Stroke is the second most common cause of death in the world, and it affects more than 17 million people every year. 1 in 6 people will have a stroke at some point in their life (every year more than 80,000 people under 20 suffer a stroke). In The Czech Republic there are approximately 25,000 strokes a year. Despite these numbers and the serious effects of stroke, most people do not know the symptoms of stroke, what they should if they another person suffering the symptoms of stroke. Most people also don’t know how to help prevent a stroke.
What is a stroke, how does it arise and what are possible effects?
Stroke is sudden disorder of blood circulation in the brain, which results in permanent damage of brain tissue. It is an acute illness that requires urgent medical treatment. Time is crucial. The earlier the symptoms are identified the earlier effective treatment can be given. There are two types of stroke: ischemic stroke and hemorrhagic stroke. Treatment is different for these two types.
Ischemic stroke (hypoperfusion of the brain) happens when a brain artery is blocked. This causes blood flow to be reduced or stopped completely.
Hemorrhagic stroke (bleeding in the brain) arises as a result of a rupture in a weakened blood vessel. This causes acute bleeding in the brain.
Pict.: Blood clot plugged a vessel and caused a brain ischemia
In both types of stroke, brain cells are not being supplied with oxygenated blood and they start to die very quickly. This can cause a loss of brain function of the affected area of the brain- e.g. locomotion control centre (movement disorders occur), language centre (the patient’s speech is not comprehensible).
Up to 30% of patients die as a result of their stroke. Permanent disability (reduced movement on one side of the body), speech and sight disorders or memory loss are common results of stroke. However, if a person suffering from a stroke, gets treatment quickly, they can recover with no or only slight health effects or physical impairments (e.g. slight limb weakness).
Pict.:On the left there is bleeding in a brain, on the right there is a brain stroke caused by ceased blood flow
Symptoms – how to identify a stroke?
The most common stroke symptoms are:
paralysis, upper and lower limbs weakness on one side of patient´s body (patient is not able to raise a hand/move a leg and so he or she has difficulties with walking)
face paralysis (one side) and dropped mouth side on one face side
speech difficulties or difficulties with comprehension (stroke patient can seem to be confused)
balance disorder and movement coordination
vertigo alternatively with sickness
intense headache (typical for hemorrhagic stroke)
sudden vision difficulties (smugdy vision)
Stroke often has sudden and dramatic onset of symptoms. In most cases patients do not feel any pain (compared to a heart attack, where chest pain and shortness of breath are typical) and that cause problems. Very often people underestimate stroke symptoms.
Some patients only have short term and temporary symptoms ahead of a serious stroke. These symptoms only last a few seconds or minutes and then disappear completely.
These temporary symptoms are called a transient ischemic attack (TIA). However symptoms of TIA must not be underestimated. If a TIA is suspected, it is essential to go to the hospital for a neurological examination where the risk of the symptoms worsening can be determined. Quick treatment and short term hospitalization in high risk patients can prevent symptoms worsening and permanent effects.
How should I help?
If you are unsure whether a stroke is happening use FAST test which is a very easy of diagnosing a potential stroke
The only correct reaction when a stroke occurs is to call an ambulance (for Czech Republic 155, alternatively 122). Keep the patient calm, so they can breathe normally. Treatment is most effective if it is given quickly, ideally within 4,5 hours of symptom onset. Time is a crucial factor.