North East Hampshire and Farnham Logo

Stroke

What should you know about stroke?

A stroke occurs when the blood supply to a part of the brain is suddenly cut off. As brain cells need a constant supply of oxygen from the blood any disruption or blockage of that supply will soon lead to the cells in the affected area of brain becoming damaged or dying.

The blood supply to the brain comes mainly from four blood vessels (arteries), which branch into many smaller arteries which supply blood to all areas of the brain. The area of brain affected and the extent of the damage depend on which blood vessel is affected. For example, if you lose the blood supply from a main carotid artery then a large area of your brain is affected, which can cause severe symptoms or death. In contrast, if a small branch artery is affected then only a small area of brain is damaged which may cause relatively minor symptoms.

There are two main types of stroke - ischaemic and haemorrhagic.

  • Ischaemic stroke - when a blood clot forms inside a vessel, blocking the passage of blood.
  • Haemorrhagic stroke - when an artery becomes damaged and ruptures, causing blood to leak into surrounding areas of the brain.

How common are strokes?

Each year around 120,000 people in the UK have a first stroke and about 30,000 have a recurrent stroke. Stroke is the largest cause of disability in the UK and the third most common cause of death (after heart disease and cancer). Most cases occur in people aged over 65. Each year about 1 in 100 people over the age of 75 will have a stroke. But a stroke can occur at any age - even in babies. About one million people in the UK are living with the effects of stroke. Half of these people depend on others for help with everyday activities.


The functions of the different parts of the body are controlled by different parts of the brain. So, the symptoms vary depending on which part of the brain is affected and on the size of the damaged area. Symptoms develop suddenly and usually include one or more of the following:

  • Weakness of an arm, leg, or both. This may range from total paralysis of one side of the body to mild clumsiness of one hand.
  • Weakness and twisting of one side of the face. This may cause you to drool saliva.
  • Problems with balance, co-ordination, vision, speech, communication or swallowing.
  • Dizziness or unsteadiness.
  • Numbness in a part of the body.
  • Headache.
  • Confusion.
  • Loss of consciousness (occurs in severe cases).

F - Facial weakness. Can the person smile? Has their mouth or eye drooped?
A - Arm weakness. Can the person raise both arms?
S - Speech disturbance. Can the person speak clearly? Can they understand what you say?
T - Time to call 999/112/911.

What can you do to prevent it and improve your self-care?

The risk factors include:

  • Smoking. If you smoke, you should make every effort to stop. The chemicals in tobacco are carried in your bloodstream and can damage your arteries. If you smoke, stopping smoking can greatly cut your risk of having a stroke.

  • High blood pressure. Make sure your blood pressure is checked at least once a year. If it is high it can be treated. High blood pressure usually causes no symptoms but can be damaging to the arteries. If you have high blood pressure, treatment of the blood pressure is likely to have the greatest effect on reducing your risk of having a stroke.

  • If you are overweight, losing some weight is advised.

  • A high cholesterol level. This can be treated if it is high.

  • Inactivity. If able, you should aim to do some moderate physical activity on most days of the week for at least 30 minutes. For example, brisk walking, swimming, cycling, dancing, gardening, etc.

  • Diet. You should aim to eat a healthy diet. Briefly, a healthy diet means:

    • at least five portions or ideally 7-9 portions of a variety of fruit and vegetables per day.

    • a third of most meals should be starch-based foods (such as cereals, wholegrain bread, potatoes, rice, pasta), plus fruit and vegetables.

    • not much fatty food such as fatty meats, cheeses, full-cream milk, fried food, butter, etc. Use low-fat, mono- or poly-unsaturated spreads.

    • include two to three portions of fish per week. At least one of these should be oily (such as herring, mackerel, sardines, kippers, pilchards, salmon or fresh tuna).

    • If you eat red meat, it is best to eat lean red meat or poultry such as chicken.

    • If you do fry, choose a vegetable oil such as sunflower, rapeseed or olive.

    • Try not to add salt to food, and limit foods which are salty.

  • Alcohol. Do not drink more than the recommended limits. That is, men should drink no more than 21 units of alcohol per week, no more than four units in any one day and have at least two alcohol-free days a week. Women should drink no more than 14 units of alcohol per week, no more than three units in any one day and have at least two alcohol-free days a week. Pregnant women should not drink at all. One unit is in about half a pint of normal strength beer, or two thirds of a small glass of wine, or one small pub measure of spirits.

  • Diabetes is a risk factor. If you have diabetes, treatment to keep your blood sugar as near normal as possible is important.

People with atrial fibrillation have an increased risk of having a stroke. This increased risk can also be reduced. See this leaflet called Preventing Stroke When You Have Atrial Fibrillation for more details.

What if you have already had a stroke?


