Strokes: A Useful Guide

Introduction

Strokes are life-threatening emergencies that require urgent medical attention. The earlier somebody suffering from a stroke receives medical treatment, the less damage is likely to be caused to their body. Sadly, strokes are a common problem in our ageing population, as your chances of stroke increase with age. This article takes a closer look at strokes. We'll be discussing the causes, symptoms, treatment options, and recovery, and we'll also look at the best ways of lowering your chances of suffering a stroke in the future. If someone you know has recently suffered a stroke, you may also be interested in our article on the five things to do after your parent has a stroke.

UK Stroke Statistics

Strokes occur when the blood supply to part of your brain is cut off. Blood provides your brain with essential nutrients and oxygen, so without it, your brain cells can be damaged or even die. A stroke can change the way your body works, as well as how you feel, think, and communicate. The statistics for strokes here in the UK are quite concerning.

Stroke occurs more than 100,000 times per year in the UK, once every five minutes. Stroke is the fourth single leading cause of death in the UK, responsible for 35,000 deaths annually. That's a life lost every 17 minutes.

The average age for men in England, Wales, and Northern Ireland to have a stroke is 74, a figure which drops to 71 in Scotland. For women, the average age in England, Wales, and Northern Ireland is 80, dropping to 76 in Scotland. Overall, people over 55 are more likely to suffer a stroke than their younger counterparts. Stroke is also a leading cause of disability in the UK, with around two thirds of all survivors left with a disability, and it remains the third-largest cause of death in the UK. Almost 38,000 people died of a stroke in the UK in 2016, and there are over 400 childhood cases each year. Black people are twice as likely to have a stroke compared to white people. Around one in four stroke survivors will experience another stroke within five years, and one in 20 stroke patients has another stroke whilst still in hospital. A third of stroke survivors experience depression, but more people are surviving stroke than ever before, with over 1.2 million survivors in the UK today.

Causes

There are two main types of stroke, defined by their different causes. An ischaemic stroke occurs when a blood clot blocks the blood supply, accounting for 85% of all cases. A haemorrhagic stroke occurs when a blood vessel supplying the brain bursts and bleeds into and around the brain.

There are a number of reasons why blockages can form and cause an ischaemic stroke. This normally occurs when fatty deposits have narrowed and hardened the arteries, which can be caused by smoking, obesity, diabetes, hypertension, and excessive alcohol intake. Heart conditions such as atrial fibrillation, or irregular heartbeat, can also trigger blood clots in your heart. These clots can break up, escape, and become lodged in the blood vessels supplying your brain. On the other hand, the main trigger for a haemorrhagic stroke is high blood pressure, which weakens the arteries in the brain and makes them prone to splitting. Again, lifestyle choices such as smoking, drinking, a lack of exercise, and a poor diet can increase the risk of high blood pressure. Other causes of haemorrhagic strokes include aneurysms, where a weak spot on an artery has thin, fragile walls that can burst easily; cerebral amyloid angiopathy, where a protein called amyloid builds up inside the blood vessels in the brain, causing damage and torn vessels; and illegal drugs such as cocaine, which can irritate blood vessel walls, making them weaker and more likely to rupture.

Symptoms

The symptoms of a stroke usually begin very suddenly. The symptoms you experience will depend on which part of your brain is affected and the extent of the damage. You can remember the main symptoms of stroke using the word FAST. Face: the person affected may be unable to smile, and their face may have dropped on one side, with their mouth or eye drooping. Arms: they may be unable to lift both arms and keep them there, due to weakness in one arm. Speech: they may slur their speech, or be unable to talk at all. Time: don't waste any time – dial 999 immediately if you notice any of these symptoms.

Other symptoms include sudden weakness or numbness down one side of the body, sudden blurry vision or loss of sight in one or both eyes, a sudden, severe headache, and sudden memory loss or confusion. If your symptoms only last for a short period, no longer than 24 hours, you may be suffering from a transient ischaemic attack, or TIA – a mini-stroke. Although the symptoms don't last as long, you still need to seek medical attention, as a mini-stroke is a warning that there's a problem with the blood supply to your brain, putting you at a higher risk of a full stroke in the near future. If you spot any of these signals, you need to call for help straight away. If you are worried about strokes, particularly if you live alone, you should consider getting a personal alarm. With a Careline365 alarm, you can call for help with the touch of a button, and in cases of stroke, mere seconds can make all the difference.

Diagnosis

Upon arrival at the hospital, you'll likely be admitted to an acute, or hyper-acute, stroke unit. Doctors will want to know as much as possible about the symptoms you experienced, and they will carry out several tests to help confirm your stroke diagnosis. These include blood tests to determine your blood sugar and cholesterol levels, blood pressure measurement, checking your pulse for an irregular heartbeat, and swallow tests. Brain scans, using CT and/or MRI, will also be carried out to determine whether the stroke was caused by a blocked artery or a burst blood vessel, which part of the brain has been affected, and how severe the stroke is. This brain scan will usually take place within an hour of arriving at hospital.

