Think FAST to recognise the signs of a stroke: Face, Arm, Speech, Take action.
If you think someone is having a stroke, call 111 immediately.
After a few minutes without oxygen and food from your blood, your brain begins to suffer damage.
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.
Stoke Foundation NZ training on what a stroke is, how to recognise the key signs of stroke and how to give someone the best chance of recovery after a stroke is available through the F.A.S.T. Training and Workplace Toolkit.
What is a stroke?
Stroke refers to a sudden interruption of the blood supply to your brain, which can cause permanent damage. There are different types of stroke, described by the Stroke Foundation NZ as follows:
Ischaemic stroke: This is the most common type of stroke, particularly in older people. An ischaemic stroke occurs when a clot blocks an artery in the brain. The clot usually forms in a small blood vessel inside the brain that has become narrowed through high blood pressure, high cholesterol, diabetes or smoking.
Embolic stroke: This occurs when a blood clot or piece of plaque (cholesterol or calcium deposits) on the wall of an artery breaks loose and travels to the brain. When this happens, the flow of oxygen-rich blood to the brain is blocked and tissue is damaged or dies.
Haemorrhagic stroke: This occurs when an artery in the brain ruptures (bursts) and leaks blood into the brain (cerebral haemorrhage). This break in the blood pipeline means parts of the brain are deprived of blood and a stroke occurs. Blood irritates brain tissue, causing swelling and pressure, which cause further damage and loss of function. Subarachnoid haemorrhage (SAH) is when blood leaks into the surface of the brain. Intracranial haemorrhage (ICH) is when there is bleeding into the brain tissue itself.
Each year about 9,000 people in New Zealand have a stroke. Strokes are more common as you get older, with 76% of strokes occurring in people over the age of 65 years. 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.
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
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.
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.
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, orthogeriatrics and community geriatrics.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Helen Kenealy, geriatrician and general physician, CMDHB
Last reviewed: 28 Apr 2020
These resources are from the Stroke Foundation of NZ. Most of them can be downloaded as pdf files. To order paper copies, email email@example.com or phone 0800 78 76 53. They will be delivered free within New Zealand.
Guidelines for safe and comfortable positioning while sitting and sleeping for those affected by right hemiplegia (paralysis on the right side of your body).
Slash the salt Information on the risks of eating too much salt and ways of cutting back on it. Contains a detachable wallet card to help you choose lower-salt foods.
Intimacy after stroke A stroke may slightly change this side of your relationship, but try to be positive about it. Here are some tips about how a stroke can actually reignite the spark between you and your partner.
Coping with stress Information about the signs and symptoms of stress. Tips about how to cope with stress and maintain a positive outlook on life after a stroke.
Fatigue after stroke Information about why you may feel tired and lethargic after stroke, as well as tips for how to overcome feelings of fatigue.
For further details about the above kaupapa Māori resources contact Nita Brown on 04 815 8970 or 027 556 9997. For more kaupapa Māori stroke information visit the He Ūpoko Tapu Stroke Prevention page from the Stroke Foundation NZ.
Here are a few personal stories about individuals who have been through stroke. Despite the mountain of troubles and problems caused by stroke, these courageous people continue to live joyful and productive lives.
Daphne suffered a stroke and was in hospital for nine weeks. She was determined to go home and with the support of Southern DHB, she was able to. Watch Daphne’s story to find out more about her patient journey through Southern DHB.
(Southern DHB, 2018)
Viewpoint of a stroke survivor
Stroke survivor Rob provides a quick insight into his life and his use of Stroke Foundation NZ services.
(Stroke Foundation NZ, 2015)
For more videos on personal stories about stroke, visit here.
What is fatigue after stroke?
Fatigue (excessive tiredness) affects up to 92% of people who have had a stroke. It's normal to get tired after a busy day or not sleeping well the night before. This usually gets better after a good night's rest.
However, fatigue after stroke is an excessive tiredness that will not go away even after a good rest or sleep. You may feel constantly worn out, or have no energy to carry out usual daily activities.
Are you affected by stroke? Are you interested in taking part in a clinical research study in New Zealand on fatigue after stroke? Find out about the FASTER study here.
Causes of fatigue after stroke
It is unclear why you get excessive tiredness after experiencing a stroke. It could be caused by a combination of factors, such as:
brain damage due to stroke
stress after having a stroke
difficulty adjusting to your new life situation.
There are also a number of medical problems that could contribute to excessive tiredness after stroke. These include:
medications that have fatigue as a side effect
See your doctor if you have excessive tiredness after stroke so that they can check if you have any of these medical problems.
Top tips to cope with fatigue after stroke
There are a number of things you can do to help cope with excessive tiredness after a stroke. These include to:
drink plenty of water
keep a diary on how much you are doing and discuss this with your doctor
do regular activities in a day
ask for help when you need it.
If you or someone you know has had a stroke, visit Stroke Foundation NZ 0800 STROKE (0800 78 76 53). The Stroke Foundation provides a wide range of support from phone support to 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.
This study is conducted by a team of health researchers who work at universities in New Zealand and is funded by the Health Research Council NZ.
What is the purpose of this study?
The purpose of this study is to test a new approach to fatigue management after stroke using cognitive behavioural therapy (CBT). This short-term, goal-oriented treatment uses a practical approach to problem-solving.
What are the criteria for this study?
To be eligible to take part in this study, you need to be:
aged 18 years or older
experiencing fatigue (feeling constantly weary, tired and lacking in energy and strength)
living in Auckland or the Waikato region
able to converse in English
able to provide consent
someone who has had a stroke (confirmed by scan) within the past 3–24 months.
If you have had a previous stroke prior to one in the past 3–24 months, you are still eligible for this study.
If you would like to take part, a researcher will ask you some questions over the phone to check if you may be eligible for this study.
What will happen in this study?
If you are eligible and would like to take part, a time will be arranged for a member of the study team to meet with you in person. The purpose of this meeting is to ask you some questions and to ask you to perform a physical task, if possible. Everyone on the study team has been trained for this project.
When a researcher comes to visit you, you will have the opportunity to ask any questions you might have about the study. If you are happy to take part, the researcher will check a few more details with you to make sure that you are fully eligible to participate. This initial visit should take about 1 hour. If you take part, a member of the study team would like to visit you on 3 occasions over the next 3 months.
If you like, you are welcome to have a support person with you during each visit. After the first visit, you will be randomly allocated to receive one of two group education programmes.
If you are assigned to Programme 1, you will be asked to attend one group education session each week for a total of 6 weeks. Each group session will take between 1–1.5 hours.
If you are assigned to programme 2, you will be asked to attend a single, one-off support group education session. This group session will take approximately 1.5 hours.
A member of the study team will come to visit you at 6 weeks and 3 months after the start of either programme. They will ask you similar questions at visit and will ask you to perform a physical task, if possible.
If you are interested, email firstname.lastname@example.org or phone 021 0237 2742. Thank you for your interest in this study.