Stroke

The effects of a stroke depend on where it takes place in the brain, and how big the damaged area is. The main symptoms of stroke – including a TIA – can be remembered with the word FAST:

1. Face – the face may have drooped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.

2. Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness in one arm.

3. Speech – their speech may be slurred or garbled, the person may not be able to talk at all despite appearing to be awake, or they may have problems understanding what you're saying to them.

4. Time – it's time to dial 999 immediately if you see any of these signs or symptoms.

Other symptoms of stroke may include:

• sudden severe headache

• feeling weak or numb down 1 side of your body

• loss of sight or blurred vision in 1 or both eyes

• finding it difficult to speak or think of words

• confusion and memory loss

• balance problems – feeling dizzy or falling over

• pain – a severe headache

• feeling or being sick (nausea or vomiting)

• sensitivity to light

• neck stiffness

• seizures

• fainting

• coma

Some common causes of ischaemic stroke are:

Carotid artery stenosis (‘furred’ arteries) – this is when a build-up of cholesterol and calcium  (plaque) in the blood vessel wall of the 2 main arteries in your neck reduces blood flow to your brain. It makes it more likely that a blockage can form if some of the plaque breaks off and gets carried into the smaller vessels in your brain.

Small vessel disease – when your brain’s smaller blood vessels are damaged over time due to issues such as high blood pressure, diabetes, and smoking. This can lead to blockage and cause smaller strokes deep within the brain tissue.

Atrial fibrillation (AF) – one of the more common cardiac causes of stroke.  It’s an abnormal heart rhythm that becomes more likely as we age. It creates an irregular heartbeat, that can lead to the formation of clots that travel to the blood vessels in the brain.

Other causes include:

• blood clotting abnormalities that create a clot somewhere in your body that travels to your brain

• a tear (dissection) in the vessel wall that reduces blood flow

Risk factors include:

• having a transient ischaemic attack (TIA or mini stroke)

• age – risk goes up over 50

• ethnicity – your risk is higher if you're from a Black or South Asian background

• lifestyle – if you live unhealthily

• taking the combined contraceptive pill

• having just had a baby

• certain health conditions – high blood pressure (hypertension), diabetes, high cholesterol, sickle cell disease (SCD), migraine, and pre-eclampsia during pregnancy

Investigating your stroke after emergency treatment usually involves an initial consultation where your neurology specialist will:  

1. Take a history to get a full understanding of your family history and your health status.

2. Ask about your symptoms.

3. Do a physical and neurological exam.

They may also recommend:

• an MRI scan of your brain, head and neck to see which blood vessels and brain areas  have been affected

• a perfusion CT scan to identify reduced blood flow

• blood tests to check kidney and liver function, look for diabetes, and measure cholesterol levels and clotting function

• heart tests such as a baseline electrocardiogram, a portable heart monitor, an implantable loop recorder or LinQ device, a transthoracic echocardiogram, a bubble study, or a transoesophageal echo

You can significantly reduce your risk of having a stroke by:

• managing underlying health conditions that can increase the risk of stroke

• eating a healthy diet rich in fruits and vegetables, whole grains, lean proteins and healthy fats

• taking regular exercise to reduce your chance of high blood pressure, cholesterol and diabetes

• drinking alcohol in moderation – no more than the recommended 14 units a week

• quitting smoking if you smoke – it speeds up the development of plaque in your arteries

The complications of stroke are very individual and depend on the type of stroke, your underlying health, plus how fast and effective your treatment was. 

After a stroke, you can be left with problems ranging from impairments to your speech, swallowing, mobility and continence. 

Other common problems are swelling on the brain, pneumonia, seizures, depression and muscle problems such as spasms. 

For many people, these can be resolved with a rehabilitation programme including medications, physiotherapy and emotional support. However, for some people, there may be long-term disabilities that stay with them.

Once your stroke, its location and cause have been diagnosed, your consultant will recommend the most appropriate next steps and will arrange treatment to ensure you make the best possible recovery. 

Options include:

• medication, such as aspirin, to dissolve blood clots blocking the blood supply, and prevent further blood clots from forming

• medication to reduce blood pressure

• cholesterol-lowering medication (statins), including if you don’t have high cholesterol, as there is evidence to suggest these are beneficial after a stroke, regardless

• a procedure known as mechanical thrombectomy, to remove the blood clots

Other procedures might be needed depending on the cause of your stroke. For example:

• surgery to treat brain swelling and reduce the risk of further bleeding if this was the cause of the stroke

• if AF is found, you might need stronger blood-thinning medication

• if you have a patent foramen ovale (PFO), a PFO closure procedure may cut the risk of a further event.  

• if you have a narrowing in your neck blood vessels, you may need surgery called carotid endarterectomy or carotid artery stenting

Our consultants have access to multidisciplinary teams who can be brought in to support your personalised angina and heart health management plan.  

At Welbeck, our neurology specialists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.