Although the number of people who experience a stroke greatly increases with age, up to 25% of all strokes happen in people younger than 65 years.
STROKE INFORMATION
Stroke Riskometer™ application
- Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
- Sudden complete or partial loss of vision on one or both sides
- Sudden confusion or trouble speaking or understanding
- Sudden loss of balance, unsteadiness or an unexplained fall
- Sudden vertigo, dizziness, swallowing difficulties or memory disturbances
- Sudden, severe headache with no known cause
A risk factor for stroke is anything that increases your chance of having a stroke. Risk factors may include medical factors (e.g. elevated blood pressure, heart disease, diabetes, elevated cholesterol in the blood, family history), behavioural and environmental factors (e.g. smoking, unhealthy diet, sedentary lifestyle).
1. Elevated blood pressure or hypertension
An adult’s blood pressure is considered to be normal if it is below 120/80. That is, less than 120 systolic blood pressure and less than 80 for diastolic blood pressure. Blood pressure above the normal value but below 140/90 is called a borderline hypertension, and blood pressure of 140/90 or greater is called hypertension. High blood pressure over time damages the walls of the blood vessels, causing hardening of the arteries and promotes the forming of blood clots and aneurysms.
2. Heart disease
People with heart problems are at an increased risk of stroke. Possible heart problems are angina, atrial fibrillation (irregular heart beat rhythm), heart failure, valve disorders, artificial valves and congenital heart defects. Valve disorder, irregular heartbeat rhythms, and sometimes previous heart attack or myocardial infarction can result in blood clots being formed in the heart. These blood clots may get loose or break down into small particles (called emoli) which can travel to the brain and block blood vessels. The blockage of the blood vessels can cause an ischemic stroke.
3. Atherosclerosis and high cholesterol levels
An artery is a blood vessel that carries blood. Hardening of the arteries is called atherosclerosis. When the arteries harden, it narrows the middle of the artery where the blood flows. About 20-30% of people who have an ischemic stroke have hardening of the arteries, especially narrowing of the carotid artery in the neck which carries blood to the brain. High cholesterol levels (low-density and very low-density cholesterols) increase your chance of having a stroke very substantially, and therefore should be carefully controlled.
4. Diabetes
Having a diabetes mellitus doubles the chance of having a stroke. Therefore people with diabetes should try to keep their blood sugar level under very tight control and make sure that all aspects of their health are carefully controlled.
5. Family history and genetics
A person’s genetics, inherited from their parents, is rarely a direct cause of stroke on its own. But genes do play a large role in some stroke risk factors such as hypertension, heart disease, diabetes, and malformed blood vessels.
6. Unruptured intracranial aneurysms
An aneurysm is caused by a weak point in the wall of an artery. As the wall of the artery is under pressure due to the blood pressure, the wall at the weak point may balloon out. This ballooning out of the blood vessel is called an aneurysm. If the aneurysm is inside the head, it is called an intracranial aneurysm. The problem is if the aneurysm bursts or ruptures, as it will cause a bleed resulting in a subarachnoid or intracerebral haemorrhage. Whether an aneurysm ruptures is dependent on the size of the aneurysm, if the person smokes or has high blood pressure, and other factors.
7. Unhealthy diet
An unhealthy diet is a major risk factor for stroke. An unhealthy diet is a diet with a lot of products that have high amounts of fat, cholesterol and salt. This is a diet with a lot of fast food takeaways, red meat, dairy products like butter and cheese, pies and baked goods like biscuits and pastries. These foods should be eaten in moderation. A healthy diet contains a mixture of vegetables, fruits, fish, nuts and cereals. A healthy diet lowers the risk of developing atherosclerosis and lowers blood pressure, both major risk factors for stroke.
8. Alcohol
Mild alcohol consumption of 1 or less standard drinks per day lowers the risk of stroke. However, drinking any more alcohol or binge drinking raises the risk of stroke.
9. Smoking
The importance of stopping active smoking cannot be underestimated, no matter how long a person has smoked or the number of cigarettes smoked. It is a common misconception that if a long-term smoker stops smoking it will do them more harm than good. This is not true; the sooner a person stops smoking the more their health will benefit, and they will lower their risk of stroke immediately.
10. Low physical activity
People who do less than 30 minutes of exercise three times per week double their risk of stroke compared to people who do exercise regularly. Lack of exercise can lead to being overweight and diabetes which are important risk factors for stroke. It can also lead to the development of atherosclerosis.
Possible after-effects of a stroke are:
Approximately two-thirds of stroke survivors have partial or complete loss of movement and strength in a hand and/or leg on one side of the body. Partial loss of movement and strength is called paresis, complete loss is called paralysis.
- 80-90% suffer from confusion, and problems with thinking and memory.
- 30% have communication problems such as an inability to speak or understand spoken language.
- 30% have difficulty swallowing, called dysphagia.
- 10% have vision problems such as complete or partial blindness, or double vision.
- 10% have impaired coordination, called ataxia.
- 30% have problems in right-left orientation.
- Up to 70% suffer from mood disorders, including depression.
- 20% develop pain in the shoulder.
- Less that 10% may develop seizures or epilepsy, especially after an intracerebral hemorrhage.
- Without adequate prevention, 20% develop a chest infection within one month of stroke and 10-20% develop bedsores and/or skin infection.
Other possible complications are falls, joint deformities and contractures (where joints cannot fully bend or stretch), urinary tract infection, constipation, pulmonary embolism and heart attack (myocardial infarction).
Approximately one-third of stroke patients recover their lost functions fully or almost fully, and get back to their pre-stroke activities within a year.
About 50% of stroke survivors under the age of 65 return to work.
However at one-year after a stroke, about two-thirds of stroke survivors will have some level of disability, ranging from light and moderate to very severe
- loss of strength (or development of clumsiness) in some part of the body, especially on one side, including the face, arm or leg;
- numbness (sensory loss) or other unusual sensations in some part of the body, especially if one-sided;
- complete or partial loss of vision on one side;inability to speak properly or to understand language;
- loss of balance, unsteadiness or an unexplained fall;
- any other kind of transient spells (vertigo, dizziness, swallowing difficulties, acute confusion, or memory disturbances);
- headache that is unusually severe, abrupt in onset, or of unusual character (including unexplained change in the pattern of headaches);
- unexplained alterations of consciousness or convulsions.
These warning signs may occur alone or in any combination. They may last a few seconds (typical TIA) or up to 24 hours and then disappear (atypical, most severe TIA), be a single episode during a day or repeated. By definition, at the onset of signs and symptoms and during the first 24 hours it is impossible to know for sure if symptoms are due to stroke or due to TIA. However, symptoms can indicate a hidden problem with blood flow in the brain, which, if ignored, could result in a stroke.
F.A.S.T. is an easy way to detect some sudden signs and symptoms of stroke and prompt immediate action.
F.A.S.T. stands for:
Face | Arm | Speech | Time
If any of the F.A.S.T. signs described here come on suddenly, it is highly probable that the person has a stroke and you need to call an ambulance immediately. Early hospitalisation could save the life of the person concerned, improve his/her recovery and reduce the burden of stroke on their family.