Overview
A stroke happens when blood stops reaching part of the brain. Brain cells begin to die within minutes, so a stroke is always a medical emergency.
There are two main types. An stroke, the more common type, is caused by a clot blocking a blood vessel in the brain. A stroke is caused by a blood vessel bursting and bleeding into or around the brain.
A (TIA), or mini-stroke, causes the same symptoms for a short time. It is a warning that a full stroke may follow, and it needs urgent medical attention too.
Symptoms
Symptoms start suddenly. The FAST check covers the most common signs:
- Face: one side of the face droops
- Arms: one arm is weak or numb, or drifts down when both arms are raised
- Speech: speech is slurred or confused
- Time: call for emergency help at once
Other sudden symptoms can include:
- Weakness or numbness on one side of the body
- Blurred vision or loss of sight
- Confusion
- Dizziness or loss of balance
- A very severe headache with no clear cause
When to see a doctor
Do not wait to see whether the symptoms improve. The treatments that work best can only be given within a few hours of the first symptoms.
Causes
An stroke happens when a clot blocks an artery supplying the brain. The clot may form on fatty deposits () in an artery, or travel from the heart, which is more likely with an irregular heartbeat called .
A stroke happens when a weakened blood vessel bursts. Long-standing high is a major cause. A bulge in a vessel wall (aneurysm) can also bleed.
Risk factors
- High
- Diabetes
- Smoking and other tobacco use
- High
- and other heart disease
- Being overweight or physically inactive
- Heavy alcohol use
- Older age
- A previous stroke or TIA
Complications
The effects depend on which part of the brain is affected and how quickly treatment begins. They can include:
- Weakness or paralysis, usually on one side of the body
- Difficulty speaking or understanding speech
- Difficulty swallowing
- Problems with memory and thinking
- Loss of bladder or bowel control
- Depression and anxiety
Prevention
- Checking regularly and treating it if it is high
- Keeping diabetes and under control
- Not smoking or using tobacco
- Eating less salt and more vegetables and fruit
- Being physically active and keeping to a healthy weight
- Limiting alcohol
- Taking prescribed medicines as advised, including blood thinners for
Diagnosis
Doctors need to find the type of stroke quickly, because a clot and a bleed are treated differently. Tests may include:
- A CT or of the brain
- Blood tests, including blood sugar and clotting
- An to look for an irregular heartbeat
- scans of the heart and the neck arteries
Treatment
For an stroke, a clot-dissolving medicine () may be given if the person reaches hospital within a few hours of the first symptoms. In some cases the clot is removed through a thin tube passed along an artery (). Medicines that reduce clotting then help prevent another stroke.
For a stroke, treatment focuses on controlling and limiting the bleeding. Some people need surgery.
Rehabilitation starts early and may involve physiotherapy, speech and language therapy, and occupational therapy to help relearn everyday skills.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“The weakness and slurred speech passed off in a few minutes, so it was nothing serious.”What is true?
Fact
Stroke symptoms can stop after a short time, and it is easy to think everything is fine. A brief episode is a warning that a full stroke may follow, so get medical help straight away even if the person feels completely well again.
Myth“Strokes only happen to the very old.”What is true?
Fact
A stroke is more likely as people get older, but it can happen at any age. The FAST signs deserve the same emergency response whatever the person's age.
Myth“Once a stroke has happened the damage is done, so there is no hurry to reach hospital.”What is true?
Fact
Every minute counts. The treatments that limit the damage can only be given in the first few hours after the symptoms begin, so the sooner the person reaches hospital, the better the chance of recovery. Note the time the symptoms started, as it helps doctors choose the treatment.
Myth“Pricking the fingers and toes with a needle, or giving water or lemon juice, will bring the person round.”What is true?
Fact
There is no home remedy for a stroke, and trying one only uses up the time that matters most. The treatments that help are given in hospital, so call an ambulance at once and note the time the symptoms began.
Myth“A stroke cannot be prevented. It simply happens.”What is true?
Fact
Many strokes can be prevented. High blood pressure is the main risk factor, so having it checked and treated helps, along with controlling diabetes and cholesterol, not using tobacco, staying active and keeping to a healthy weight. Medicines are used when these changes are not enough.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
The symptoms went away after a few minutes. Is it still serious?
Yes. Symptoms that pass quickly may be a transient ischaemic attack (TIA), which is a warning that a full stroke could follow. It needs urgent medical assessment, even if the person feels completely well again.
Can a person recover fully after a stroke?
Recovery varies widely. Some people recover fully, while others are left with lasting difficulties. Early treatment and rehabilitation give the best chance of regaining movement, speech and independence.
Is a stroke the same as a heart attack?
No. A stroke affects the brain and a heart attack affects the heart. Both are often caused by a blocked blood vessel, they share many risk factors, and both are emergencies.
