Stroke 

Introduction 

Stroke: an animation

This animation explains how a stroke happens, the different types of stroke and how lifestyle changes may help to reduce the risks.

Media last reviewed: 14/11/2013

Next review due: 14/11/2015

A stroke is a medical emergency

If you think you are having a stroke, dial 999 immediately. Limiting the damage from a stroke is important to your chances of recovery.

Flu and the flu vaccine

Your guide to flu symptoms and the flu vaccine, including who should be vaccinated this winter

A stroke is a serious medical condition that occurs when the blood supply to part of the brain is cut off.

Strokes are a medical emergency and prompt treatment is essential because the sooner a person receives treatment for a stroke, the less damage is likely to happen.

If you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.

The main symptoms of stroke can be remembered with the word FAST: Face-Arms-Speech-Time.

  • Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have dropped
  • Arms  the person with suspected stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness
  • Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake
  • Time – it is time to dial 999 immediately if you see any of these signs or symptoms

Read more about the symptoms of stroke.

Why do strokes happen?

Like all organs, the brain needs the oxygen and nutrients provided by blood to function properly. If the supply of blood is restricted or stopped, brain cells begin to die. This can lead to brain damage and possibly death.

Types of stroke

There are two main causes of strokes:

  • ischaemic (accounting for over 80% of all cases)  the blood supply is stopped due to a blood clot 
  • haemorrhagic  a weakened blood vessel supplying the brain bursts and causes brain damage

There is also a related condition known as a transient ischaemic attack (TIA), where the supply of blood to the brain is temporarily interrupted, causing a 'mini-stroke'. TIAs should be treated seriously as they are often a warning sign that a stroke is coming.

Who is at risk from stroke?

In England, strokes are a major health problem. Every year over 150,000 people have a stroke and it is the third largest cause of death, after heart disease and cancer. The brain damage caused by strokes means that they are the largest cause of adult disability in the UK.

People over 65 years of age are most at risk from having strokes, although 25% of strokes occur in people who are under 65. It is also possible for children to have strokes.

If you are south Asian, African or Caribbean, your risk of stroke is higher. This is partly because of a predisposition (a natural tendency) to developing diabetes and heart disease, which are two conditions that can cause strokes.

Smoking, being overweight, lack of exercise and a poor diet are also risk factors for stroke. Also, conditions that affect the circulation of the blood, such as high blood pressure, high cholesterol, atrial fibrillation (an irregular heartbeat) and diabetes, increase your risk of having a stroke.

Read more about the causes of stroke.

Treating a stroke

Treatment depends on the type of stroke you have, including which part of the brain was affected and what caused it.

Most often, strokes are treated with medicines. This generally includes drugs to prevent and remove blood clots, reduce blood pressure and reduce cholesterol levels.

In some cases, surgery may be required. This is to clear fatty deposits in your arteries or to repair the damage caused by a haemorrhagic stroke.

Read more about treating stroke.

Life after a stroke

The damage caused by a stroke can be widespread and long-lasting. Some people need to have a long period of rehabilitation before they can recover their former independence, while many will never fully recover.

The process of rehabilitation will be specific to you, and will depend on your symptoms and how severe they are. A team of specialists are available to help, including physiotherapists, psychologists, occupational therapists, speech therapists and specialist nurses and doctors.

The damage that a stroke causes to your brain can impact on many aspects of your life and wellbeing, and depending on your individual circumstances, you may require a number of different treatment and rehabilitation methods.

Read more about recovering from a stroke.

Can strokes be prevented?

Strokes can usually be prevented through a healthy lifestyle. Eating a healthy diet, taking regular exercise, drinking alcohol in moderation and not smoking will dramatically reduce your risk of having a stroke. Lowering high blood pressure and cholesterol levels with medication also lowers the risk of stroke substantially.

Read more about preventing stroke.

Page last reviewed: 29/08/2012

Next review due: 29/08/2014

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Comments

The 20 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Strokes said on 18 May 2014

I was sleeping in my bed and then i had a sharp pain in my chest and my partners sisters took me to the hospital and the doctor told me i had a mini stroke and i stayed in hospital for 4days and it took 1month to recuver im ok now from colin

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truckerprof said on 09 February 2014

informative for 'the man in the street'

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dougalpet said on 03 May 2013

I had a mild stroke in 2010, woke at 03.00 to go to toilet but when I got up I fell down, realised what had happened and used mob to call ambulance. Crew decided to take me directly to a stroke centre rather than A&E, blues and twos even at the early hour. Seen straight away by a consultant and admitted to the unit. Had scan within an hour and within a month was ready for discharge, during my period in the hospital they ignored the fact that for many years prior to stroke I had been wheelchair bound, I was made to walk despite excrutiating pain in back, hips, knees and ankles but I did it. Now three years later I use an electric wheelchair as my right side is fairly weak but otherwise few of the problems remain. I am lucky in that I have an excellent GP practice, my local council has allocated a sheltered flat to me and so far so good, I must admit that my life has not been that healthy since leaving the army of my homeland in 1969, I smoke heavily but rarely have drunk alcohol, my only excercise being work when I was fit enough to work. The stroke clinic is based at Northwick Park Hospital in Harrow and their care was first class, the Consultant was very complimentary to the Ambulance crew for taking the decision to go directly there rather than the much nearer Ealing Hospital's A&E.

