Strokes affects thousands of people each year – 16 per cent of all women are likely to die of a stroke compared with 8 per cent of men. They can occur at any age without warning and can be devastating. Although it is more like to effect men it is more likely to kill a woman because they are usually older when it occurs.
A stroke happens when the blood supply to the brain is disrupted. Although a stroke can kill and leave parts of the brain permanently dead some cells may only be damaged temporarily. Ten per cent of stroke survivors recover almost completely and 25 per cent recover with minor impairments and 50 per cent experience moderate to severe impairments and require special care in the long term. Fifteen per cent die shortly after the stroke. Most people who recover from stroke are put on a lifetime programme of aspirin-derived drugs, which thin the blood and lower the risk of clots forming.
There are two main categories: ischemic and haemorrhagic. The most common form of stroke is ischemic – 80% – and caused by lack of blood supply to part of the brain. They are most commonly caused by atherosclerosis, a build-up of plaque in the arteries. One form of ischemic strokes is thrombotic, which occurs when a blood clot blocks blood flow to the brain. A less frequent form is embolic, when a tiny blood clot breaks loose from an artery and is swept into smaller vessels in the brain, where the clot lodges. Ischemic strokes usually occur in older people because of damaging lifestyle – smoking, heavy drinking, lack of exercise, an unhealthy diet or diabetes.
Twenty per cent of strokes are known as haemorrhagic which are usually genetic or unexplained ( as in the case of actress Sharon Stone) and occur when an artery in the brain leaks or ruptures and damages surrounding tissue. The most common cause of haemorrhagic stroke is high blood pressure, which can weaken blood vessel walls. Another cause is leakage from an aneurysm, a weak spot in an artery wall. A sudden, unexplained severe headache may be a warning sign of an aneurysm.
Although they are most common in people over the age of 60, people are generally at higher risk if they have high blood pressure, diabetes, atherosclerosis, angina, abnormal heartbeats or have had heart attacks. Those who smoke, drink excessively and don’t exercise can increase their risk by up to 40 per cent. Symptoms can vary but usually include a sudden numbness or weakness of face, arm or leg, especially on one side of the body. Other indications are confusion, difficulty speaking, blurred vision, dizziness, a severe headache and nausea, fever and vomiting. In a severe stroke, the patient experiences loss of consciousness.
There are a number of treatments including drugs depending on the state of health of the individual. Thrombolytics: These help re-establish cerebral circulation by dissolving clots. Neuroprotectives: These drugs minimise the chain reaction of chemical and electrical processes which cause further cell death after a stroke and are in clinical trials. Oxygenated Flurocarbon Nutrient Emulsion (OFNE) Therapy: Oxygen and nutrients are directly to the brain through the cerebral spinal fluid. Neuroperfusion: Although still in trial stages this procedure can alter the way the circulatory system works in the area affected by the stroke. It uses the healthy veins to deliver oxygenated blood to the brain tissue.
Rehabilitation begins a day or two following the stoke. The aim is to improve function so that the stroke survivor can become as independent as possible and any basic skills that the stroke has taken away, such as eating, and walking, can be relearned. Usually a team of physiotherapists, speech and occupational therapists work with the patient to aid recovery.
More information at The Stroke Association www.stroke.org.uk