10 stroke facts and figures
In this article, we will describe 10 facts and figures about strokes.
- What is a stroke?
A stroke is an illness when part of your brain loses its blood supply. Doctors call stroke a cerebrovascular accident (CVA). This a strange phrase as its not really an accident.
- Is a stroke is an emergency?
Yes, very much so. Prompt treatment is crucial. Early action can reduce brain damage and other complications.
- How happens in stroke?
A stroke occurs when the blood supply to part of the brain is interrupted or reduced, brain tissue is prevented from getting oxygen and nutrients. Brain cells begin to die in minutes.
- Where should I go if I think I’m having a stroke?
If you are having a stroke (or think you are), the ambulance will take you to the nearest ‘Stroke Unit’. This will usually be in a regional teaching hospital, i.e. they may drive past your local hospital. Or it may be better if you get someone to drive you to such a hospital, i.e. quicker than an ambulance.
There are more treatment options there, including thrombolysis (see treatment below) – and you can have a CT of your brain 24 hours a day.
Note. If you do not absolutely need an ambulance, please do not call one. Ask your family to take you to A&E, having checked its in a hospital with a Stroke Unit.
- What does ‘FAST’ mean?
The word FAST can help you recognise the most common signs, and what to do.
- Facial weakness. Can the person smile? Has their mouth or eye drooped?
- Arm weakness. Can the person raise both arms?
- Speech problems. Can the person speak clearly and understand what you say?
- Time to call 999 – if you see any of these signs.
A ‘FAST presentation’ is not the only way strokes present. See below for a more complete list describing what a stroke may be like.
- Causes of a stroke
A stroke is not a single disease. It is a group of diseases, with two main types:
Ischaemic stroke – is caused by a blood clot in a narrowed blood vessel (artery) cutting off the blood supply to the brain. This is the most common type of stroke (over 80%). It can be though of as a ‘brain attack’ and similar to a ‘heart attack’ (myocardial infarction). Long term high blood pressure (hypertension) and diabetes are risk factors
Haemorrhagic stroke – is caused by bleeding in or around the brain. There are several causes, e.g. a subarachnoid haemorrhage, which a bleed from a weakness in an artery (blood vessel) called an aneurysm. Again, high blood pressure is a risk factor. Or it can be a bleed into a tumour or other brain abnormality.
- What is a TIA?
A transient ischaemic attack or TIA is also known as a ‘mini-stroke’. It is the same as a stroke, except that the symptoms only last for less than 24 hours. This is because the blockage that stops the blood getting to your brain is temporary.
This is an American image, so the spelling is slightly different.
- Symptoms of a stroke
- Trouble speaking and understanding what others are saying (dysphasia or dysarthria). You may experience confusion, slur words or have difficulty understanding speech
- Paralysis or numbness of the face, arm or leg (hemiparesis). You may develop rapid numbness, weakness or paralysis in the face, arm or leg. This often affects just one side of the body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Also, one side of your mouth may droop when you try to smile
- Problems seeing in one or both eyes. You may suddenly have blurred or loss of vision (even blindness) in one or both eyes, or you may see double (diplopia)
- Headache, drowsiness or confusion. A rapid severe headache, or onset of drowsiness or confusion, may indicate that you are having a stroke. If it occurs with a headache, and you have neck stiffness, and/or the light is hurting your eyes (photophobia), this is especially concerning – and may indicate a bleed in the brain is causing the stroke
- Trouble walking. You may stumble or lose your balance, or have a loss of coordination in another way.
- Treatment for stroke
Blood-thinning (antiplatelet) drugs
If you have had an ischaemic stroke (due to a blood clot) or TIA (mini-stroke) you will usually be given a blood-thinning antiplatelet drug, usually aspirin. Antiplatelets help to stop more clots from forming in your blood and brain in the future.
Thrombolysis
Some people with ischaemic stroke are eligible for a clot-busting drug. The drug aims to disperse the clot and restore the blood supply to your brain. The most common medicine is called ‘alteplase’, or recombinant tissue plasminogen activator (rt-PA). The process of giving this medicine is known as ‘thrombolysis’.
For most people, thrombolysis needs to be given within 4-5 hours of your stroke symptoms starting. In some circumstances, your doctor may decide that it could still be of benefit after six hours However, the more time that passes, the less effective thrombolysis will be. This is why it’s important to get to the hospital as quickly as possible when your symptoms start.
After thrombolysis, 10% more patients survive and live independently. Despite its benefits, there is a small risk that thrombolysis can cause bleeding in your brain.
- Surgery for stroke
Thrombectomy
Thrombectomy is a treatment that physically removes a clot from the brain. It usually involves inserting a mesh device into an artery in your groin, moving it up to the brain, and pulling the clot out. It only works with people where the blood clot is in a large artery.
Like thrombolysis, it has to be carried out within hours of a stroke starting. Only a small proportion of stroke cases are eligible for thrombectomy but it can have a big impact on those people by reducing disability.
Haemorrhagic stroke
If you have a haemorrhagic stroke (due to bleeding in or around the brain) you might be given treatment for high blood pressure. If you are on anticoagulants (strong blood thinning drugs) you’ will be given medication to reverse the effects and reduce bleeding.
If a bleed is due to a burst aneurysm (weakened blood vessel), you might have an x-ray procedure (called an endovascular ‘coil’) or operation to repair the blood vessel. This will stop it bleeding again.
To avoid further damage to the brain due to lack of blood supply, you may be given a drug called nimodipine.
Craniectomy (decompressive)
A few patients with stroke require surgery to reduce pressure caused by a build-up of fluid. One operation is called a ‘craniectomy’. This is an operation in which a neurosurgeon (brain surgeon) removes a section of a person’s skull. This is done to ease pressure on the brain that happens because of swelling or bleeding.
Summary
We have described 10 stroke facts and figures. We have also discussed what causes a stroke and what is the treatment for stroke. Stroke is a medical emergency. Prompt treatment is crucial – especially thrombolysis for ischaemic stroke.
Other resource
The Stroke Association website is very good – and some of this page is derived from there.
