Stroke Education

What is a Stroke

A Stroke occurs when a part of the brain loses blood supply, and therefore oxygen, causing brain cell death. This is known medically as a Cerebral Vascular Accident (CVA).

The brain is divided into regions which control different parts and functions of the body. The area of the brain affected will lead to loss of activity in the part of the body it controls. It is important to understand this could result not only a physical change, but also in an alteration of behaviour and temperament. Note the left side of the brain controls the right side of the body and visa versa.

Signs of a Stroke

The symptoms of a stroke are a sudden numbness or weakness in the face, arm or leg, especially on one side of the body.

A Stroke is a medical emergency. Use FAST to recognize a stroke:

F= Facial weakness- one side of the face drops, lop sided smile, loss of sight in one or both eyes

A= Arm weakness - inability to raise both arms or keep them raised

S = Speech problems - slurred or garbled or no speech, inability to understand, confusion

T= Time to call 999 - the quicker medical help is given the better the outcome

Other signs are a severe sudden headache with no apparent cause, dizziness, difficulty walking, loss of balance, poor coordination.

General Statistics

• Strokes are the third leading cause of death in the UK
• Strokes are the largest cause of disability in England.
• It is estimated that some 110,000 people have a stroke each year in the UK.
• The support service offerred is not provided by the NHS – in general there is no physiotherapy after-care after 6 weeks following a stroke.
• Without our presence, stroke survivors and their carers feel abandoned and ultimately this leads to other health issues.
• By providing our services it is expected that more stroke survivors will attain an improved standard of life

Effects of a Stroke

Unless your life has been touched by a stroke it is difficult to understand how suddenly your world seems to collapse. Suffering a stroke, or seeing the changes it brings to someone you love, can dramatically transform your life. The trauma can leave you isolated, confused and even angry with a sense of uncertainty about your future. The effects of a stroke may be temporary or last for several years. Recovery may be different for everyone and will require determination and support - Stroke Care for Newbury & West Berkshire was formed to provide that support to stroke survivors and their families and carers.

At this time physiotherapy provision from the NHS only continues for a limited period post release from hospital - Stroke Care for Newbury & West Berkshire’s programme offers the opportunity for ongoing physiotherapy which is important for achieving recovery.

It is an understood fact that nobody reaches a plateau, unless by choice or if rehabilitation is withdrawn. Plasticity (when a different part of the brain will start to respond to messages and take over from the dead part) is becoming well documented. For example, if the use of a hand has been affected by a stroke, if the survivor continually tries to exercise it, then eventually the use may return.

Types of Stroke

Transient Ischaemic Attack (TIA)

A TIA is a mini stroke caused by a temporary disruption to the blood supply and a lack of oxygen to part of the brain. This can cause symptoms similar to those listed above. A TIA does not last as long as a full Stroke, a time frame of a few minutes to a few hours and any symptoms usually resolve themselves within 24 hours.

A TIA is a warning signal. Call 999 and request an emergency ambulance even if it is initially unclear whether it is a full Stroke. Should the symptoms resolve whilst waiting for the ambulance it is still of paramount importance to be assessed in hospital. URGENT ACTION IS VITAL to provide risk management, determine a treatment plan and reduce the chances of a future Stroke.

Ischaemic Stroke

Some 87% of Strokes are ischaemic. They are caused by a clot (thrombosis) blocking an artery or in very rare instances a vein.

Haemorrhagic Stroke

When a weakened blood vessel in the brain ruptures, the escaping blood causes pressure on nearby structures.

It is worth mentioning that a Traumatic Brain Injury can also lead to a haemorrhagic Stroke.

What might happen to you in West Berkshire Family Support and Stroke Care for Newbury

Whilst under the care of Acute Stroke Unit Team a specific treatment plan will be put in place for you.

The first priority will be to stabilise you, followed by rehabilitation, possibly a stay in hospital which can be short or long, determined by the severity of the Stroke.

At this point the Family Support Service kicks in, having been informed of your admission. They are invited to the Multi Disciplinary Team (MDT) meetings with your Consultant, Physiotherapist and Occupational Therapist. At these meetings your treatment plan and progress will be discussed.

The Family Support is there for you, your family and/or your carers to help you with any aspect of having a Stroke that is worrying you, whilst you are an inpatient and following your discharge. Family Support works alongside the medical team and changes dependent on your needs. You can access this help at any point, even if initially you do not require any of the services it provides and you can move on when the time is right for you.

On discharge, a leaflet with details of how to contact Family Support is in your package of paperwork or you can find contact information here on the website.

Discharge from Hospital will be determined by your recovery, your personal needs and circumstances. The recovery path is ongoing. Whilst the NHS cannot provide physiotherapy indefinitely Stroke Care for Newbury & West Berkshire is very far sighted in having a physiotherapy provision to continually assess progress, set goals together with you, and provide a tailored exercise regime to help guide your further recovery. The enormous benefits of this service cannot be underestimated.

Other benefits of our charity is our ability to listen, encourage, lend support, and give friendship to you the stroke survivor, your family and your carers. We continue to be there on a journey that can sometimes seem lonely, long and hard. Our experience over the years allows us to understand changing needs.

Action if you suspect a Stroke

Remember T for Time

Get to a hospital accident and emergency unit (A&E) as quickly as possible where you will be assessed.

We are very fortunate in West Berkshire to have an exceptional Acute Stroke Unit at Royal Berkshire Hospital. The assessment & triage medical team decides the order of treatment.

During this time factors (see below) that could have led to the Stroke will be flagged up for treatment.

Interventions might include Thrombolysis when a drug is given intravenously which can break down a clot and restore blood flow to the brain. Time is of the essence for this treatment, it usually needs to be within 4 hours from the start of symptoms.

A full-blown Stroke will lead to admission under the care of the Acute Stroke Unit Team.

A brain scan will be performed, either a CT scan (Computerised Tomography) or MRI (Magnetic Resonance Imaging).

CT Scans use x-rays taken from varying angles to build a picture of the brain. This will determine whether the stoke is ischaemic (clot) or haemorrhagic (bleed)

MRI Scan uses magnetic fields and pulsing radio frequency to show any changes in the brain.

Artificial Intelligence (AI) is now being introduced in the UK to help clinical decisions and to ensure that wherever you are in the country when you suffer a Stroke, you can be transferred to the specialist medical stroke unit speedily to allow for the best possible outcome.

Risk Factors

Certain factors and conditions lead to an increased risk of Stroke. Some risk factors cannot be changed such as genetics (a family history of stroke), your age, ethnicity and gender. But even so knowing a risk factor gives you some control.

Factors that can be changed include: