Health - BLOOD CONDITIONS & DISORDERS - STROKE : Signs, Syndroms, Exams and Treatment

A stroke is a serious, life-threatening medical condition that occurs when the blood supply to part of the brain is cut off.

Strokes are a medical emergency and urgent treatment is essential because the sooner a person receives treatment for a stroke, the less damage is likely to happen.

If you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.

Signs and symptoms

The main symptoms of stroke can be remembered with the word FAST: Face-Arms-Speech-Time.

• Face – the face may have dropped on one 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 arm weakness or numbness in one 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.
• Time – it is time to dial 999 immediately if you see any of these signs or symptoms.

Read more about the symptoms of a stroke.

Why do strokes happen?

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 two main causes of strokes:

• ischaemic – where the blood supply is stopped due to a blood clot (this accounts for 85% of all cases)
• haemorrhagic – where a weakened blood vessel supplying the brain bursts

There is also a related condition known as a transient ischaemic attack (TIA), where the supply of blood to the brain is temporarily interrupted, causing a "mini-stroke" often lasting between 30 minutes and several hours. TIAs should be treated seriously as they are often a warning sign that you are at risk of having a full stroke in the near future.

Read more about the causes of strokes.

Who is at risk?

In the UK, strokes are a major health problem. Every year, around 110,000 people have a stroke in England and it is the third largest cause of death, after heart disease and cancer. The brain injuries caused by strokes are a major cause of adult disability in the UK.

Older people are most at risk of having strokes, although they can happen at any age – including in children.

If you are south Asian, African or Caribbean, your risk of stroke is higher. This is partly because of a predisposition (a natural tendency) to developing high blood pressure (hypertension), which can lead to strokes.

Smoking, being overweight, lack of exercise and a poor diet are also risk factors for stroke, as are high cholesterol, atrial fibrillation and diabetes.

How strokes are treated

Treatment depends on the type of stroke you have, including which part of the brain was affected and what caused it.

Most often, strokes are treated with medication. This generally includes medicines to prevent and remove blood clots, reduce blood pressure and reduce cholesterol levels.

In some cases, surgery may be required to treat brain swelling and reduce the risk of further bleeding in cases of haemorrhagic strokes.

Read more about diagnosing strokes and treating strokes.

Life after a stroke

Around one in every four people who has a stroke will die, and those who do survive are often left with long-term problems resulting from the injury to their brain.

Some people need to have a long period of rehabilitation before they can recover their former independence, while many will never fully recover and will need support adjusting to living with the effects of their stroke.

Local authorities should provide free "reablement services" for anyone assessed as needing them. These services help the person recovering from a stroke to learn or relearn the skills necessary for independent daily living at home. Read more about the reablement services you may be entitled to.

Around half the people who have a stroke will be dependent on some form of care for help with their daily activities.

For example, a care worker could come to the person's home to help with washing and dressing, or even just to provide companionship. Read more about care services in your home.

A team of specialists are also available to help, including physiotherapists, psychologists, occupational therapists, speech therapists and specialist nurses and doctors.

Read more about recovering from a stroke.

If you're recovering from a stroke or caring for someone who is, it may be useful to read your guide to care and support. This is written for people with care and support needs, as well as their carers and relatives.

Can strokes be prevented?

You can significantly reduce your risk of having a stroke through a healthy lifestyle, such as eating a healthy diet, taking regular exercise, drinking alcohol in moderation and not smoking.

Lowering high blood pressure and cholesterol levels with medication also lowers the risk of stroke substantially, as does taking anticoagulant medication if you have an irregular heartbeat due to a condition called atrial fibrillation.

If you have had a stroke or TIA in the past, these measures are particularly important because your risk of having another stroke in the future is greatly increased.

Read more about preventing strokes.