A stroke happens when the blood supply to the brain stops suddenly. After a few minutes without oxygen and food from your blood, your brain begins to suffer damage. If you think someone is having a stroke, call 111 immediately. If treatment is started within a few hours, permanent damage can be avoided.
Is it a stroke? Think FAST and call 111 immediately if you suspect a stroke.
Face: Is it drooping on one side?
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
- a sudden, severe headache for no reason.
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?
Each year about 9,000 people in New Zealand have a stroke. Strokes are more 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.
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.
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:
- lowering cardiovascular risk factors such as high blood pressure or high cholesterol
- quitting smoking and/or avoid second-hand smoke
- keeping your weight at a healthy level or reduce if overweight
- increasing physical activity levels
- reducing your salt intake (many foods are hidden sources of salt)
- reducing stress
- managing any anxiety or depression and seek help if low mood or anxiety are not settling with simple measures.
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.
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 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.
Stroke information Stroke Foundation of NZ, 2014
Survivors' Stories Different Strokes, UK
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