Stroke explained

A stroke is when blood can’t get to all parts of your brain. Blood carries oxygen and nutrients for your brain cells. If blood can’t get through, your brain can be injured. Your arteries can get blocked, which is called an ischaemic stroke. Or your arteries can break, which is called a haemorrhagic stroke.

The F.A.S.T. test is an easy way to remember the signs of stroke. If you see any of the signs, call triple zero (000) straight away. Even if you aren’t sure, or the signs only last for a few minutes, call triple zero (000).

After a suspected stroke everyone should have a brain scan.

Stroke affects everyone differently. It depends on:

• Which part of your brain was injured
• How badly it was injured.

Rehabilitation is where you work on things that have changed since your stroke. Your rehabilitation team will help you to do things again and find new ways to do things.

Signs of a stroke

The F.A.S.T. test is an easy way to remember the most common signs of stroke.

• Face. Check their face. Has their mouth drooped?
• Arms. Can they lift both arms?
• Speech. Is their speech slurred? Do they understand you?
• Time is critical. If you see any of these signs call triple zero (000) straight away.

If you suddenly experience any of these symptoms, get to a hospital immediately. Remember, a stroke is a life-threatening emergency.

There can be other signs too:

• Your face, arm or leg can be numb, clumsy, weak, or paralysed. This can be on one or both sides of your body
• Feeling dizzy, losing balance, or falling over for no reason
• Losing your vision. This can be in one or both eyes
• Headache, usually severe and sudden
• Trouble swallowing
• Nausea and vomiting.

If you see any of the signs of stroke, call triple zero (000) straight away. Even if you aren’t sure, or the signs only last for a few minutes, call triple zero (000).

Causes

A stroke risk factor increases your risk of having a stroke.

Stroke risk factors include:

• High blood pressure
• High cholesterol
• Atrial fibrillation
• Diabetes
• Not being physically active.
• Unhealthy eating
• Being overweight
• Drinking alcohol
• Smoking.

Medical problems can also cause strokes:

• Weak or tangled arteries in the brain
• A hole in the heart
• Heart problems.

These things increase women’s risk of having a stroke:

• Taking the contraceptive pill
• Taking hormone replacement therapy (HRT)
• Being pregnant.

After a stroke, your doctor will talk to you about your risk factors. They’ll let you know what you need to do to lower your risk of another stroke. They’ll talk with you about being active, eating well, being a healthy weight, avoiding alcohol and stopping smoking. They’ll prescribe medication to lower your risk of having another stroke.

Tests

Tests vary from person to person. Some of them include:

• Brain scans. Computerised tomography (CT scan) or magnetic resonance imaging (MRI) take detailed pictures of your brain. After a suspected stroke, everyone should have a brain scan. Doctors determine if you have had a stroke by looking at the scan. The scan shows which part of your brain was injured and how badly.
• Imaging of the arteries. Ultrasound, CT angiogram or MRI show how the blood flows through the arteries.
• Heart tests. An electrocardiogram (ECG) tests for abnormal heart rhythm. You may also need to wear a Holter monitor for 24 hours or longer. Your doctor may also order an echocardiogram.
• Blood tests. You may need cholesterol (fasting lipids), blood sugar levels, and tests to see how well your kidneys work and the way your blood clots.
• Blood pressure check. After an initial check of your blood pressure, you will need it checked regularly.

Your doctor will discuss your test results with you.

Treatment

Ischaemic stroke. You may be given medication to clear your artery. This is called thrombolysis. You may have an operation to unblock the artery. This is called thrombectomy or endovascular clot retrieval (ECR).

Haemorrhagic stroke. Doctors and nurses may give you medication to slow down or stop the bleeding in your brain. You may need an operation to remove blood, relieve pressure or repair an artery in your brain.

You may also need treatment for medical problems that caused your stroke.

Changes after stroke

Stroke affects everyone differently. It depends on:

• Which part of your brain was injured
• How badly it was injured.

After a stroke, you may experience some of the changes listed below.

