Strokes

Symptoms of a stroke

The main symptoms of stroke can be remembered with the word FAST:

• Face – the face may have dropped on one side, the person may not be able to smile, or their mouth or eye may have dropped
• Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of weakness or numbness in one arm
• Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake
• Time – it's time to dial 999 immediately if you see any of these signs or symptoms

The sooner a person receives treatment for a stroke, the less damage is likely to happen.

Other possible symptoms

Symptoms in the FAST test identify most strokes, but occasionally a stroke can cause different symptoms.

Other symptoms and signs may include:

• complete paralysis of one side of the body
• sudden loss or blurring of vision 
• dizziness
• confusion 
• difficulty understanding what others are saying
• problems with balance and coordination 
• difficulty swallowing (dysphagia)
• a sudden and very severe headache resulting in a blinding pain unlike anything experienced before
• loss of consciousness

However, there may be other causes for these symptoms.

Diagnosing a stroke

Strokes are usually diagnosed by carrying out physical tests and studying images of the brain produced during a scan.

When you first arrive at hospital with a suspected stroke, the doctor will want to find out as much as they can about your symptoms.

A number of tests can be carried out to help confirm the diagnosis and find out the cause of the stroke.

This may include: 

• blood tests to find out your cholesterol and blood sugar levels
• checking your pulse for an irregular heartbeat
• taking a blood pressure measurement

Causes of a stroke

Like all organs, the brain needs the oxygen and nutrients provided by blood to function properly.

If the supply of blood is restricted or stopped, brain cells begin to die.

This can lead to brain injury, disability and possibly death.

There are two main causes of strokes:

• ischaemic – where the blood supply is stopped because of a blood clot, accounting for 85 per cent of all cases
• haemorrhagic – where a weakened blood vessel supplying the brain bursts

 Transient ischaemic attack (TIA)

There's also a related condition known as a transient ischaemic attack (TIA), where the blood supply to the brain is temporarily interrupted.

This causes what's known as a mini-stroke, often lasting between a few minutes and several hours.

TIAs should be treated urgently. 

They're often a warning sign you're at risk of having a full stroke in the future.

Seek medical advice as soon as possible, even if your symptoms get better.

Certain conditions increase the risk of having a stroke, including:

• high blood pressure (hypertension)
• high cholesterol
• atrial fibrillation
• diabetes

Treating a stroke

Treatment depends on the type of stroke you have, including which part of the brain was affected and what caused it.

Strokes are usually treated with medication. This includes medicines to prevent and dissolve blood clots, reduce blood pressure and reduce cholesterol levels.

In some cases, procedures may be required to remove blood clots.

Surgery may also be needed to treat brain swelling and reduce the risk of further bleeding in cases of haemorrhagic strokes.

Recovering from a stroke

People who survive a stroke are often left with long-term problems caused by injury to their brain.

Some people need a long period of rehabilitation before they can recover their former independence.

Many people never fully recover and need support adjusting to living with the effects of their stroke.

If required, you will be offered further rehabilitation in your home after you have been discharged from hospital to assist in your recovery.

Some people will be dependent on some form of care for help with their daily activities. For example, a care worker could come to the person's home to help with washing and dressing, or to provide companionship.

Read about:

• reablement services
• health services

Preventing a stroke

You can significantly reduce your risk of having a stroke through leading a healthy lifestyle by:

• eating a healthy diet
• taking regular exercise
• drinking alcohol in moderation
• not smoking

If you have a condition that increases your risk of a stroke, it's important to manage it effectively, for example, by lowering high blood pressure or cholesterol levels with medication.

If you've had a stroke or TIA in the past, these measures are particularly important because your risk of having another stroke is greatly increased.

Stroke in children

Stroke doesn't just affect adults. Every year around 400 children in the UK will have a stroke, according to the Stroke Association.

• Childhood stroke

More useful links

• Stroke
• Emergency department waiting times
• Stroke Association Northern Ireland
• NICHS respiratory support