Stroke
Published by Bupa's health information team, March 2009.
This factsheet is for people who have had a stroke, or who would like more information about stroke.
A stroke happens when the blood supply to the brain is interrupted. It's sudden and can cause immediate loss of feeling and weakness, usually on one side of your body. A stroke can also affect your speech, vision, memory and emotions.
- About stroke
- Symptoms of stroke
- Complications of stroke
- Causes of stroke
- Diagnosis of stroke
- Treatment of stroke
- Prevention of stroke
- Questions and answers
- Related topics
- Further information
- Sources
About stroke
This factsheet gives a general overview of stroke. See Related topics for more detailed information on the different types of stroke.
Every year in the UK, around 150,000 people have a stroke. It's the third most common cause of death in the UK, and also the leading cause of severe disability. A stroke is a medical emergency, so recognising the symptoms quickly and getting early treatment in hospital is important.
Most people who have a stroke are over 65, but many are younger than this. Anyone can have a stroke, including babies and children.
Types of stroke
- Ischaemic stroke happens when the blood supply to part of the brain is blocked by a blood clot or a piece of fatty material. See factsheet on ischaemic stroke.
- Haemorrhagic stroke is caused by bleeding inside the brain. This can be due to a blood vessel bursting inside the brain, or, more rarely, on the surface of the brain. See factsheet on haemorrhagic stroke.
- Transient ischaemic attack (TIA or "mini-stroke") is similar to a stroke, except the symptoms are only temporary. TIAs happen when the blood supply to the brain is interrupted for a short time. See factsheet on TIAs.
- Stroke due to cervical artery dissection is caused when the lining in one of the arteries in your neck is torn, restricting the blood supply to your brain. See factsheet on cervical artery dissection.
Symptoms of stroke
The symptoms of a stroke vary depending on the type of stroke you have had and the part of the brain it affects. Symptoms usually come on suddenly, within seconds or minutes. Rarely, the symptoms can get worse over a period of hours or days.
Stroke and TIA symptoms may include:
- numbness, weakness or inability to move your face, arm or leg on one side of your body
- difficulty speaking
- sudden loss of sight in one eye or blurred vision
- confusion or difficulty understanding
- loss of balance or coordination
- severe headache
- seizures
- loss of consciousness
A good way to recognise if someone has had a stroke is to use the face-arm-speech test (abbreviated to FAST). This involves checking for three of the main symptoms of stroke - facial weakness, arm weakness and speech problems. If you notice someone has any of these symptoms, you should call for emergency help.
Long-term problems
Some strokes may be quite mild and the effects only temporary, while others may be more severe and cause more lasting damage. How much damage a stroke will cause depends on where in the brain the stroke happened and how many brain cells were affected. Common problems after a stroke include:
- weakness or paralysis, usually on one side of the body
- difficulty swallowing (called dysphagia)
- extreme tiredness
- problems with speech, reading and writing
- problems with vision - such as double vision, or partial blindness
- memory and concentration difficulties
- difficulty in controlling your bladder and bowel movements (incontinence)
- anxiety and depression
These problems can often improve as you recover.
Complications of stroke
One of the main effects of stroke is not being able to move some or all of your body, as the parts of the brain involved in controlling movement have been damaged. This immobility can increase the chances of getting:
- pneumonia
- pressure sores
- constipation
- deep vein thrombosis (DVT)
- contractures (altered position of the hands, feet, arms or legs due to muscle tightness)
Other complications of stroke can include seizures (fits) - especially in the weeks and months after the stroke.
Causes of stroke
A stroke happens when the blood supply to your brain is disrupted. This can be by a blood clot blocking an artery in your brain (ischaemic stroke) or a blood vessel bursting in your brain (haemorrhagic stroke).
Risk factors for stroke include:
- smoking
- high blood pressure
- high cholesterol
- being overweight or obese
- diabetes
- a family history of stroke/heart disease
- abnormal heart beat (arrhythmia)
- conditions that increase your bleeding tendency (eg haemophilia)
- regular, heavy drinking
- using illegal drugs, such as cocaine
A stroke can also happen after an injury to an artery in your neck. This is called cervical artery dissection. See Related topics for further information.
