How common is stroke?

Approximately 150,000 people ⁽¹⁾ suffer a stroke every year in the UK. Stroke is the third commonest cause of death ⁽¹⁾ in the country, while over 250,000 people ⁽¹⁾ presently live with disabilities caused by stroke.

Are there different types of stroke?

1. A haemorrhagic stroke happens when a blood vessel ruptures and bleeds into your brain tissue. High blood pressure is one of the main causes of burst blood vessels.
2. An ischaemic stroke happens when a blood clot blocks the flow of blood to your brain. Blood clots are often caused by atherosclerosis, which is a build-up of fatty deposits in the arteries, caused by high blood cholesterol levels. This is the most common type and is why doctors warn us about high cholesterol levels.
3. A TIA (transient ischaemic attack) is often known as a mini-stroke, as it happens when the blood flow is disturbed for a very short time, depriving the brain of oxygen for only a few minutes. The effects of a TIA are the same as those for a full stroke, but they only last a short while and usually disappear after about 24 hours. Don't underestimate the importance of a TIA, as it's a sign that there is a problem with the blood flow to your brain, and puts you at risk of a more severe stroke. The UK Department of Health advice is that people who have had a TIA should be assessed by a specialist within seven days ⁽³⁾.

Stroke symptoms

Stroke generally happens suddenly and the symptoms appear straight away. Symptoms vary, depending on which part of your brain has been damaged, but the main ones include:

• Difficulty speaking and/or understanding conversation
• Feeling numb, weak or paralysed down one side
• Severe headache
• Feeling dizzy
• Loss of sight or blurred vision
• Being unsteady on your feet

A useful mnemonic to help you remember and identify the major symptoms of stroke is the FAST test (Face-Arm-Speech Test).

F (facial weakness)

Look out for a drooping mouth or eye

A (arm weakness)

Can the person lift both arms or only one?

S (speech)

Is the person slurring their words, can they understand what you're saying to them?

T (test)

If you suspect that you or someone you know has had a stroke, dial 999 for an ambulance straight away. The sooner you can get medical help, the more likely it is you will survive.

What will happen to me in hospital?

Depending on the type of stroke you have had, your treatment will vary. Again, the sooner you get medical treatment, the better your chances of survival and future recovery.

The best course for someone who has had a stroke is to get to hospital straight away, and gain admittance to a specialised stroke unit if at all possible. These units are run by specially trained doctors and nurses who only take care of stroke patients.

Once in hospital, you'll have an assessment to find out as much as possible about your stroke - what type it is, what caused it, where it is and how bad it is.

A doctor will take your blood pressure, perform some blood tests and give you an ECG (electrocardiogram) to see if your heart rhythm is regular. You should also have either a CT scan or an MRI scan as soon as possible, so the doctor can identify which area of your brain has been affected.

You may also have a swallow test to check whether you can drink and eat without help, as stroke can often affect your ability to swallow.

If you have had an ischaemic stroke, your doctor may prescribe the following treatments:

• If you got to a hospital within three hours of the stroke, you may be given a clot-busting drug (thrombolytic) that dissolves clots and unblocks your arteries. Thrombolytic drugs are not appropriate for everyone, however, and not all hospitals offer them
• You may also receive anticoagulant or antiplatelet drugs (aspirin), which reduce the likelihood of clots forming. You will also normally receive a 300mg dose of aspirin as soon as possible, to reduce the size of the clot

• If you have high blood pressure, you may be given drugs to reduce it
• If your cholesterol levels are high, you may receive treatment to reduce it
• You may also have surgery to clear the blockage in the artery
• If doctors discover you have atrial fibrillation, you may be given an anticoagulation drug to stop blood clots forming

In cases of haemorrhagic stroke, doctors may decide that surgery is needed to remove any blood that has leaked into the brain, or to repair the damaged artery, but surgery is not carried out routinely.

Will I ever recover?

The damage caused by a stroke can vary enormously from person to person.

Approximately 30 per cent of people go on to make a good recovery, while about another thirty per cent can be left with mild to more serious disabilities. The remaining stroke patients suffer serious brain damage and go on to die inside a year ⁽⁴⁾.

Medical professionals that work with stroke patients on their rehabilitation try to achieve the best possible improvement for each person, so that they are as mobile and independent as possible.

Rehabilitation staff involved in your rehabilitation may include specialist nurses and doctors, dieticians, occupational therapists, speech therapists, physiotherapists and psychologists.

Recovery time can be very different for each stroke patient. Most patients make the most rapid progress in the first few weeks following a stroke, but usually improvement slows down over time. In some cases, improvements can continue for a year or more.

How do I reduce my risk of having a stroke?

You can help protect yourself from the likelihood of having a stroke by making relatively small changes to your lifestyle. If you follow the guidelines below, you will also reduce blood pressure, cholesterol levels and lower the risk of heart attack and developing certain cancers.

• Stop smoking
• Cut down on alcohol. Find out how many units of alcohol is safe
• Take more exercise. Current recommendations say you should aim for 30 minutes of moderate to vigorous exercise five days a week ⁽⁶⁾. Brisk walking is ideal, but anything that leaves you slightly breathless, including gardening and housework, can help
• Eat healthily. Cut back on fats, especially saturated fats, eat plenty of fruit and vegetables - a minimum of five portions ⁽⁵⁾ a day - and whole grains
• Eat more oily fish a week (oily fish is high in omega-3 fatty acids), and cut back on red meat and salt. About two portions a week should be enough
• Lose weight. Being overweight or obese increases your risk of stroke, as will high cholesterol and high blood pressure levels. If you don't know what your levels are, have them checked at your GP's surgery

Existing health problems that increase stroke risk:

• Diabetes
• High blood pressure
• Heart disease
• Irregular heartbeat (atrial fibrillation)
• Heart attack
• Having already had a stroke or mini-stroke

Other factors influencing stroke risk

• People from Asian and Afro-Caribbean backgrounds are genetically more likely to develop certain conditions, such as heart disease, high blood pressure and diabetes and so are more at risk of stroke ⁽⁷⁾
• If you have had close relative has had a stroke, this increases your risk, as does your age. If you are over 65, you are more at risk of stroke, as risk increases as you age
• Hardening of the arteries (atherosclerosis) is a major risk factor for stroke. The condition develops when the high levels of cholesterol in your blood leave deposits (plaques) in your arteries, narrowing them. Even young adults and children can be affected. Men are at higher risk of stroke than women

Infolinks:

• The Stroke Association