What causes stroke?
Strokes happen when an area of the brain is starved of oxygen. This either happens because a clot blocks a blood vessel, or because a blood vessel springs a leak, thus preventing blood from reaching a part of the brain. Clots are by far the more common of the two causes.
Who is at risk?
For many people who have stroke, there are no warning signs at all. There are, however, groups of people who have a higher risk. These include:
- being over 75
- having a heart condition called atrial fibrillation, where the top chambers of the heart beat very quickly
- having congestive heart failure
- high blood pressure
- having a history of stroke or TIA (transient ischaemic attack)
How can you lower your risk?
- If you smoke, quit! Smoking thickens the blood and increased the build up of fatty deposits in your arteries.
- treat any underlying conditions such as high blood pressure or heart problems. High blood pressure is the biggest risk factor for stroke. Monitor blood pressure as you age, and if necessary take steps to lower it. These include salt reduction, avoiding high cholesterol foods, and eating plenty of fruit, veg and whole grains.
- Lose weight. Obesity comes with a whole host of health problems that increased the risk of stroke. Obesity can lead to diabetes, and high blood pressure, as well as other problems. Keeping your BMI less than 25 will massively reduce your risk!
- Exercise! Although exercise walks hand in hand with weight loss and lowering blood pressure, it also stands alone as an independent stroke reduction factor. Try to exercise at a moderate intensity for 30 minutes at least five days per week.
How do you know if you're having a stroke, and what should I look out for in others?
There are four tell tale signs of a stroke, that follow the acronym FAST. F - Face, does one side droop during smiling? A - arms, if both arms are lifted to 90 degrees, does one drift back towards the floor? S - speech, is speech slurred or does it sound odd? T - time - if you see any of these signs in yourself or anyone else, call 999 immediately. Time is critical, and getting treatment within three hours can mean the difference between recovery and lifelong disability.
How are strokes treated?
Treatment of stroke has changed dramatically in the last 30 years. Before 1996 there was almost nothing that could be done apart from giving supportive care, and waiting for nature to take its course. In 1996, the FDA approved tissue plasminogen activating factor (TPA), a clot busting drug to break apart the clot and restore blood to the brain. This drug must be given in the first few hours after a stroke to have any benefit, so rapid treatment is key.
Today we heard the results of a new study showing that a new stroke treatment is changing the management, and outcomes in stroke patients. Mechanical Embolus Removal in Cerebral Ischaemia (MERCI) involves using a special metal implement, inserted on a wire through an artery in the leg, that is passed into the brain to fish out the clot, using a mesh that acts like a net. Currently only 600 people in the UK have been treated like this, but the report today says that up for 9000 would benefit from the technique. It's going to take some time to train enough interventional neurologists to do this technique, but hopefully in the next few years more and more people will be able to benefit!