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Stroke Awareness

Monday, 12 April 2010

Dr Sean Murphy, Consultant Physician from the Irish Heart Foundation's Council on Stroke

Marie Walsh

"One in five people will have a stroke at some time in their life. Most are over 65, but stroke can strike at any age. Even young people and children can be affected.

It could happen to you, a friend or family member. If it does, the more you know about stroke the better you will be able to deal with the consequences.

Until recently many people, including doctors, believed little or nothing could be done following a stroke.

We now know it is very treatable and, if the right actions are taken quickly, the patient may not have any long term effects.
Therefore, recognising the symptoms and accessing treatment immediately can be crucial. Knowledge of what a stroke can do to a person can also help to minimise its impact.

Dr. Sean Murphy

As with Marie's case she was on the pill and this was attributed to her stroke. Is this common, should someone on the pill be worried?

No, this is relatively uncommon, and is mainly attributed with people who are on the pill who smoke. There is a recommendation for women who are older to reconsider taking the pill if they are smokers, because it does aggravate blood pressure. If blood pressure is normal then there is usually no problem, but people should always investigate family history.

Is it common for someone so young to have a stroke?

You are never too young to have a stroke but certainly it wouldn't be for the same reasons that most people have it (see risk factors below). There is normally an underlying condition. However the important thing is that we know how to recognise when someone is having a stroke, regardless of the cause.

For someone to get to the hospital quickly may be the difference between having a good recovery or being left with a disability that can have a devastating effect. People should also investigate stroke units because it is proven that anyone who has care in a stroke unit will be more likely to make a good recovery, so this is really important.

What is a stroke?

A stroke is a brain attack. A stroke occurs when a blood vessel, which is carrying oxygen and nutrients to the brain, bursts or is blocked by a clot. This causes an interruption of the blood supply to part of the brain. This can damage or destroy brain cells which will affect body functions.

For example, if a stroke damages the part of the brain that controls limb movement, a person's ability to move an arm or leg may be affected. A stroke can also affect mental processes such as how people feel, think, communicate, or learn.

The term 'stroke' comes from the fact that it usually happens without warning, 'striking' the person from out of the blue. The effects of a stroke on the body are immediate.

Stroke Symptoms Include:

o Numbness, weakness, or paralysis on one side of the body
o Slurred speech, difficulty thinking of words or understanding other people
o Confusion
o Sudden blurred vision or sight loss
o Being unsteady on your feet
o Severe headache

How to Act F.A.S.T.

A simple test can help you recognise if someone has had a stroke:

Facial weakness - can the person smile? Has their mouth or eye drooped?

Arm weakness - can the person raise both arms?

Speech problems - can the person speak clearly and understand what you say?

Time to call 999 for an ambulance if you spot any one of these signs.

Why does a stroke happen?

It is often not obvious why someone should have suffered a stroke. Even though many people believe it to be a factor, stress is not a cause of stroke.

A stroke can happen to anyone. Some people are at greater risk for reasons beyond their control such as age and family history. Also, statistics show that people from Asian and African communities are more likely to have a stroke.

Other Risk Factors Include:

. High blood pressure
. Smoking
. Being overweight
. Diabetes
. High cholesterol
. Heavy drinking.

All of these risks can be modified or changed through medication or lifestyle changes.

What are the results of stroke?

A stroke causes damage to the brain. The effects depend on the part of the brain that is affected. But every stroke is different.

For some people the effects are mild and last a short time. Other strokes may cause more severe or lasting disability.

The effects of stroke will depend on the part of your brain that has been damaged; how bad the injury is; and your general health when the stroke occurs.

The right half of the brain controls the left side of the body and vice versa. For example, weakness or paralysis in the left arm may result from a stroke in the right side of the brain.

For most people, the left side of the brain controls language (talking, reading, writing, understanding). The right side controls perceptual skills (making sense of what you see, hear, touch) and spatial skills (judging size, speed, distance, position).

Additional Info:

What common disabilities can stroke cause?
Weakness or hemiplegia- About 80 per cent of people who survive a stroke will suffer paralysis on one side of the body. This can either be partial or complete depending on the seriousness of the stroke.

Paralysis -Paralysis is caused because of injury to the area of the brain that sends messages to the arms and legs. Sometimes this loss of power also affects one side of the face.

Your balance may also be affected making you likely to fall or to lean sideways in bed, or on a chair.

Loss of sensation on one side of the body - This can be more than just loss of feeling in the skin. It can mean that without looking you will not know how your arm or leg is positioned. You may also have difficulties knowing right from left and with judgment of depth and distance.

Swallowing - Swallowing difficulties affect about 50% of people who have a stroke. Liquids are more difficult to swallow than solid food.

Difficulties in communicating - You may experience aphasia (also known as dysphasia). This affects your ability to understand and use language.

There are two major communication problems after stroke:
Not being able to understand the spoken word.
Not being able to express words.

You may lose your ability to speak completely, but still understand everything that is said to you. If you meet someone affected by stroke you should not assume because they cannot speak that they cannot understand.

For other people who have had a stroke, it can almost make it seem like everyone else is speaking a foreign language. After a stroke you may be able to speak, but what you say may not always make sense. Your reading and writing abilities can also be affected.

Loss of intellectual or thinking ability.

You may have problems with attention, concentration, working out problems and grasping new information. Memory problems usually relate to day-to-day events rather than long-term memories.

Loss of vision - You may lose half your field of vision where you can see everything on one side, but nothing on the other. If you have weakness of the left side of your body, you may find it difficult to see things on that side. Often people are unaware of this problem and may be surprised to keep bumping into furniture and door frames.

Emotional changes - Emotional ups and downs can be caused either by the distress that comes from having a stroke, or changes that have happened in the brain.

Mood swings, caused by changes in the brain, are often experienced after stroke. Depression, anger, anxiety, sadness and loss of confidence are all common.

You may find it hard to control your emotions and may laugh or cry for no apparent reason.

Is there any treatment for stroke?

Stroke services can have a profound impact on patient outcomes by targeting medical care early and providing a preventive plan against further strokes.

Drug treatment in the early hours after stroke may also benefit certain people. Treatments such as thrombolysis (clot busting) aim to dissolve the blood clot with powerful blood thinners.

Do people recover?

Recovery is usually a gradual process after stroke and can take many months as the brain needs time to heal.
The recovery varies from person to person and ranges from those who are left with a slight disability, to those with more serious impairments. In general, most recovery is made in the first six months, but progress can continue after this time."

Stroke and The pill:

The oral contracep¬tive pill can cause a stroke in women, but the risk is very small. If 10,000 women take the pill for one year, on average one of these women will have a stroke as a result. These figures are based on the use of the combined pill, which includes an oestrogen and a progestogen.

The risk is about three times that of a similar aged woman not on the pill. The risk appears to be higher if you smoke cigarettes. Despite this threefold risk, the chance of a stroke is still tiny, because strokes are so rare during the child-bearing years. This risk is also small when com¬pared with the usual risks of preg¬nancy. Overall, the benefits of the pill usually overwhelm the small increased risk of a stroke.