholesterol and blood pressure will probably go up, and these will all increase the risk of stroke. A "Mediterranean" diet with lots of fruit, vegetables, beans, pulses and fish cuts the risk of stroke as well as heart disease.
• Alcohol – Heavy drinking increases blood pressure, and binges raise the risk of burst blood vessels in the brain.
• Exercise - Regular exercise keeps your heart and blood vessels healthy, while a sedentary, "couch potato" lifestyle tends to increase the chances that your arteries will clog up.
• Smoking - If you smoke, your risk of having a stroke is doubled.

A Preventable Disease

If you're worried about having a stroke, take heart. 80% of strokes are actually preventable, with the right lifestyle modification and medical care.