Know the signs: Your guide to Stroke awareness

Dr Thapelo Motshudi
31 October 2023
5 min read

World stroke awareness week is a globally recognised event dedicated to raising awareness about strokes, their prevention, and the importance of early intervention. Strokes, often referred to as "brain attacks," are a major health concern worldwide, impacting millions of lives each year. This annual campaign serves as a platform to educate people about the risk factors associated with strokes, their signs and symptoms, and the steps individuals can take to reduce their susceptibility.

What is a stroke?

Strokes are caused by a lack of blood supply to a part of the brain. If the blood supply is not restored, then the affected part will die and stop functioning. Blood flow can stop because of the presence of a clot, or other causes like a tumour obstructing a vessel, or it can be due to bleeding. If the cause is due to obstructed blood flow, then it is called an ischemic stroke, and if bleeding is the cause, then it is a haemorrhagic stroke.

Sometimes one can develop symptoms of a stroke for a short period of time due to reduced blood flow to the brain, but then the flow is restored to normal within 24 hours. This is called a transient ischemic attack, or TIA.

What are the causes?

There are many conditions that can cause a stroke, and they tend to be different in the various age groups. Strokes commonly occur in the elderly due to illnesses like hypertension, diabetes, and heart disease. Smoking and obesity are very big risk factors. Other less common conditions include illnesses that cause blood clotting abnormalities, trauma, and some medications.

What are the symptoms of a stroke?

Symptoms depend on the part and size of brain tissue that is affected. In general, the right half of the brain controls the left side of the body, and the opposite is also true. Also, different bodily functions like walking, talking, breathing, and seeing, are controlled by well-known parts of the brain, therefore symptoms can be predicted and explained by the anatomical region of the brain that is affected.

Patients can present with different symptoms, ranging from inability to move one side of the body or limb; inability to speak; sudden dim vision in one eye; loss of consciousness; to convulsions and even death in extreme cases. A quick way of assessing for the presence of a stroke is the FAST test:

Face:                     Smile and see if one side of the face droops.

Arms:                    Raise both arms and see if one arm drops down.

Speech: Say a short phrase and check for slurred or strange speech.

Time:                     If the answer to any of these is yes then get help immediately and record the time when symptoms began.

How is the diagnosis made?

Once the patient presents with symptoms of a suspected stroke during the initial critical period a brain scan must be performed with the utmost urgency.  There are several reasons for performing a scan, the most important of which are to confirm the diagnosis of a stroke, and to differentiate between ischemic or haemorrhagic strokes as this is important for management.  Lastly, a scan can diagnose other conditions mimicking a stroke, like a brain tumour.  Usually, a CT scan is performed because these tend to be more readily available and are quick to perform, however an MRI scan is great if one has access to it.

What is the treatment?

Treatment depends on the type of stroke, and how quickly one can access an appropriate health facility with the relevant equipment and personnel. Patients are first stabilised using standard emergency care protocols, and then a scan is performed.

If an ischemic stroke is diagnosed then clot-dissolving medication must be administered, provided the patient came to hospital about 3 to 4.5 hours after symptoms began. It is also critical that the blood pressure be controlled.

Can strokes be prevented?

While the risk of developing a stroke increases with advancing age and cannot be eliminated, some measures can be taken to minimise these risks. Key among these is to be aware of the symptoms, and then consult a local health professional with urgency.

It is advisable to always ensure blood pressure and sugar levels are controlled by complying with the prescribed treatment; performing regular exercise; losing excessive weight; and stop smoking. There is also a benefit in taking regular blood thinning tablets in the appropriate patient population.

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