A stroke is a brain attack. It happens when the blood supply to part of your brain is being cut off.
Blood carries essential nutrients and oxygen to your brain. Without blood your brain cells can be damaged or die.
This damage can have different effects, depending on where it happens in your brain.
A stroke can affect the way your body works as well as how you think, feel and communicate.
Different types of stroke
Most strokes are caused by a blockage cutting off the blood supply to the brain. This is an ischaemic stroke.
However, strokes can also be caused by a bleeding in or around the brain. This is a haemorrhagic stroke.
A transient ischaemic attack or TIA is also known as a mini-stroke. It is the same as a stroke, except that the symptoms last for a short amount of time and no longer than 24 hours. This is because the blockage that stops the blood getting to your brain is temporary.
What causes stroke
As we age our arteries become harder and narrower and more likely to become blocked. However, certain medical conditions and lifestyle factors can speed up this process and increase your risk of having a stroke.
Can you recover from stroke?
All strokes are different. For some people the effects may be relatively minor and may not last long.
Others may be left with more serious problems that make them dependent on other people.
Unfortunately not everyone survives – around one in eight people die within 30 days of having a stroke. That’s why it’s so important to be able to recognise the symptoms and get medical help as quickly as possible.
The quicker you receive treatment, the better your chances for a good recovery.
Strkes are generally of threee types:
- Ischaemic stroke
- Haemorrhagic stroke
- Transient ischaemic attack
Make sure you know how to recognise the symptoms of stroke.
Ischaemic stroke
Most strokes are caused by a blockage cutting off the blood supply to the brain. This is called an ischaemic stroke. Causes
A blockage can be caused by a blood clot forming in an artery leading to the brain or within one of the small vessels deep inside the brain. This is known as cerebral thrombosis.
Blockages in the brain can also be caused by a blood clot or other matter (such as an air bubble) moving through the blood stream from another part of the body. This is called a cerebral embolism.
There are a number of reasons why blockages can form and cause an ischaemic stroke. These include:
- atherosclerosis occurs when fatty deposits build up on the inside walls of your arteries. They cause your arteries to become harder and narrower, making them more likely to become blocked.
- small vessel disease is when the tiny blood vessels within your brain become blocked. Deposits collect in the blood vessels, causing them to thicken and become less flexible.
- some heart conditions can cause blood clots to form in your heart, which can then move through your blood stream up into your brain.
- arterial dissection occurs when tears develop in the lining of an artery and allow blood to get between the layers of your artery walls. This can happen for no clear reason or it can happen because of an injury, such as whiplash.
Diagnosis
A stroke is a medical emergency and if you have one you need to call 999 immediately.
You may start off in accident and emergency or another assessment ward, but it is likely you will be quickly admitted to an acute (or hyper-acute) stroke unit. An acute stroke unit has a range of trained professionals who are experienced in stroke care.
The quicker your stroke is diagnosed and treated, the better your recovery will be.
A stroke is usually diagnosed using a brain scan: either a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan. The scan will show whether your stroke has been caused by a blockage or by something else.
Treatment
If your ischaemic stroke is caused by a blood clot, you may be treated with a clot-busting medicine, known as thrombolysis.
Thrombolysis can break down and disperse a clot that is preventing blood from reaching your brain. However, for it to have the best effectr, it needs to be given within four and a half hours of your stroke symptoms starting.
Most people who have an ischaemic stroke will be given anti-platelet medication, which helps to prevent your blood from clotting.
Haemorrhagic stroke
Some strokes are due to bleeding in or around the brain. These are called haemorrhagic strokes.
Although they are not as common, this kind of stroke can be much more serious than ischaemic strokes, which are caused by a blockage.
Causes
A haemorrhagic stroke can happen when an artery inside your brain bursts causing bleeding within your brain. This known as an intracerebral haemorrhage .
It can also happen because of bleeding on the surface of your brain. Your brain sits inside a cushion of membranes that protect it from your skull.
Between the layers of membrane is a space, which is filled with fluid. If blood vessels near the surface of the brain burst, blood can leak into this space. This known as a subarchnoid haemorrhage.
