Every 5 minutes someone in the UK has a stroke. A stroke is a condition where parts of the brain become deprived of blood flow. This can either happen due to the blood vessel becoming blocked with a clot, or because the blood vessel leaks, causing a catastrophic bleed. About 10% of all strokes are cased by bleeds, the rest are caused by blockages. Strokes may lead to permanent damage of brain tissue, unless the blood flow can be restored with swift treatment.
Symptoms caused by a stroke depend on the area of the brain that is affected. Commonly this manifests itself with a sudden onset of any combination of the following symptoms: one-sided facial weakness, problems with vision, slurring of speech and weakness in one arm and/or a leg. Having a stroke is a medical emergency and requires an urgent 999 response.
Transient Ischemic Attack (TIA)
Transient ischemic attacks (TIAs) are often incorrectly called “mini strokes.” Unlike an actual stroke, however, TIAs lead to temporary symptoms, which last no longer than 24 hours. This temporary blockage results in areas of the brain being deprived of blood flow, and hence oxygen, for a short period. The blockage clears, blood flow returns, and the brain recovers. Though a TIA is only temporary, they can indicate a potentially serious increase in the risk of having a stroke with in the following seven days.
What happens when a Stroke is suspected?
As soon as a patient is brought in with a suspected stroke, they will be seen by doctor and often an urgent brain scan is arranged. The scan helps to show whether the stroke symptoms are being caused by a blockage or a haemorrhage. If a blockage is found, then special clot busting drugs can often be used to help destroy the clot and restore blood flow. In most cases, this can prevent or minimise any loss of brain tissue. For the treatment to be successful, it is important to have the patient scanned within 3 hours of the appearance of the symptoms, so it is crucial that people recognise the signs early and call emergency services immediately.
If there has been a haemorrhage, this tends to be more severe and sometimes a neurosurgical opinion may be required. Strokes caused by bleeding are more difficulty to treat and usually have a poorer outcome.
If a patient comes in to hospital and symptoms are resolving, this usually suggests a TIA. A scan, however, is usually still done to confirm this. The aims of treatment here are to lower the risks of the person going on to having a full-blown stroke in the immediate future. At this point, the patient will probably be put on special blood thinning drugs. Furthermore, the patient's blood pressure, cholesterol and any other risk factors would be addressed.
FAST
It is important that everyone is able to identify the major signs of a possible stroke. In doing so, we can ensure people get to the hospital quickly. Prompt admission, scanning and treatment will in most cases improve the outcome.
All you need to learn is FAST:
Face
Arm
Speech
Time to call 999
Face: Look at the person's face, does one side of the face seem to be drooping? Are they having difficulty smiling or opening their eye?
Arm: Are they having difficulty lifting both arms and/or legs?
Speech: Does their speech sound slurred ? Are they not making sense, or using the wrong words?
Time to call 999: If they have any of the above symptoms, you should call 999 without delay.
Additional Information
Strokes can present with other symptoms as well. If you would like more general information about stroke symptoms, tests and treatments please visit the Stroke Association website. In addition, if you have specific questions regarding tests you may have had, or if you would like to know about screening, feel free to e-mail one of our DrAdvice doctors.
References
The Royal College of Physicians. (2008). Stroke National clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). Available: http://guidance.nice.org.uk/CG68/Guidance/pdf/English. Last accessed 16 November 2009.
Dr Shazan Chughtai MB BS
