Stroke

A stroke happens when the blood supply to your brain stops suddenly. It is a medical emergency and if you think you or someone else has had one, act fast.

Is it a stroke? Think FAST and call 111 immediately if you suspect a stroke.

Face: Is it drooping on one side?
Arm: Is one arm weak?
Speech: Is it mixed-up, slurred or lost?
Take action: Call 111 immediately.

Key points about stoke

  1. Think FAST to recognise the signs of a stroke: Face, Arm, Speech, Take action.
  2. If you think someone is having a stroke, call 111 immediately.
  3. After a few minutes without oxygen and food from your blood, your brain begins to suffer damage.
  4. If treatment is started within a few hours, permanent damage can be avoided.

What are the symptoms of stroke?

The signs and symptoms of stroke usually come on suddenly. The type of signs experienced will depend on what area of the brain is affected.

Common first signs of stroke include:

  • Face: sudden drooping, weakness and/or numbness of face
  • Arm: sudden weakness of the arm (and/or leg)
  • Speech: difficulty speaking, words jumbled or lost voice.
These FAST symptoms are present in 85% of strokes.

What is a stroke?

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

Source: Health Sketch 2015

Who is at risk of having a stroke?

Each year about 9,000 people in New Zealand have a stroke. Strokes are more common as you 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.

About 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, NZ, 2015.

How is a stroke diagnosed?

To diagnose a stroke, ambulance and medical teams will ask you a series of questions. These will be about your symptoms, when they started, whether 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 tests will be done, such as:

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

These tests should be performed as soon as possible after a stroke. In some cases they may need to be performed as an emergency procedure.

What is the treatment for stroke?

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 2 months after you have a stroke. In many cases, if treatment is received early enough, full recovery is possible. 

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 and exercise levels, support quitting smoking, managing stress and more. 

How can I reduce my risk of 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 include:

Read more about how to reduce your risk of stroke.

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, including support groups and educational 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.

Communicating after stroke Resources for Māori whānau affected by communication difficulties after stroke

Learn more

Stroke information Stroke Foundation of NZ
Communication after stroke Information and support for Māori whānau with communication difficulties caused by stroke 
Survivors' stories Different Strokes, UK
Jacqueline Hynd's personal story – living well after stroke Day by Day: Karen Day's blog
Haemorrhagic stroke – explained American Heart Association
Ischaemic stroke – explained American Heart Association

References

  1.  New Zealand clinical guidelines for stroke management 2010 Stroke Foundation NZ, 2010

Reviewed by

Dr Helen Kenealy is a geriatrician and general physician working at Counties Manukau DHB. She has a broad range of interests and has worked in a variety of settings including inpatient rehabilitation, orthgeriatrics and community geriatrics.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Helen Kenealy, geriatrician and general physician, CMDHB Last reviewed: 28 Apr 2020