Understanding

Stroke

By Professor Richard Iain Lindley

IMPORTANT NOTICE

This information is intended not as a substitute for personal medical advice but as a supplement to that advice for the patient who wishes to understand more about his or her condition.

Before taking any form of treatment YOU SHOULD ALWAYS CONSULT YOUR MEDICAL PRACTITIONER.

In particular (without limit) you should note that advances in medical science occur rapidly and some of the information about drugs and treatment may very soon be out of date.

Contents

Introduction

What is a stroke?

Types of strokes

Why have you had a stroke?

The stroke: what should you do?

Stroke care

Complications after a stroke

Life after a stroke

Caring for someone after a stroke

Glossary

Useful addresses

Introduction

This book is about strokes. A stroke occurs when part of the brain is damaged as a result of a lack of blood supply or the rupture of a blood vessel – a haemorrhage. Some strokes cause catastrophic collapse with a sudden loss of consciousness. These types of stroke are usually caused by a massive brain haemorrhage, and are so characteristic that the ancient Greeks coined the term ‘apoplexy’, an old name for a stroke. Another old term for a stroke is ‘cerebrovascular accident’. A stroke is certainly not an accident and is often the result of decades of wear and tear and ‘furring up’ of the blood vessels supplying the brain. However, the
abbreviation ‘CVA’ (for cerebrovascular accident) is still commonly used.
In the United Kingdom, over 110,000 people have a stroke for the first time each year. This is a rate of around two per 1,000 people annually. The risk of a stroke increases with age and is higher in men than in women.
Strokes are so common that most of us will know a friend or a relative who has had one. Until fairly recently, however, stroke has not been a major medical priority, perhaps because many of the people having one were old or simply too disabled to make much fuss. But stroke should not be ignored. It is the third most common cause of death in the UK and one of the major causes of serious disability. During the 1990s, health services for stroke and stroke research were made a government priority, but by the end of 1999 stroke seemed to have slipped down the priority list (dominated by heart disease, cancer and mental health). However, the last decade has seen an explosion of interest in stroke services and research. Doctors are now wiser and recognise that much can be done to prevent a stroke, treat the stroke itself and improve the outcome through an organised rehabilitation programme.
Many people confuse a stroke with a heart attack. There are similarities, in that heart attacks are caused by blood vessels becoming blocked in the heart and strokes result from blood supply problems in the brain. However, heart attacks tend to occur with sudden chest and arm pain (together with faintness, panic and sickness), whereas strokes are usually painless and occur with various combinations of symp­toms including a sudden loss of movement and problems with speech, vision and/or balance.
Recently, a group of stroke experts suggested changing the name of stroke to ‘brain attack’ to raise awareness among both the medical profession and the public that the brain was just as important as the heart.