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Do you really know what a stroke is?

09 October, 2014

In 2012, over 60,000 people in Australia alone experienced a stroke. With staggering figures like this, chances are someone you know may be affected by a stroke in the future. But would you know the signs or even know what to do?

Causes of stroke

A stroke is when the blood supply to the brain is interrupted, causing cells to be starved of oxygen and eventually die. This happens when a blood vessel is either blocked or ruptured because of a variety of factors, including:

 

 

  •  High cholesterol or blood pressure
  • A diet high in salt and fat
  • Obesity or lack of exercise
  •  Cardio vascular disease
  • Diabetes
  • Illicit drugs
  •  Excessive alcohol use
  • Cigarette smoking
  • Other medical conditions, such as obstructive sleep apnoea

Statistics also show there are other important risk factors to consider, including your own family history, age, gender and race – men suffer a higher rate of strokes, as do the over-55’s and African-American people.

There are two main types of strokes: ischemic and haemorrhagic. The most common type is the ischemic stroke, where the blood vessels become either narrow or blocked from fatty deposits, which prevent blood from flowing freely. In fact, up to 80% of strokes are a form of ischemic stroke. Embolic strokes (when a clot is swept through the blood to become lodged in the brain) also fall into this category.

Haemorrhagic strokes occur when something causes a blood vessel to either leak or rupture. This is caused by medication, physical trauma or vascular malformations, and is signalled by a sharp sudden headache. When the blood leaks from the vessel, the area beyond is deprived of oxygen – the longer the oxygen is absent, the greater the area affected.

There is also another category, called the Transient Ischemic Attack (TIA) or the mini-stroke. Symptoms usually last for under 5 minutes but can be as intense as a full-blown attack. Many say that a TIA is a warning sign that a proper stroke is imminent and seeking medical advice within 4.5 hours of first experiencing symptoms is advisable. Unlike an ischemic or haemorrhagic stroke, the complications in a TIA usually disappear over time.

How to tell if someone is having a stroke

Health professionals worldwide use a simple method to determine if someone is having a stroke, and say that everyone should know about the FAST technique.

Facial weakness – does the person’s face droop on one side? Can they smile?

Arm weakness – can they raise both arms simultaneously?

Speech difficulties – is the person’s speech clear? Can you understand what they are saying?

Time is important – call 000 immediately if one or more of these signs are present.

Other signs that someone is having a stroke include:

  • Feelings of numbness in the arms, legs and/or face
  •  Loss of consciousness
  •  Balance problems or unexplained falls
  • Breathlessness
  • Headaches or confusion
  • Vision problems in one or both eyes
  • Dizziness
  • Sudden pain
  • Trouble with speech and/or comprehension

These symptoms may appear individually or as a combination; and can last for a few minutes or for a full day. Quite often the person may look as though they are simply drunk. Either way, to maximise the chances of recovery always see a doctor within 4.5 hours of noticing symptoms.

What to do when someone is having a stroke

If someone is having a stroke, seek immediate medical assistance. Although you can’t reduce the effects of the stroke, you can do a few things while you are waiting for an ambulance to arrive. The DRS ABCD is a good technique to minimise the risk to the patient while waiting for help.

Danger – is there anything dangerous that could cause more injuries?

Response – is the person conscious?

Send for help – when you are sure the patient is relatively safe for a minute, ring for an ambulance

Airway check – clear the airways

Breathing – check that they are breathing correctly and put them in the recovery position if they are.

CPR – If the person isn’t breathing, begin CPR. Perform 30 compressions on the lower breastplate followed by two breaths into the mouth and repeat until professionals arrive.

Defibrillation – A defibrillator may need to be used by medics if breathing hasn’t resumed with CPR.

Obviously, it feels as though there is little a person can do for someone experiencing a stroke, but keeping them safe and breathing is the most important thing. Following the DRS ABCD is a great way to do this.

Risk factors/complications

Whether injuries are permanent or only temporary will depend on the severity of the stroke, as the longer the brain cells are without oxygen, the more damage there will be. Long term complications can include paralysis and loss of movement, pain, problems with eating and swallowing, memory loss, confusion and problems with thinking, behavioural issues and emotional problems.

Treatment

The type of stroke a person has suffered will determine what treatment a person needs. The two above-mentioned main categories, haemorrhagic and ischemic, have similar symptoms even though the treatments for each are different.

When a haemorrhagic stroke occurs, a vessel has either ruptured or leaked and this deprives the brain of oxygen past the rupture point, causing massive amounts of pressure. The main focus here is to stop the bleeding and reduce the pressure to prevent further injury – this is done by either a) removing the burst vessel where possible (mostly regarding malformed vessels) or b) surgical clipping or the coil method (where the surgeon threads a coil through a blood vessel up to the rupture site).

Ischemic strokes, where a blockage has occurred, are generally treated with blood thinning medication to help break the clot down. This needs to be administered within 4.5 hours of initial symptoms to increase the chances of effectiveness.

No matter what type of stroke a person has had, extensive rehabilitation is part of the recovery process to rebuild muscle strength and regain independence. As each stroke patient suffers differently, each rehab program is adapted to suit an individual’s situation. The services and professionals involved therefore vary, but they could include:

  • Speech therapist
  •  Physical therapist
  •  Occupational therapist
  • Neurologist
  • Social worker
  • Nurse
  • Dietician
  •  Psychologist
  • Chaplain
  •  Case manager

To find out more about stroke rehabilitation options that are covered by CBHS, contact our Clinical Health Manager Sam or our Health and Wellness Consultant Karen at wellness@cbhs.com.au, or you give Member Care a call on 1300 654 123.

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