Diagnosis of stroke
You will have a brain scan (a CT scan or an MRI scan) as soon as possible after you have had a stroke to work out what type of stroke you have had and which part of your brain is affected. You may also need to have other scans of your heart and blood vessels.
Your doctor will try to find out why the stroke happened so you can have treatment to prevent further strokes in the future. You may have tests to detect:
- raised blood pressure
- high cholesterol
- diabetes
- irregular heart rhythms
- blood clotting abnormalities
Treatment of stroke
You may be treated in a specialist stroke unit or on a general ward while in hospital for stroke. You will be cared for by a team of doctors, nurses and other health professionals.
If you're unable to swallow, you will be given fluid through a drip in your arm and all the nutrients you need though a tube in your nose. You may be given oxygen through a face mask, if you need it, to help you breathe.
You will be helped to sit up and move around as soon as you are able. If you're unable to move, you will be helped to regularly turn in your bed, to reduce your chance of getting pressure ulcers (bed sores) and of developing a blood clot in your leg veins (deep vein thrombosis).
The exact type of treatment you have will depend on the type of stroke you have; however, it may include the following.
Medicines
Your doctor may prescribe medicines soon after your stroke. If you have had an ischaemic stroke or a TIA, these may include medicines to prevent further blood clots, such as aspirin or clopidogrel. If you have had a haemorrhagic stroke, you may be given medicines to promote blood clotting and reduce bleeding and/or medicines to control your blood pressure.
See Related topics for further information on treatment of each type of stroke.
Surgery
You may sometimes be offered surgery to reduce your risk of having another stroke. This will depend on the type of stroke you have had. See Related topics for specific information.
Stroke rehabilitation
Rehabilitation is a crucial part of stroke treatment - it's the process of overcoming or learning to cope with the damage a stroke has caused. After a stroke, you may need to relearn skills and abilities, learn new skills or adapt to the damage a stroke has caused.
Stroke recovery can be difficult to predict; most people will make most of their recovery in the early weeks and months following the stroke. However, recovery can continue after this time.
The stroke team at the hospital will work out a rehabilitation programme for you (sometimes called a care pathway), designed around your particular needs. This will continue after you leave the hospital. Your rehabilitation programme may involve physiotherapists, speech and language therapists, occupational therapists, ophthalmologists and psychologists, as well as doctors and nurses.
Prevention of stroke
You can take steps to lower your risk of stroke by making changes to your lifestyle, such as:
- stopping smoking - giving up smoking can cut your risk of stroke in half, no matter how old you are or how long you have been smoking
- improving your diet - too much fat in your diet can contribute to the furring up of your arteries, while too much salt can increase blood pressure
- increasing the amount of activity you do - regular activity (30 minutes a day, five days a week) can help to lower your blood pressure and regulate the fat levels in your body
- reducing the amount of alcohol you drink
Make sure you also get your blood pressure and cholesterol levels checked regularly, and take any medicines prescribed to you for high blood pressure/cholesterol.
Related topics
Further information
- The Stroke Association
0845 3033100
www.stroke.org.uk
Sources
- What is a stroke? The Stroke Association. www.stroke.org.uk, accessed 12 November 2008
- Stroke, Hemorrhagic. emedicine. www.emedicine.com, accessed 1 December 2008
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005:606-607
- Stroke rehabilitation. The Stroke Association. www.stroke.org.uk, accessed 15 December 2008
- When a stroke happens. The Stroke Association. www.stroke.org.uk, accessed 12 November 2008
- Cardiovascular disease. British Heart Foundation. www.bhf.org.uk, accessed 12 November 2008
- Stroke. GP Notebook. www.gpnotebook.co.uk, accessed 25 November 2008
- National Collaborating Centre for Chronic Conditions. Stroke: national clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). London: Royal College of Physicians, 2008
- Preventing a stroke. The Stroke Association. www.stroke.org.uk, accessed 1 December 2008
This information was published by Bupa's health information team and is based on reputable sources of evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: March 2009
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