Walk and move

• Your arms, legs and hands may not work like they used to. This can change how you sit, stand, balance, walk and move.
• Your muscles may be weak and floppy. They may be stiff and tight. Your brain may have trouble getting them to move.

Talk, understand, read, write

You may find:

• It’s hard to think of the right word
• You use the wrong word
• You don’t understand what someone is saying
• You have trouble reading and writing.

This is called aphasia.

If the muscles you use to talk don’t work properly, your speech may be slurred.

Swallow

You may have trouble swallowing. Food and drink can go down the wrong way. It can get into your lungs instead of your stomach. This can make you sick.

Think and remember

It may be hard to:

• Pay attention
• Figure out how to do things
• Remember things that just happened.

Personality

You may find you:

• Don’t feel like doing things
• Get annoyed easily
• Do things without thinking it through
• Say or do things that seem a bit strange.

Vision

Your vision can change:

• You may have a blind spot
• See double
• Things may be blurry
• Your eyes may move all the time
• Your eyes may be more sensitive to light.

Touch, taste, smell

You may find how things taste or smell is different. You may find you:

• Feel touch, hot and cold differently.
• Have no feeling or have pins and needles.
• Don’t know where parts of your body are
• Ignore people and things on one side of your body
• Feel overwhelmed when you are in a busy, noisy place.

Pain

You may feel pain if a part of your body is injured. Stiff and tight muscles can cause pain.

You may also feel pain because of changes in your brain, even though you are not injured.

Going to the toilet

You may not know you need to go to the toilet. Movement changes can make it hard to get to the toilet in time.

Sex

Stroke can change how your body feels, and how you feel about yourself. You may have trouble with:

• How well you can move
• Muscle weakness, stiffness or tightness
• How you feel touch, as well as pain
• How you go to the toilet
• Feeling sad, worried or tired.

Fatigue

Fatigue is a feeling of weariness, tiredness or lack of energy. Fatigue is common after a stroke.

Emotions

It’s normal to have strong feelings after a stroke. You may be worried, scared, sad, embarrassed, grateful or hopeful.

Emotional lability is when your emotional responses don’t make sense. You may laugh at something sad. You may laugh or cry uncontrollably.

Depression and anxiety

It’s normal to feel sad or worried after a stroke. Depression and anxiety are different – they are medical conditions. Depression and anxiety make life hard.

• Depression: you may have depression if you:
  • Feel sad or down for more than two weeks.
  • Lose interest in things you enjoy.
  • Have no energy.
  • Find it hard to concentrate.
  • Can’t sleep or sleep more than usual.
• Anxiety: you may have anxiety if you:
  • Feel nervous a lot of the time.
  • Find it hard to calm down.
  • Feel restless or fidgety.

Never ignore the signs of depression and anxiety. You can get treatment. Most people get better. Talk with your doctor. Let your family and friends know how you are feeling.

Rehabilitation

Rehabilitation is where you work on things that have changed since your stroke.

There are different types of rehabilitation services. It depends on what’s best for you and what’s available in your area. Your rehabilitation team will help you to do things again and find new ways to do things.

Rehabilitation helps your brain change. If part of your brain has been injured, a different part can learn to take over its job. It takes a lot of work to make this happen. You’ll need to do exercises and practice doing things over and over.

Medication

After a stroke, most people need to take medication for the rest of their life. Your doctor may prescribe:

• Blood pressure lowering medication
• Cholesterol lowering medication
• Blood thinning medication.

Always talk with your doctor before you:

• Stop taking a medicine
• Change how much you take.

Where to get help

If you see any of the signs of stroke, call triple zero (000) immediately. Even if you aren’t sure, or the signs go away, call triple zero (000).

• Your GP (doctor).
• StrokeLine. StrokeLine’s allied health professionals provide advice on stroke prevention, treatment and recovery. StrokeLine is a free and confidential service. Call Tel. 1800 787 653 Monday to Friday 9am to 5pm, (AEST). Visit strokefoundation.org.au
• Carer Gateway is a free service that can help you get the support and services you need. Call Tel. 1800 422 737 Monday to Friday, 8am to 5pm.