Stroke

Stroke

Stroke Strikes every 5 minutes in the UK

A stroke is a serious life-threatening condition; however, its name makes it sound like something nice. It has been said that the name makes you think of nice things like stroking a cat, which couldn’t be further from the truth.

We believe that a better description of a stroke is a brain attack.

Like a heart attack a stroke is caused when the blood supply to a part of the brain is cut off. It is important to remember at this point that the brain is the most important organ in your body, and for it to work effectively it needs the nutrients and oxygen that the blood delivers. Therefore, should the blood supply get cut off, the brain doesn’t receive the nutrients and therefore starts to get damaged and not work as effectively as it should do. Depending on where the damage occurs will have different effects on the brain.

A stroke will affect the way the body works, as well as thought, speech and the way you communicate.

What causes a stroke?

As you get older, arteries become harder and narrower which makes it easier to become blocked. However, it is not just the ageing process that aids the blocking of the arteries that feed the brain, some medical conditions and lifestyle choices can contribute to the narrowing of the arteries.

What are the different types of stroke?

The different types of stroke are:

  • Ischaemic Stroke,
  • Haemorrhagic Stroke,
  • Transient Ischaemic Attack (TIA).

Ischaemic Stroke

Ischaemic Stroke is the most common type of stroke, where the blood vessels are being blocked, so the blood supply doesn’t reach the brain. The main cause of an Ischaemic Stroke is through a blood clot forming in an artery leading to the brain or within one of the small vessels which are deep inside the brain, this is called Cerebral Thrombosis.

This type of stroke can also be caused by something called, Cerebral Embolism, which is when a blood clot or other matter, for example an air bubble, moves through the bloodstream from another part of the body to the brain, to cause the obstruction.

There are a number of reasons why blockages can form and cause a stroke these will include:

  • Atherosclerosis,
  • Small Vessel Disease,
  • Heart Conditions,
  • Arterial Dissection

Atherosclerosis will occur when fatty deposits build up inside the arteries. They cause the arteries to become hard and narrower, enabling them to become blocked.

Small Vessel Disease is about the small arteries in the brain becoming blocked, caused by deposits collecting in the vessels and making them less flexible due to their thickening.

Heart Conditions can cause blood clots to form in the heart and then flow through the bloodstream up to the brain.

Arterial Dissection will occur when little tears appear in the lining of the artery and allow blood to get between the layers of the artery wall. This can happen for absolutely no reason as well as being a possible result of a neck injury.

Haemorrhagic Stroke

Haemorrhagic Stroke can be more serious than an Ischaemic Stroke but is less common.

These types of strokes are caused by a bleed in or around the brain.

Haemorrhagic Stroke can be caused when an artery inside the brain bursts, which causes bleeding inside the brain known as Intracerebral Haemorrhage. Other causes include bleeding on the surface of the brain. The brain sits inside a cushion of membranes that protect the brain from the skull. There is space between the layers of the membrane which is filled with fluid. Should a blood vessel burst and bleed into this space this is called Subarachnoid Haemorrhage.

There are a number of causes of Haemorrhagic Stroke, which include:

  • High blood pressure,
  • Cerebral amyloid angiopathy,
  • Aneurysm,
  • Anticoagulant medication,
  • Illegal Drugs.

High blood pressure is a factor in around half of all strokes.

What is Cerebral amyloid angiopathy I hear you cry, well I can tell you that it is a condition where amyloid, which is a protein, builds up in the blood vessels. The build-up of amyloid makes it more likely that the blood vessels will tear. This is something that is more likely to occur in older people.

An Aneurysm is a weak spot on an artery where the walls have become thin and weak, making it easier for the vessels to burst particularly in patients with high blood pressure. Some aneurysms are present from birth, but some lifestyle choices can also cause aneurysms, for example smoking. Another risk factor for aneurysms is whether there is a family history of aneurysms.

The main aim of anticoagulant medication is to prevent blood clots forming. People with heart conditions like Arterial Fibrillation (AF) as discussed last month, are prescribed these medications and are then closely monitored to reduce the chance of bleeding.

Certain illegal drugs like cocaine can irritate the blood vessel walls making them weaker and more likely to rupture.

Transient Ischaemic Attack (TIA)

A Transient Ischaemic Attack, also known as a Mini-Stroke or a TIA, is the same as a stroke but the symptoms happen for a much shorter time; it is none the less as serious. A TIA can be seen as a sign of there being a problem for the patient, which is why some people call a TIA a warning stroke.

As we have already said the TIA is the same as an Ischaemic Stroke, therefore a blood clot has occurred in the vessels in the brain, however this blockage is temporary and can either dissolve on its own or move to another part of the body therefore removing the clot and the symptoms disappear.

How do you recognise a stroke?

It is highly likely that everyone is familiar with the recognition of a stroke due to some excellent TV adverts produced by the NHS.

We have included the links to the videos here:

Man in crowd Advert

Stroke Animation

Lady Stroke Advert

The Stroke Association has published some really good posters which we have included here for you to be able to download and use for awareness if you would like to:

So, what is the FAST test?

FAST is a memorable way of remembering the signs and symptoms of a stroke.

F = Facial Weakness:

Can the casualty smile? Has their mouth or eye drooped?

A = Arm Weakness:

Can the person raise both arms?

S = Speech Problems:

Can the person speak clearly and understand what you say?

T = Time to call 999/112:

If your casualty fails any test, call 999/112 because a stroke is a medical emergency.

There are other signs and symptoms that you could consider, these are:

  • Loss of balance,
  • Lack of coordination,
  • Sudden severe headache,
  • Sudden onset of confusion.

How do we treat a stroke?

As a First Aider there is very little that you can do to treat a medical emergency that is a stroke. However, there are things that you can do to help save the person’s brain. It is crucial that a casualty who is having a stroke is seen by a medical practitioner as soon as is possible.

The quicker you act the more of the person you can save.

As a First Aider:

  • Maintain the airway and breathing,
    • Call 999/112 for emergency help,
    • Place the casualty in the recovery position should they be unconscious,
    • Lay a conscious casualty down with head and shoulders raised,
    • Reassure the casualty, do not assume they cannot understand,
    • Monitor and record breathing, pulse, and levels of response.

Once the casualty is in the care of a medical practitioner they will be given an urgent scan to try to identify the cause of the stroke, so that the right treatment can be given.

REMEMBER:

Think FAST,
Act FAST,
Call 999/112 when you suspect a stroke.

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