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kimik said on 21 May 2012

My father suffered a full stroke two years ago. He was left doubly incontinent , unable to move without help and speech and cognivity hugely affected. He also has vascular dementia
He is now in a Nursing Home.
His treatment at Worcester was fantastic, The problem with stroke is that it continues after the first signs .. ie speech , paralysis etc.
Scans etc cannot give a definite result until this situation stabalises , this could be days later.
The true effects are seen months later
My Mum has just suffered a mini stroke leaving her with expressive dysphasia..
She is receiving wonderful treatment from Cheltenham hospital and is remaining at home with help.
Stroke is not a simple case of being admitted and diagnosed with treatment prescribed within the first week. there are ongoing effects which gradually show themselves .
It involves a lot of different people in a wide field of expertise in health care

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carolinef83 said on 15 February 2012

my mother in law has just suffered a stroke whats so frustrating as seems to be most peoples cases theres no rush for that scan my mil was admitted by ambulance to coventry & warwickshire university hospital weds 08/02 where after waiting several hours and showing symptoms of a stroke was givena ct scan 4 hours after arriving to be told it wasnt a stroke to go home and wait for a normal routine appointment from the specialist as she had lost all feeling in her right side sat morning 11/02 she woke up lost all feeling in her leg and couldnt walk took her back to the same hospital where she was put in to a bed and advised by a doctor they would arrange a mri scan as soon as no docotr was seen till tuesday 14/02 when they took her for a ct scan (again ) and advised her yes it was a stroke and quite serious then said they would arrange at some point to take her to the stroke ward so frustrating that for 4 days she was just left sitting in her bed without anyone seeing her and our family gp who she went to see weeks before with a few of the symptoms sent her home with some anti imflamitrys and a sppech about how the neck is made up of sugar coated wiring and some times when this comes away it causes the symptoms she was experiencing
when i asked the nurse on the ward why she was firstly sent home the first time she was admitted i was advised it wasnt the time or place to talk about it and if i wanted my question answered i could have a meeting with the doctor before walking off!

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Sue45 said on 14 December 2011

I took my partner into a & e cos he had chest pains. He was seen almost immediately and was diagnosed with atrial fib with a heart rate of over 180. They tried to being it down but were unable to keep it down. He was admitted and I went home to get him some things when I returned I noticed he couldn't see me when I wa on his left I told the staff I thought he had suffered a stroke. This was proved correct and e had had a mini stroke. On going back the next day what a shock to find e ad suffered a massive stroke and had lst the use of his left side. He regained consciousness 3 weeks later but was extremely poorly. He contracted pnuemonia and died a week later. Why could the massive stroke not have been prevented? He was only 63 !!!!

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KELLY WILLIS said on 12 December 2011

I had a stroke in February at the age of 29. it came as a great shock as the doctors told me i was to young. i had weakness to my left side, as i made a full recovery only gaining 90% of my left arm back. I tried to carry on and get my live back to normal having two children. Then in December i was hit with having a seizure which i was not imformed that i could have, even though i wasnt in hospital as long. it was one of the worst experiences of my life.

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ycl4160 said on 02 October 2011

I had a stroke in 2001 aged 41 and now I have just had my second last month aged 51. I dont drink I dont some, I eat healthy, I just lost a stone, I jogg 3/4 times a week yet I still had a stroke.

It is so unfair I work hard and am on my own yet this has happened again.

So what is the answer? I do all the things it tells you to do to prevent another one and yet they still come, am too young to die.

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beingabee said on 10 September 2011

My 78 years old father-in-law suffered a stroke during the night on a Wed about 4 weeks ago. It's only found out by my mother-in-law in the middle morning the next day. She contacted his GP and the GP came to see him in their house in the afternoon. Although he suspected a stroke attack but my father-in-law wasn't admitted to hospital until Sunday, 4 whole days too late! Now he is not having any treatment as the damage to his brain is so profound that nothing could be done to save him.We were told he only has days to live. I thought when a stroke attacks F.A.S.T. should be carried out! Clearly it didn't work in my father-in-law's case. We are devasted and very upset to watch him slipping away so quickly......

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Happygolucky178 said on 02 April 2011

I've recently been told I've had a mini stroke, and now suffering badly with left arm weakness as a result. I'm 36 years old so why won't these so-called medical professionals accept the fact they can happen at any age? I got told I'm too young.

