Strokes can happen to anyone at any age, what causes them, how to spot them and what to do.
A stroke (or CVA Cerebral Vascular Accident) is a disturbance to the blood flow of the brain caused by a blockage or bleed in one of the blood vessels supplying the brain. 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, 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?
Tongue – if they stick their tongue out, is it crooked to one side or another?
Unequal pupils are another indication that the casualty could be experiencing a stroke.
Other potential symptoms
- loss of consciousness
- paralysis or weakness on 1 side of the body
- a sudden and very severe headache resulting in a blinding pain unlike anything experienced before
- sudden blurring or loss of vision
- difficulty understanding what others are saying
- difficulty speaking
- problems with balance and co-ordination
- difficulty swallowing
There are 2 main causes of strokes: Caused by a blockage or a bleed:
ischaemic – where the blood supply is stopped because of a blood clot; this accounts for 85% of all cases, or it 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) is a related condition which can cause stroke-like symptoms that resolve fairly quickly. The arteries in the brain have become blocked by fatty plaques (in the same way as with angina in the heart) and TIAs are warning signs that someone is at high risk of having a stroke. Any stroke-like symptoms should be taken seriously, and a medical professional consulted immediately. Early diagnosis and treatment can prevent a full stroke. TIA’s can last from just a few minutes to up to 24 hours.
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– if the stroke is caused by a blood clot and they are able to receive clot-busting drug treatment (Alteplase) within 3 hours, the symptoms of the stroke can often be reversed.
Treating a stroke
Treatment depends upon the type of stroke you have. It is also 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 full and swift recovery, for others it can be a very long and traumatic process.
In some cases a lengthy period of rehabilitation is needed before the person who has suffered a stroke can fully recover. Sadly, some are never able to fully regain their former independence and need on-going support to manage the effects of their stroke. Physiotherapy can be extremely helpful.
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.
Link with the contraceptive pill
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.
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.
Lifestyle choices have a major impact on the risk of stroke. Too much stress, 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.
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.