Strokes can happen to anyone at any age, what causes them, how to spot them and what to do.
A stroke is a brain attack. Blood flow in the brain is interrupted by a blockage or bleed in one of the blood vessels, causing brain cells to be damaged or die. Blockages to the brain are a lot more common than bleeds. Both have the same symptoms.
A stroke can happen to anyone of any age, even babies, although they are more common in older people. Some people are able to make a full recovery following a stroke, others experience life-changing damage and sadly for some people a stroke is fatal.
What you are looking for?
Face – can they smile and show their teeth?
Arms – can they raise their arms and keep them held there, or does one arm fall?
Speech – can they repeat a phrase you give them? Is their speech slurred? Do they have difficulty remembering words?
Time – If you see any of these three signs, it’s time to call 999.
Other potential symptoms
sudden weakness or numbness on one side of the body, including legs, hands or feet
difficulty finding words or speaking in clear sentences
sudden blurred vision or loss of sight in one or both eyes
sudden memory loss or confusion, and dizziness; or a sudden fall.
a sudden or severe headache
There are 2 main types of stroke: Caused by a blockage or a bleed.
Ischaemic – which are caused a blood clot blocking blood flow in the brain; these are more common and account for 85% of all cases. They can be caused by a build-up of plaque and fatty deposits in the arteries. If these plaques break away, or if they slow the blood flow to the extent that it forms a clot, they can block a blood vessel supplying the brain and cause a stroke.
Haemorrhagic – where a weakened blood vessel supplying the brain bursts
Trans-Ischaemic Attacks (mini-strokes)
A Trans-Ischaemic Attack (TIA) also known as a mini-stroke, is the same as a stroke, except that the symptoms last for a short amount of time, from just a few minutes to up to 24 hours. . TIAs are warning signs that someone is at high risk of having a stroke. The FAST test can be used to recognise the signs of a TIA, any stroke-like symptoms should be taken seriously, and treated as a medical emergency. Do not wait to see if symptoms get better, early diagnosis and treatment can prevent a full stroke.
Rapid response is vital
The quicker someone having a stroke receives treatment, the less damage is likely to happen.
If someone is showing the signs of a stroke, phone an ambulance immediately and get them to a specialist Stroke Unit as soon as possible. Time is critical – an estimated 1.9 million neurons in the brain are lost every minute a stroke is untreated. If the stroke is caused by a blood clot and they are able to receive clot-busting drug treatment (Alteplase) within four and a half hours, the symptoms of the stroke can be dramatically reduced.
Treating a stroke
Treatment depends on a number of factors. Your age, health and medical history need to be taken into account, so too does the type of stroke you have had. Treatment is determined by what caused the stroke and which part of the brain was affected.
Mostly strokes are treated with medication. The medication would target reducing blood pressure, reducing cholesterol and preventing and dissolving blood clots.
Sometimes, blood clots can be removed in surgery. It is possible to perform a procedure similar to angioplasty in the heart, where blockages are removed by inserting a miniature wire into the blocked artery, removing the blockage and possibly inserting a stent to keep the vessel open and improve blood flow.
In the case of haemorrhagic strokes, surgery can also treat brain swelling and reduce the risk of further bleeding.
Recovering from a stroke
Those who survive a stroke can sustain an injury to their brain leaving them with long-term problems. Some people make a good and swift recovery, for others it can be a very long and traumatic process. Stroke is a leading cause of disability in the UK. Almost two thirds of stroke survivors in England, Wales and Northern Ireland leave hospital with a disability
In some cases a lengthy period of rehabilitation is needed before the person who has had a stroke can fully recover. Although, the biggest steps in recovery are usually in the first few weeks after a stroke, the brain’s ability to ‘re-wire’ itself, known as neuroplasticity, means it is possible to continue to improve for months or years.
It can take a lot of effort and determination to keep going with rehabilitation. It can be very hard work, physically and mentally, but many people find it helps them make vital progress with speaking, walking and other key skills. Therapists work with you to set achievable goals. You can keep a record of your progress and celebrate your successes. You might not be able to cope with much rehabilitation in the early days. When you feel stronger, you can do more.
Main risk factors for stroke
The risk of suffering from a stroke increases as you get older. This is due to the natural narrowing and hardening of our arteries as we age. Strokes are most common in people over the age of 55.
Certain medical conditions can increase your risk of stroke including:
high blood pressure
An important way to reduce your risk of stroke is to find out if you have any of these conditions and work with your doctor to manage them.
Lifestyle choices have a major impact on the risk of stroke. Smoking, drinking too much alcohol, consuming too much salt, being overweight and eating unhealthy foods, damages blood vessels, increases blood pressure and dramatically raises the risk of stroke. Conversely, changing lifestyle and making healthy choices to reduce the stress to blood vessels can substantially reduce the likelihood of someone experiencing a stroke.
Some ethnicities are at higher risk of stroke
People with African, Caribbean or South Asian backgrounds have a higher predisposition to diabetes, atherosclerosis and high blood pressure. These underlying medical conditions greatly increase the risk of stroke.
Link with the contraceptive pill
Overall, the risk of stroke from using contraception is low but some types of hormone-based contraception do carry an increased risk of stroke. However, your risk of stroke should be carefully checked before you are given any of these treatments by the doctor. Women with risk factors for stroke may not be able to use contraceptive pills containing oestrogen. This is because high levels of the female hormone oestrogen can make your blood more likely to clot. However, if you are concerned about using the pill, or you want to find out more about your risk of a stroke, speak to your GP.
Health conditions that can affect pregnant women such as pre-eclampsia and gestational diabetes can raise your risk of a stroke. However, routine ante-natal checks should pick up and treat these issues if they occur. Furthermore, if you have any health concerns when pregnant, always speak to your midwife or GP immediately.
To read our article on strokes and high blood pressure click here
Written by Emma Hammett for First Aid for Life
It is strongly advised that you attend a fully regulated Practical or Online First Aid course to understand what to do in a medical emergency. Please visit firstaidforlife.org.uk or call 0208 675 4036 for more information about our courses.
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First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.