Be vigilant about stroke

It’s Stroke Awareness week September 12 to 19. Check out our two features from local health professionals on prevention and care advice
The bare facts

During Stroke Awareness Week it’s timely to remember one of the highest causes of death in Australia. The Stroke Foundation reports that around one in six Australians are likely to suffer a stroke and either die, or live with the serious physical, social, and emotional costs.

These statistics are an opportunity to remind ourselves how to minimise risks, recognise symptoms and what to do if faced with a possible acute stroke affecting friends, family members  or ourselves.

Paralysis on one side of the body, being unable to speak or write, or having to relearn simple daily tasks like bathing, dressing and eating can have a devastating impact on the individual, as well as their family and friends.

What is a stroke?
A common misconception is that a stroke is a heart attack. A stroke occurs when blood supply to the brain is disrupted, reducing oxygen levels and causing brain cell death. When it’s caused by a clot or plaque causing a blockage of an artery, it’s an ischaemic stroke. A haemorrhagic stroke occurs when there’s a break in or burst of an artery leading to bleeding into brain tissue.

In some cases strokes can be fatal  but more commonly they lead to temporary or permanent disability. Recognition of symptoms and rapid access to medical treatment is extremely important and can make a life-changing difference. It’s been estimated that 1.9 million brain cells can be lost per minute during a stroke, hence the phrase ‘time is brain’.

Temporary disruption of the blood flow to the brain can result in weakness or numbness of the face, arm or leg, difficulties speaking or understanding, dizziness, loss of balance or impaired vision, difficulty swallowing, or a sudden and unusual headache.

Signs to look out for
The ‘FAST’ acronym is a good way to remember how to react if a stroke is suspected.

Facial weakness: look at their face. Has their facial expression changed or the mouth dropped?

Arms: can they lift both arms?

Speech: is their speech abnormal or slurred? Do they understand you?

Time: if any of these signs apply, time is critical, so call an ambulance immediately. While waiting the patient should be laid on their side with their head supported.

Early recognition of the signs of stroke and immediate presentation to the nearest emergency department is essential as there are treatment options only available within the first hours of symptom onset. These early treatments can reduce the effects of stroke and often improve the prognosis significantly. The most commonly used treatment is a ‘clot-busting’ infusion that can help resolve clots blocking arteries and may help to restore blood flow.

More recently there have been advances in ‘clot-retrieval’ therapy where the blockage can be opened mechanically with a small wire catheter inserted through an artery in the groin. This will hopefully be more widely available across Australia in future.

Once a patient with a stroke has been identified and treated, the next important step is to identify potential causes. Again early identification of risk factors is important as there’s an increased risk of having a further stroke early on after the initial event. For this purpose patients are commonly admitted to hospital even if symptoms have improved or resolved. If there are ongoing symptoms, initiation of physiotherapy, speech pathology, occupational therapy and other interventions may be necessary.

The Sydney Adventist Hospital is able to provide all of these services and has a dedicated team of highly experienced doctors, nurses and allied health staff specialising in the acute management of stroke.

Who’s at risk?
The individual stroke risk depends on several factors including age, genetics and lifestyle. There are stroke risk factors that can be controlled including high blood pressure, high cholesterol, smoking, obesity or being overweight, diabetes, poor diet, lack of exercise, excess alcohol consumption or irregular pulse.

Common medications to prevent first or second strokes include blood pressure lowering drugs, anti-platelet medications, anticoagulants and cholesterol lowering drugs. The choice of medication depends on each patient and their personal risk factors.

Prevention tips

  •         Check and reduce your blood pressure
  •         Exercise 30 minutes a day
  •         Limit salt and fat intake
  •         Maximise vegetable and fruit, wholegrain foods, lean meats, nuts and seeds, legumes    and beans and low fat dairy products

 Don’t smoke

For further information contact the StrokeLine 1800787653

Dr Peter Puhl is a neurologist at the Sydney Adventist Hospital Wahroonga

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