You and Your Health: Stroke

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What to do when a stroke strikes

Pharmacist Andrew Watson looks at what happens to the brain in a stroke and how important it is to act FAST

 

A stroke is a life threatening brain attack that can change your life in an instant. It is often sudden, frightening, serious and unfortunately very common.

Like all major organs, the brain needs oxygen to function properly. When the blood supply to the brain is cut off, brain cells begin to die which leads to a stroke, with over 150,000 strokes occurring every year in the UK – about one every five minutes.

One in five strokes are fatal and around half the survivors are left with a brain injury or disability and need help with daily tasks. So it is important to recognise the signs of a stroke and how to keep ourselves healthy so as to minimise our risk.

Remembering the word F.A.S.T is helpful in spotting symptoms of a stroke.

  • Face – has their face fallen on one side? Can they smile?
  • Arms – can they raise both arms and keep them there?
  • Speech – is their speech slurred?
  • Time – call 999 if you see any single one of these signs of a stroke.

Ischaemic Stroke

The most common type of stroke occurs because the blood supply to the brain is restricted by a blood clot or debris in an artery reducing the flow of blood. This is called an ischaemic stroke and happens in around 85 percent of all cases.

The clot can either form in the arteries of the brain itself, or be carried from another part of the body, often the heart, to lodge in the narrow arteries of the brain. One of the main causes of this is fatty deposits called plaques in the arteries.

Haemorrhagic Stroke

A less common type of stroke occurs when a blood vessel bursts and leaks into the brain tissue causing damage. Called a haemorrhagic stroke, the cause of this is commonly uncontrolled high blood pressure. Over treatment with blood thinning medication, weakness in a blood vessel and injury to the brain may also cause this.

Mini Strokes

Mini strokes known as transient ischaemic attacks (TIA) are less damaging but may forewarn of a more serious stroke and are caused by a lesser amount of debris blocking an artery. The symptoms may only last a few minutes and are temporary, but it is important to seek medical attention to prevent a full stroke from happening.

How to reduce your risk factors:

Similarly to heart disease, the risks of having a stroke can be increased due to high blood pressure, high cholesterol and diabetes. Age is also a factor, with people over 65 more likely to be at risk; however, a quarter of all cases happen in younger people.

It is essential that as soon as possible after a stroke, a brain scan is given to determine which type of stroke has occurred as treatment varies depending on the condition.

If your stroke is caused by a blood clot, you may be treated with a clot-busting drug called alteplase to try to disperse the clot and return the blood supply to your brain; a process known as thrombolysis.

Longer term therapy usually involves a daily dose of aspirin which should also be taken after a TIA to prevent further attacks.  Aspirin has anti-platelet properties which helps stop further blood clots forming. Other similar medicines are clopidogrel and dipyridamole.

An anticoagulant may also be prescribed. This thins the blood making it flow more easily. Warfarin is often given but requires frequent blood tests to make sure the dose is correct.  Examples of newer anticoagulants are apixaban and edoxaban which may be prescribed if your doctor thinks these are suitable.

If cholesterol levels are too high, causing a build-up of fatty deposits in the arteries and preventing a smooth flow of blood, then taking a statin such as atorvastatin is advisable. Medication to decrease high blood pressure may also be necessary.

If the stroke is caused by a bleed sometimes surgery can be done to drain off the blood from the brain. Usually medication to reduce blood pressure is given and any blood thinning medicine is stopped or carefully monitored.

To prevent having a stroke, make sure you are registered with a GP to be entitled to your free NHS health checks from age 40. Along with being weighed and measured, blood pressure and cholesterol levels will be checked and a urine sample tested to determine if you have diabetes or are at risk of developing it. Samples of blood may be taken to be analysed for any abnormalities.

Checks are usually done every five years but will be more frequent if anything is wrong.

As with all health issues, following a healthy lifestyle can help minimise risk. Eating a healthy diet with plenty of fruit, vegetables lean meat and oily fish is advisable as is stopping smoking and exercising when possible.

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