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rogerbowen said on 07 March 2011

I had 8 TIA`s in 80`s and 90`s.
& whilst on prescribed medicines 1 on herbal meds.
I have had porridge and garlic every day since . My cholestreol has gone down from 9.8 to5.
R Bowen

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jeanni1 said on 16 February 2011

Regarding Lee Hardy's comment: If you are concerned about a family members treatment in hospital if you ring your local hospital and ask for Patient Liason Service known as PALS they should put you through, you could speak to someone who will liase with the hospital on your behalf, you could also ask questions that you dont like asking the staff on the ward and they will find out for you. I think more people should use this service. Good luck

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Thepirate said on 02 February 2011

Reference to the comment by LeeHardy. I can understand fully how frustrated you must feel re thr time taken for a scan. I had a TIA and was taken to haspital on a Friday morning, no rush, no blue lights etc. I Was pparalysed on left side. After waiting about 4 hours to see a doctor, i was shifted to another ward, where i quickly improved. The same doc came to see me early evening and told me i would be checked in the morning and if I was ok, would be SENT HOME, to return Monday for a scan. Medical Emergency??, not on your life! I Was fine in the morning, foe a while, then had a larger "event". Had scan about 40 hrs too late, and no treatment for another18, as no-one could read the scans. Typical weekend / post code syndrome. Hope your gran ok now.

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ellieharkin said on 24 January 2011

hi! my uncle had a stroke on a golf course while playing golf. when he had the stroke he fell on the floor and hit himself over the head with his golf club which made it even more of a problem. he is alive and well and is having speech therapy. he is progressing really well and is able to string a sentence together now!!!

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Children have strokes too said on 14 January 2011

My 21 month old child survived a stroke after heart surgery.Anyone any age can have a stroke.Chicken pox can be a risk factor of stroke in children.
500 people die in the UK alone from Missed Stroke every year.It is believed Childhood Stroke could be as common as Childhood Cancer.

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LeeHardy said on 03 December 2010

What this page could probably do with is a link to 'What to do if you have concerns regarding the treatment of a stroke victim'. I appreciate that this information may be located within these pages somewhere but I cannot find it easily.

I need advice or the help of someone I can talk to, to understand why the treatment of my 93 year old grandmother is differing so drastically from the NICE guidelines for stroke treatment.

She suffered a stroke on Weds 1st Dec 2010, between 17:30 and 18:15. She was admitted to Bournemouth hospital at 19:15. I have a number of concerns but the main one is that 32 hours after the event, she has still not had a brain scan. I am extremely worried that we may have missed the opportunity to consider any of the treatment options relayed within the NICE guidelines and hence may have missed the chance to reduce the effects of the stroke and/or its impacts. She continues to be 'observed'. The brain scan is now promised today; Friday 3rd.

So back to my first comment. What I could really have done with is an understanding of to whom I should be talking to confirm that her treatment and the timescales of such have been appropriate. I will call her GP in the morning.

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hgd39 said on 23 October 2010

my husband had a stroke and luckily we knew exactly when it happened and he was eligible for the thrombolosis injection which is and was excellent....the nhs were first class on the friday but he was lefttil the tuesday for physio as it was a bank holiday weekend....however after a month in hospital he got a lot of hisfunctions back.....the weekly physio were good but as soon as he got slightly better they were stopped due to the queue waitingwe paid privately to continue) HOWEVER.........no one warned us of the risks of SEIZURES which were as bad as the stroke and threw us completely......apparently these are common after strokes.......these were frightening and set him back immensely......he has now had 3 after stroke seizures in 2 years and are horrible....so please be aware and be prepared as i thought at the first one that he was dead.............

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mazb18 said on 22 March 2010

i agree with the comments recovery does depend on where you live, my husband had a massive stroke last May the paramedics were brilliant and had him straight into the stroke unit in 15 minutes.. the hospital was good but upon transfer to a hospital nearer our home 2 weeks later we got lost in the system... a 3 month follow up appointment with the consultant took 7 months and an appointment with an O.T took 8 months. luckily my husband is very determined and did a lot of the recovery himself but is still partial disabled and always will be.

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colebrook said on 15 February 2010

I have extremely High Blood Pressure and was warned last year that if we cant get it done I would have a stroke.
It is still high, at least 165/90, yet despite having weakness and pains in my left arm/face and legs, a phone call to the surgery just resulted in my being told it must be muscular. No doctor was consulted.!!
I could luft my arm partially when asked but couldnt keep it up as it was too weak/painful.
Could I have had a mini-stroke without knowing it??
If so, what happens next time I get these pains??
I was admitted to hospital.last year when my BP was 205/102.
What chance do I have if the receptionist can make decisions on her own??

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BHPearl said on 21 July 2009

Forgive me, but reading this article one would think that although a stroke was serious, most people recover fully eventually. In fact you actually say that most strokes can be successfully treated.
I wish that were true! My doctor told me 33.3% die quickly, 33.3% are permanently disabled, some seriously leaving only 33.3% who recover fully. If he is right, most people are NOT successfully treated.
Treatment also seems to depend where you live, with physiotherapy being very difficult to arrange for the elderly in some areas.

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