Stroke

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Overview

Damage to the brain from interruption of its blood supply.

A stroke is a medical emergency.

Symptoms of stroke include trouble walking, speaking and understanding, as well as paralysis or numbness of the face, arm or leg.

Early treatment with medication like tPA (clot buster) can minimise brain damage. Other treatments focus on limiting complications and preventing additional strokes.

Symptoms

Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination.

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

Face – the face may have dropped on 1 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 1 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; they may also have problems understanding what you're saying to them.

Time – it's time to dial 999 immediately if you see any of these signs or symptoms.

Causes

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 2 main causes of strokes:

ischaemic – where the blood supply is stopped because of a blood clot, accounting for 85% of all cases

haemorrhagic – where a weakened blood vessel supplying the brain bursts

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

This causes what's known as a mini-stroke. It can last a few minutes or persist up to 24 hours.

TIAs should be treated urgently, as they're often a warning sign you're at risk of having a full stroke in the near 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

irregular heart beats (atrial fibrillation)

diabetes

Risk factors

High blood pressure. ...

Heart disease. ...

Diabetes. ...

Smoking. ...

Birth control pills (oral contraceptives)

History of TIAs (transient ischemic attacks). ...

High red blood cell count. ...

High blood cholesterol and lipids.

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Complications

Blood clots (deep vein thrombosis or pulmonary embolism)

Brain swelling.

Seizures.

Memory loss.

Vision and hearing problems.

Muscle weakness.

Bed sores.

Depression.

Prevention

Whether or not particular preventive measures against a stroke are worthwhile will depend on whether the person has any other conditions and risk factors.

If someone has already had a transient ischemic attack or a stroke, doctors will usually suggest preventive measures after carefully examining them.

People with high blood pressure can reduce their risk of a stroke by taking blood-pressure-lowering medication. Anticoagulants are an option for people who are at greater risk of blood clots forming – for example, if they have atrial fibrillation.

Sometimes a wire mesh stent (blood vessel support) is recommended in order to keep a blood vessel in the brain free of clots. But studies have shown that this procedure more often causes bleeding in the brain, resulting in a greater risk of further strokes than would be the case without a stent.