Stroke

A stroke happens when the blood supply to the brain stops suddenly. This can cause permanent damage. If you think someone is having a stroke, ring 111 immediately. If treatment is started within a few hours, permanent damage can be avoided.

Is it a Stroke? Act FAST. Call 111 if you notice the following symptoms:

  • Face – smile (is one side droopy?)
  • Arms – raise both arms (is one side weak?)
  • Speech – speak a simple sentence (slurred? Unable to?)
  • Time – lost time could be lost brain, get to hospital FAST

What is a stroke?

Stroke refers to a sudden interruption of the blood supply to the brain, which can cause permanent damage. This interruption can be caused by a blood clot (known as an ischaemic stroke), or by bleeding in the brain (known as a haemorrhagic stroke).

Source: Health sketch 2015

Who is at risk of having a stroke?

Strokes are relatively common as people get older, with 1 in 10 occurring in people aged 75 or older. However, they can occur in younger adults and even children on rare occasions.

Approximately 80% of strokes are preventable so check with your doctor, nurse or pharmacist as to what your risk is and what you can do to reduce it.

Risk factors for stroke

Check your risk with the  Stroke Riskometer app developed by the Auckland University of Technology, 2015.

What are the symptoms of stroke?

The symptoms of a stroke can include sudden numbness or weakness (especially on one side of the body), they may also include:

  • sudden confusion or trouble speaking
  • sudden problems seeing
  • sudden dizziness
  • weakness or loss of movement on one side (face, arm, leg) 
  • loss of balance or trouble walking
  • or a sudden, severe headache for no reason.
If you think someone is having a stroke, ring 111 immediately.

How is a stroke diagnosed?

To diagnose a stroke, ambulance and medical teams will ask you a series of questions. What symptoms do you have, when did they start, do you have any other health conditions, etc. They will also use some standard assessment tools to help assess how urgently you need treatment. 

If a stroke is suspected, further investigative tests will be done such as:

  • blood tests to check full blood count, electrolytes, renal function tests, fasting lipids, erythrocyte sedimentation rate and/or C-reactive protein, and glucose
  • electrocardiogram, to check heart rhythm
  • head CT scan 
  • selected patients may require the following additional investigations: angiography, chest x-ray, syphilis serology, vasculitis screen, prothrombotic screen and Holter monitor.

These tests should be performed as soon as possible after stroke onset, and in selected patients, some of these tests may need to be performed as an emergency procedure.

Self care

What can I do if I am at high risk for stroke?

If you are at higher risk of having a stroke or have had one, talk with your doctor, nurse or pharmacist about what you can do to lower this risk.

Key steps tend to include:

What is the treatment for stroke?

Treatment for a stroke has improved dramatically over the last 5 to 10 years. In many cases, if treatment is received early enough, full recovery is possible. 

The symptoms you have in the first few days after a stroke may not last forever. If your symptoms are going to improve, they usually do so in the first two months after you have a stroke.

Early treatment is critical

Time is brain, meaning every minute counts and the longer brain cells are without oxygen, the more damage that is done. If treatment is started within a few hours, more brain cells can be saved. 

Where possible, stroke patients are now treated within specialist stroke units. In most cases, treatment includes medication, rehabilitation and lifestyle changes.

In the acute phase:

  • Medicine may be given intravenously to help dissolve blood clots (acute stroke thrombolysis)
  • Sometimes surgery is needed to treat brain swelling or help reduce further bleeding in cases of haemorrhagic strokes.

In the recovery phase:

  • Medication is given to lower blood pressure and reduce cholesterol levels.
  • Depending on the type of stroke and parts of the body affected, a range of rehabilitation support may be needed for weeks to months. 
  • Rehabilitation support can range from speech and language therapy to physical therapy and work retraining.
  • Lifestyle changes are also needed as above to improve diet, exercise levels, quit smoking, manage stress and more. 

Support

If you or someone you know has had a stroke, visit Stroke Foundation of NZ 0800 STROKE (0800 78 76 53). The Stroke Foundation provides a wide range of support from phone support, to support groups and education resources. 

Community Stroke Advisors are available throughout most of New Zealand to work with stroke survivors, their family, whānau and carers. Their role ensures people achieve the best possible outcome after stroke. This service is free.

Learn more

Stroke information Stroke Foundation of NZ, 2014 
Survivors' Stories Different Strokes, UK, 2012
Jacqueline Hynd's personal story: Living well after stroke Day by Day: Karen Day's blog
Haemorrhagic stroke – Explained Watch, Learn, Live: Interactive Cardiovascular Library – American Heart Association
Ischaemic stroke – Explained Watch, Learn, Live: Interactive Cardiovascular Library – American Heart Association

References

  1.  New Zealand Clinical Guidelines for Stroke Management 2010 (pdf, 3mb)
Credits: Editorial team.