Some of the things that can cause bleeding in and within your brain include:
- High blood pressure is the main cause of all strokes. High blood pressure weakens the arteries and makes them more likely to tear.
- Cerebral amyloid angiopathy is a condition where a protein called amyloid builds up inside the blood vessels in the brain. This causes damage and makes your blood vessels more likely to tear. This condition is more common among older people.
- An aneurysm is a weak spot on an artery, where the walls have become thin and weak because they have been stretched. This means that they can easily burst, especially if you have high blood pressure. Some aneurysms are present from birth, but things like smoking, using cocaine and some medical conditions can also make them more likely to develop.
- Anticoagulant medication helps to prevent your blood from clotting. If you have an irregular heartbeat (known as atrial fibrillation) it’s likely that you will be given this type of medication to help reduce your risk of stroke. However, if it is not carefully monitored it can sometimes cause bleeding.
- Drugs, such as cocaine, can irritate blood vessel walls making them weaker and more likely to rupture.
Diagnosis
A stroke is a medical emergency and if you have one you need to call 999 immediately.
The quicker your stroke is diagnosed and treated, the better your recovery will be.
Doctors will usually diagnose your stroke using a brain scan: either a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan. The scan will show whether your stroke has been caused by bleeding or by something else.
If you have a subarchnoid haemorrhage then your doctors may carry out a lumbar puncture as well as a brain scan. To do this they remove a small amount of the fluid that sits around your brain and spinal cord, to see if any blood has leaked into it.
Treatment
If you have a haemorrhagic stroke you may need surgery to stop the bleeding, remove blood or relieve any pressure that has built up around your brain.
This is usually done with an operation called a craniotomy. This is when a surgeon cuts away a small piece of your skull so that he or she can get to your brain and the cause of the bleeding.
If your stroke was caused by a burst aneurysm, an operation may be needed to seal it and stop it bleeding again.
You may be given medication to lower your blood pressure or if your bleed was caused by anticoagulant medication, you will usually be given another drug to reverse the effects as soon as possible.
Transient ischaemic attack
A TIA or transient ischaemic attack (also known as a mini-stroke) is the same as a stroke, except that the symptoms last for a short amount of time and no longer than 24 hours.
Although the symptoms may not last long, a TIA is still very serious. It is a sign that there is a problem and you are at risk of having a stroke. Because of this, a TIA is often called a warning stroke.
Causes
Like a stroke, a TIA is caused by a blockage cutting off the blood supply to part of your brain.
The only difference when you have a TIA is that the blockage is temporary – it either dissolves on its own or moves, so that the blood supply returns to normal and your symptoms disappear.
The blockage is usually a blood clot, although it can also be caused by other things, such as an air bubble in your blood stream.
Blood clots form in areas where your arteries have become narrowed or ‘furred up’ by fatty deposits. If you have a heart condition, such as atrial fibrillation, blood clots can form in the heart and move up into your brain.
Diagnosis
If you, or someone you know, show any of the signs of a stroke or TIA you must call 999. If you think you have had a TIA but have not seen a doctor about it, you need to see your GP urgently.
When you go to hospital (or to your GP) you’ll be asked about the symptoms you had and how long they lasted.
If the doctor thinks that you have had a TIA, you will be referred to someone who specialises in stroke for assessment and treatment.
You should see a specialist within seven days, but if your doctor thinks you are at a high risk of having a stroke, they should make sure you see someone within 24 hours.
Treatment
When you see your stroke specialist, they may want you to have a brain scan to help them rule out anything else that could have caused your symptoms.
They will also measure your blood pressure and carry out blood tests. This is to check for conditions that could have caused your TIA, such as diabetes or high cholesterol. You may also have other tests to check for other conditions.
Once they’ve completed these tests, your specialist should talk to you about what you need to do to reduce your risk of having another TIA or a stroke.
This may mean taking medication to treat any medical conditions that could be increasing your risk. It could also mean making some changes to your lifestyle, such as giving up smoking or doing more exercise.
Anyone who has had a TIA is at an increased risk of stroke. So don’t ignore it. Get it treated urgently.
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