Immediate care

Ideally, you will be assessed quickly by a doctor. Commonly, a scan of the brain is organised as soon as possible. The aim of the scan is to confirm the diagnosis and to tell whether the stroke is an ischaemic or haemorrhagic stroke. This is very important to know, as the initial treatment of the two is very different.

If an ischaemic stroke is diagnosed and it has been less than four and a half hours since symptoms started, you may be given a medicine directly into a vein, called alteplase. This is a clot-busting medicine which aims to dissolve the blood clot. The medical word for this is thrombolysis. If the blood clot that caused the stoke can be dissolved shortly after symptoms begin, it can improve the eventual outcome. This is because brain cells that would have died are able to survive.

A plan for any other treatments should be devised and started as soon as possible. Treatments should be tailored to the particular need of the individual. The treatment plan can depend on factors such as the severity of the stroke, the effects it has, the cause of the stroke, and other diseases that may be present. Treatments that may be considered include the following:

Antiplatelet medication. Platelets are tiny particles in the blood which help blood to clot. Antiplatelet medication is usually advised if you have had an ischaemic stroke (due to a blood clot). Antiplatelet medication reduces the stickiness of platelets. This helps to prevent blood clots forming inside arteries, which helps to prevent a further stroke. Aspirin (low-dose) is the most commonly used antiplatelet medicine when the stroke has just happened. Another antiplatelet medicine, clopidogrel, is usually given long-term after the initial treatment.

If you are unable to swallow, you will be given food and fluids via a tube that is passed into your stomach. As mentioned earlier, a swallowing test is usually done early after being admitted to hospital.

Medication may be advised to reduce any risk factors for having a further stroke (as discussed later in this leaflet). For example, medication to lower a raised blood pressure, sugar level or cholesterol level.

If you have atrial fibrillation, you have an increased risk of a blood clot forming in a heart chamber and travelling to the brain to cause a stroke. If you have atrial fibrillation (or certain other heart conditions), a medicine called warfarin may be prescribed. Warfarin helps to prevent blood clots forming. Warfarin is an anticoagulant.

If you have carotid stenosis then you have an increased risk of having a stroke. Carotid stenosis means a narrowing of one of your carotid arteries, due to atheroma. If the narrowing is severe, you may be advised to have surgery to strip out the atheroma. Your doctor will advise if this is an option.

If you have a bleeding (haemorrhagic) stroke and are taking an anticoagulant medicine such as warfarin, treatment to reverse the effect of the anticoagulation is given.

If a subarachnoid haemorrhage is the cause of the stroke, an operation to fix the leaking blood vessel (artery) is sometimes an option.

Other operations are occasionally done. For example, sometimes surgery is considered to ease the pressure within the skull if the pressure becomes high following certain types of stroke.

As soon as possible after having a stroke you should be helped to sit up in bed and to get out of bed and move around if you are able to do so. This is to start the process of rehabilitation as soon as possible. Also, this reduces the risk of having a deep vein thrombosis (DVT) in a leg vein, which is a risk if you are inactive in bed for long periods.


Rehabilitation

The aim of rehabilitation is to maximise activity and quality of life following a stroke. Hospitals which deal with stroke patients have various specialists who help in rehabilitation. These include physiotherapists, occupational therapists, speech therapists, dieticians, psychologists, specialist nurses and doctors. One or more of these may be required, depending on how the stroke has affected you. Good-quality rehabilitation is vital following a stroke and can make a big difference to your eventual outcome.

Contact details for local sources of help.

See the contact details for organisations helping you to develop a healthy lifestyle.


The Stroke Association

The UK's leading stroke charity. You can use their website to find local support groups.

These include:

Farnborough and District Speakability Group

Speakability Self-Help Groups are run by and for people with Aphasia - language-loss following stroke, head injury or other neurological condition.   

At meetings people support each other, share experiences, make new friends, rebuild self-confidence and develop new skills.

Contact: Mrs Janet Thompson. email: jan243@btinternet.com. Tel: 01252 515 898

Meetings are held at Farnborough Community Centre, Meudon Avenue, Farnborough GU14 7LE


Blackwater Valley Stroke Support Group

This group fosters a special interest in patients with aphasia and computer based speech rehabilitation.

Contact: Lesley Gaudin. email: lesley.gaudin@googlemail.com. Tel: 01276 682 901


Rushmoor Healthy Living

Delivering a variety of projects across the local community, working together with individuals, groups and companies with the aim of improving people’s health and wellbeing, whether through exercise and rehabilitation classes or through health education.

website: www.rhl.org.uk

email: admin@rhl.org.uk

Tel: 01252 362 660

We want to hear your feedback, so please fill out the form below.
1000 characters left

We use cookies to improve our website and your experience when using it. Cookies used for the essential operation of the site have already been set. To find out more about the cookies we use and how to delete them, see our privacy policy.

I accept cookies from this site.

EU Cookie Directive Module Information