Stroke

Strokes are a medical emergency that require immediate attention. Don’t wait, time is crucial. Be ready:

• Make the call. If you suspect that someone is having a stroke, phone 112 and ask for an ambulance

• Inform about the emergency. Tell the person on the emergency line that you suspect that you or someone else is having a stroke

•  Tell them your current location. Tell the person on the emergency line your address or Eircode if you know it

• Wait for the ambulance to arrive, keep your phone close to you and follow any indication given by the emergency department line

• Note the time when your signs started. This might help doctors to determine the most appropriate treatment option. 

Not all strokes are the same and no two people are affected by stroke in the same way. The effects of a stroke depend on the area of the brain affected and the extent of the damage to your brain. Recovery is different for each person too. Some people may recover completely whereas others may be left with more serious disabilities or even die. Recovery is usually a gradual process and can take months as the brain heals. 

The brain has two sides, left and right. Signals from the left brain control the right body and vice versa. This is why a stroke on the left side of the brain will affect the right side of the body.

• Left Brain Stroke: Right-side weakness, trouble speaking, slow/cautious behaviour, difficulty with speech and language or understanding what you hear and read.

• Right Brain Stroke: Left-side weakness, trouble with perception, impulsive behaviour. Doing creative things like painting, playing music and making sense of what you see, hear and touch may be more challenging too. In addition, as your perception capacity might be affected, you may also find it difficult to recognise emotions in others and understanding your own.

• Brain Stem: It can affect both sides of the body due to the way nerve pathways cross in the brain stem and can have severe consequences as this area of the brain controls critical functions such as breathing, swallowing, heartbeat, body temperature, digestion, blood pressure, sleep regulation, level of consciousness, etc. It can also lead into what is called Locked-In Syndrome – a rare but severe condition where the individual is conscious but unable to move or communicate except through eye movements.

Some symptoms may improve in time and many people can make a good recovery following a stroke. Early treatment, appropriate medication and rehabilitation all have an impact on the final outcome.

A risk factor is anything that increases the likelihood of developing a disease or condition, such as a stroke. There are two types of risk factors – modifiable and non-modifiable. Understanding these can help you make informed choices to lower your stroke risk.

Non-Modifiable Risk Factors are those that can’t be changed, they’re part of who you are. While you can’t control them, knowing about them helps you make better lifestyle choices to manage your overall health and lower your risk.

The key non-modifiable risk factors for stroke are: 

• Age: The risk of stroke increases with age, doubling every decade after 55

• Sex: Younger women may have a higher risk of stroke due to pregnancy-related factors and hormonal contraceptives, but older men tend to have a slightly higher risk

• Ethnicity: People of African descent may be at a higher risk, especially for hemorrhagic strokes, due to higher rates of hypertension in this demographic

• Family History/Genetics: If stroke, heart disease, or diabetes runs in your family, you might have a higher chance of developing these conditions yoursel

Modifiable Risk Factors can negatively affect your health but can be changed or controlled by making different choices in your daily life. By making healthier lifestyle choices, you can reduce your risk of stroke and improve your overall health. The key modifiable risk factors for stroke are: 

• Hypertension (High Blood Pressure): It is also called the silent killer. This is the most important modifiable risk factor for stroke as it causes about 50% of ischemic strokes and is the principal risk factor for hemorrhagic stroke 

• Diabetes: People with diabetes has a 2-fold increased risk of stroke and it can even be higher in women. Pre-diabetics are also at increased risk of stroke

• Dyslipidemia (High Cholesterol): High cholesterol levels can cause arteries to clog, leading to ischemic stroke. Did you know that just by lowering the bad cholesterol levels by 1.0 mmol/L we can reduce up to 15% of the risk of any type of stroke and by 9% the risk in total mortality

• Atrial Fibrillation (AF): This irregular heartbeat can cause blood to pool and form clots, which can lead to stroke

• Sedentary Behaviour: A lack of physical activity contributes to many health issues, including an increased risk of stroke. People who are physically active have a lower risk of stroke and stroke mortality than those who are inactive 

• Obesity and Body Weight: Carrying extra weight can strain your body, increasing the risk of stroke. A good health indicator for body weight is waist-to-hip ratio, more than body mass index, as there are many factors that influence our body, such as bone density or muscle mass

• Metabolic Syndrome: Metabolic syndrome is a cluster of risk factors that, when they occur together, increase your risk of stroke, heart disease, and diabetes. These risk factors include high blood pressure, high blood sugar, and excess belly fat. If you have multiple of these conditions your overall health is at greater risk, making it crucial to manage them effectively through lifestyle changes such as improving your diet, increasing physical activity and managing stress

• Alcohol Consumption: Alcohol has the capacity to impact blood pressure levels and vascular tissue, therefore, alcohol consumption can increase the risk of strokes, and especially hemorrhagic strokes. There is no such thing as an ideal alcohol consumption level. Zero alcohol intake, specifically after stroke, is the golden target

• Smoking: It is estimated that smoking contributes to ≈15% of all stroke deaths per year. Smoking cessation rapidly reduces the risk of stroke, with excess risk nearly disappearing 2 to 4 years after smoking cessation. Second-hand smokers also have a 30% increased risk of having a stroke

• Obstructive Sleep Apnea: Present in between 30-70% of stroke survivors, this condition causes pauses in breathing during sleep, disrupting rest and increasing the risk of stroke

• Oral Contraception: Hormonal contraception can increase to double the relative risk of ischemic stroke, particularly for women who smoke or have high blood pressure levels. Mainly associated with the use of combined estrogen oral contraception