Treatment

The quicker your stroke is diagnosed and treated, the better your recovery is likely to be. The course of treatment you receive will depend on the type of stroke you have suffered: an ischaemic stroke or a haemorrhagic stroke.

For an ischaemic stroke, a combination of medication is used to treat the condition and prevent it from happening again. The most common type of treatment is known as thrombolysis, which involves injecting alteplase to dissolve blood clots and restore blood flow to the brain. The sooner this is started, the more effective it can be, although if more than 4.5 hours have passed since the stroke, it's not clear how beneficial it is. Some cases can be treated using an emergency procedure known as thrombectomy, which removes blood clots and helps restore blood flow to the brain – this is only effective for ischaemic strokes. Other treatments for an ischaemic stroke include antiplatelets, to reduce the chances of another clot forming; anticoagulants, to prevent blood clots by changing the chemical composition of your blood; antihypertensives, to lower your blood pressure if it's too high; statins, to reduce the level of cholesterol in your blood; and carotid endarterectomy, surgery to unblock any blocked arteries.

After a haemorrhagic stroke, you may need emergency surgery to remove any blood from the brain and repair any burst blood vessels. This is usually done using a surgical procedure known as a craniotomy, during which a section of the skull is cut away to allow the surgeon access to the cause of the bleeding. The surgeon will repair any damaged blood vessels and ensure there are no blood clots present. Once the bleeding has stopped, the piece of bone removed from the skull is replaced, often with an artificial metal plate. Surgery may also be offered to treat a complication of this type of stroke known as hydrocephalus, which occurs when the damage caused by a stroke leads to a build-up of cerebrospinal fluid in the cavities of the brain. As with ischaemic strokes, some people who have had a haemorrhagic stroke will also be offered medication to lower their blood pressure and prevent further strokes.

After immediate treatment is complete, you may need further short-term treatment to help manage some of the problems caused by the stroke. This can include a feeding tube inserted into your stomach through your nose to provide nutrition if you have difficulty swallowing, fluids from a drip if you're at risk of dehydration, nutritional supplements if you're malnourished, oxygen given through a nasal tube or face mask if your levels are low, and compression stockings to prevent blood clots in your legs.

Recovering from a Stroke

Your recovery from a stroke will depend on the severity and extent of the damage caused to your brain. Some people may recover quickly, whilst others need long-term support and treatment to help them regain their independence. As you move into a rehabilitation ward, your stroke team and family will work with you to assess the effects of your stroke, including your mobility, swallowing, communication and cognitive function, nutritional and hydration status, pressure area risk, and continence. The team on your stroke unit will include different health professionals with specialist training and experience in strokes, such as physiotherapists, psychologists, occupational therapists, speech and language therapists, and dietitians. You will have daily sessions with your therapists to help you relearn any skills you may have lost and to build up your confidence.

Preventing Strokes

Living a healthy lifestyle is the best way to reduce your chances of a stroke. In particular, you should try to stop smoking, since smoking narrows your arteries and makes your blood more likely to clot. Cutting down or quitting alcohol is also important, as excessive drinking can lead to high blood pressure and trigger an irregular heartbeat. Finally, consuming a balanced diet matters too, since an unhealthy diet can lead to high blood pressure and high cholesterol; a low-fat, high-fibre diet is recommended.

You should also try to combine a healthy diet with regular exercise, as this will help you maintain a healthy weight. The NHS suggests:

For most people, at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week is recommended.

If you're changing your lifestyle habits following a stroke, you should discuss any potential exercise plans with your rehabilitation team. It's important to ensure that you're not pushing too hard too soon, and regular exercise may not be possible in the first weeks or months after a stroke.

How Careline365 Can Help

The thought of having a stroke, or any kind of medical emergency, can be very distressing. As we get older, health is often a growing concern, especially for those of us who live alone. That's where a Careline365 alarm can make all the difference. Our life-saving service gives you and your loved ones total peace of mind, so you can carry on living independently at home, safe in the knowledge that help will always be there when you need it. If you were to suffer a stroke, you would simply need to press the button on your device. Our 24/7 Emergency Response Team would immediately call the emergency services, as well as your chosen emergency contacts. For more information about our life-saving personal alarm service, please call us on 0800 101 3333. Alternatively, you can get a personalised alarm plan here on our site.

VAT Exemption

If you have suffered a stroke, you qualify for VAT exemption when purchasing a personal alarm. VAT exemption is also available to anyone with a long-term medical condition or disability, representing more than 90% of our customers. Therefore, you are very likely to pay no VAT whatsoever on your new Careline365 alarm.