The warning signs and symptoms of a stroke

A stroke occurs when the blood supply is cut off to an area of your brain. It happens suddenly and should be treated as a medical emergency as every second counts when it comes to reducing the damage caused by a stroke. 

What is a stroke?

Stroke is the fourth most common cause of death in the UK, as well as the biggest cause of disability. A stroke can happen to anyone at any time. 

It is caused by the blood supply to part of your brain being cut off or drastically reduced. The brain needs a constant supply of oxygen, which it gets from its blood supply, to function. This means that if the blood supply to the brain is stopped for even a few minutes, it can have a huge impact. Brain cells start to die, which causes a loss of brain function. The result can be a brain injury, disability or death. 

A stroke can affect your ability to:

• Control your bowel
• Control your emotions
• Control vital bodily functions
• Eat
• Move
• Speak, think and remember

It can also cause problems with depression and anxiety, as well as neurological problems.

As a stroke can have such a huge effect on your life, it’s important to know what signs to look for so you can get urgent medical treatment.

Types of stroke

There are two types of stroke:

Ischemic stroke

This is the most common type of stroke and is the result of a major blood vessel in your brain becoming blocked. The blockage is either caused by a blood clot or by plaque (a build-up of cholesterol and fatty deposits).

A mini-stroke, medically known as a transient ischaemic attack (TIA), can also occur. In this case, the blockage is only temporary, lasting a short amount of time. However, it still requires emergency medical treatment as it can sometimes be a sign of an impending major stroke. 

Haemorrhagic stroke

This type of stroke is caused by a blood vessel in your brain bursting, causing blood to spill into nearby tissues. This causes pressure to build up in your brain tissue and consequently tends to cause more damage than an ischemic stroke. 

Symptoms of a stroke

Stroke symptoms can differ for men and women but there are some common symptoms you should look for, including:

• Confusion, including trouble speaking or understanding speech
• Face drooping on one side
• Numbness or weakness in the face, arm or leg, especially on one side of the body
• Severe headache
• Trouble walking or a lack of coordination
• Vision problems

Although these are the most common symptoms, it is important to be aware of the differences in symptoms between men and women in case they do not display the above signs.

Signs of a stroke in women

Women can be at greater risk of stroke if they are pregnant, have preeclampsia or are taking the birth control pill or hormone replacement therapy. Their symptoms can also present differently than men.

As well as the above signs of stroke, women may experience:

• Fatigue
• General weakness
• Memory problems and disorientation
• Nausea or vomiting

Signs of a stroke in men

Unlike in women, there are no stroke symptoms that are unique to men. However, men are more likely to have a stroke.

What do you do if someone is having a stroke?

The easiest way to recognise the signs of a stroke and to take action is to remember FAST. This stands for:

• F — face drooping: is the person’s smile uneven? Is one side of their face drooping or numb?
• A — arm weakness: is one of their arms suddenly weak or numb? If they lift both arms at the same time, does one drift downwards?
• S — speech difficulty: are they struggling to speak or slurring their words? Can they repeat a simple sentence correctly?
• T — time to call 999: if someone is displaying any of these symptoms, call 999 immediately; You should call as soon as you can, even if the symptom or symptoms go away, and try to make a note of when the symptoms first appeared

The sooner a stroke is diagnosed and treated, the better the chances are of recovery. 

How are strokes diagnosed?

There are several tests that can be performed to confirm whether someone has had a stroke, as well as finding out what the cause of the stroke was. These can include blood tests, checking your pulse to see if it is irregular, checking your blood pressure and a swallow test, where you will be asked to drink some water and the number of swallows needed will be monitored. 

Even if the physical signs of a stroke are clear, a brain scan (either a CT scan or an MRI scan) should be done within one hour of arriving at the hospital. This will allow your doctor to determine the type of stroke, how severe it is and which part of the brain has been affected by it. 

How are strokes treated?

The findings from these tests will determine the right course of treatment. Effective treatment can help avoid long-term disabilities and save lives. 

Treating ischaemic strokes

Ischaemic strokes are usually treated with a combination of medicines to reduce the chances of another stroke. Some of these will be given to you immediately and only need short-term use while others may be needed in the longer term.

Sometimes, this type of stroke can be treated with thrombolysis, which is when an injectable medication is used to dissolve blood clots and restore full blood flow to the brain. This treatment needs to be given to someone as soon as possible, so it is usually administered within the first four and a half hours.

Treating haemorrhagic strokes

If you’ve had a haemorrhagic stroke, you may be given medicine to reduce your blood pressure and the chances of another stroke in the future.

In some cases, emergency surgery may be needed to remove blood from the brain and repair burst blood vessels. Surgery may also be needed to treat a build-up of fluid in the brain called hydrocephalus, which is a complication of this type of stroke.

Hydrocephalus can cause sickness, drowsiness, loss of balance and headaches. To avoid this, a surgeon will place a shunt into your brain that will drain the excess fluid.