Contact

Stroke

A stroke is a serious and life-threatening medical condition that occurs when the blood supply to a part of the brain is disrupted, leading to brain cell damage and loss of function.

In Australia, stroke is a leading cause of disability and in the top five most common cause of death. Prompt recognition and treatment are crucial in minimising the long-term effects of a stroke and improving outcomes.

What is a Stroke?

A stroke occurs when the blood supply to a part of the brain is either blocked or reduced, preventing brain tissue from receiving the oxygen and nutrients it needs to function properly. Brain cells begin to die within minutes of the blood supply being interrupted, making stroke a medical emergency that requires immediate attention.

Types of Stroke

There are three main types of stroke, each with different causes and treatment approaches.

Overview
Ischaemic stroke is the most common type, accounting for approximately 85% of all strokes. It occurs when a blood clot blocks or narrows an artery leading to the brain, cutting off the blood flow. This blockage can be caused by a thrombus (a clot that forms in a blood vessel within the brain) or an embolus (a clot that forms elsewhere in the body and travels to the brain).

Causes

  • Atherosclerosis: The build-up of fatty deposits (plaque) inside arteries, leading to narrowing and potential clot formation.
  • Atrial Fibrillation (AF): An irregular heart rhythm that can cause blood clots to form in the heart, which can then travel to the brain.
  • Carotid Artery Disease: Narrowing of the carotid arteries in the neck, which supply blood to the brain, increasing the risk of clots.

Symptoms

  • Sudden numbness or weakness in the face, arm, or leg, particularly on one side of the body
  • Confusion, trouble speaking, or difficulty understanding speech
  • Sudden vision problems in one or both eyes
  • Difficulty walking, dizziness, loss of balance or coordination
  • Severe headache with no known cause

Overview
A haemorrhagic stroke occurs when a blood vessel in the brain bursts, causing bleeding within or around the brain. This type of stroke accounts for about 15% of all strokes but tends to be more severe and associated with higher mortality rates.

Causes

  • High Blood Pressure (Hypertension): The most common cause, as it can weaken blood vessels over time.
  • Aneurysms: Weak spots in blood vessel walls that can bulge and burst.
  • Arteriovenous Malformations (AVMs): Abnormal tangles of blood vessels in the brain that can rupture.
  • Trauma: Head injuries that cause bleeding in or around the brain.

Symptoms

  • Sudden severe headache, often described as the “worst headache ever”
  • Nausea and vomiting
  • Sudden loss of consciousness or altered mental state
  • Sudden weakness, numbness, or paralysis, typically on one side of the body
  • Vision problems or difficulty speaking
  • Seizures

Overview
A transient ischaemic attack (TIA), often called a mini-stroke, is a temporary disruption of blood flow to the brain. Unlike a full stroke, the blockage is short-lived and does not cause permanent damage. However, a TIA is a serious warning sign of an increased risk of a future stroke.

Causes
TIA is caused by the same factors that cause ischaemic stroke, such as blood clots, atherosclerosis, or other conditions that restrict blood flow to the brain.

Symptoms
TIA symptoms are similar to those of a full stroke but typically last only a few minutes to a few hours:

  • Sudden weakness or numbness in the face, arm, or leg, especially on one side
  • Sudden confusion, trouble speaking, or difficulty understanding speech
  • Sudden vision problems in one or both eyes
  • Sudden dizziness, loss of balance, or difficulty walking
  • Sudden severe headache

Diagnosis

Prompt diagnosis and treatment are critical for improving the chances of recovery after a stroke. The diagnosis typically involves a combination of the following:

  • Clinical Examination: A neurologist or emergency physician will assess the patient’s symptoms, medical history, and physical condition, focusing on neurological signs such as weakness, speech difficulties, and coordination problems.
  • Imaging Tests:
    • CT Scan: A computed tomography (CT) scan is often the first imaging test performed in an emergency setting. It can quickly identify haemorrhagic strokes and rule out other conditions.
    • MRI Scan: Magnetic resonance imaging (MRI) provides more detailed images of the brain and is particularly useful for identifying ischaemic strokes.
    • Carotid Ultrasound: This test uses sound waves to create images of the carotid arteries in the neck to check for narrowing or blockages.
    • Angiography: Cerebral angiography involves injecting a contrast dye into the blood vessels to visualise blockages or abnormalities in the brain’s blood supply.
  • Blood Tests: Blood tests may be conducted to check for underlying conditions, such as blood clotting disorders, high cholesterol, or diabetes.

Treatment Options

The treatment of stroke depends on the type, severity, and location of the stroke. The main goals of treatment are to restore blood flow to the brain, prevent further strokes, and minimise long-term disability.

  • Thrombolysis: The administration of clot-busting medication, such as alteplase (tPA), can dissolve the blood clot causing the stroke. Thrombolysis is most effective when given within 4.5 hours of the onset of symptoms.
  • Mechanical Thrombectomy: In some cases, a catheter-based procedure called mechanical thrombectomy may be performed to physically remove the clot from the blocked artery. This is typically done within 6 to 24 hours of symptom onset, depending on the location of the clot.
  • Antiplatelet and Anticoagulant Medications: These medications, such as aspirin or clopidogrel, help prevent new clots from forming and are often used after an ischaemic stroke or TIA to reduce the risk of further strokes.
  • Emergency Surgery: In cases of severe haemorrhagic stroke, surgery may be required to remove the blood, relieve pressure on the brain, and repair damaged blood vessels. Surgical options may include craniotomy, where part of the skull is temporarily removed to access and repair the brain, or aneurysm clipping to prevent further bleeding.
  • Endovascular Procedures: Minimally invasive procedures, such as coiling or stenting, can be used to treat aneurysms or AVMs by reinforcing the weakened blood vessels.
  • Blood Pressure Management: Aggressive management of high blood pressure is crucial to prevent further bleeding and stabilise the patient.

Stroke rehabilitation is essential for helping patients regain lost functions, adapt to new limitations, and improve their overall quality of life. Rehabilitation may include:

  • Physical Therapy: Focuses on improving mobility, strength, and coordination. Exercises may help patients relearn how to walk, balance, and perform daily activities.
  • Occupational Therapy: Helps patients regain independence by teaching them how to perform daily tasks, such as dressing, eating, and bathing, using assistive devices or adaptive techniques.
  • Speech and Language Therapy: Assists with communication difficulties, such as aphasia, and may also help with swallowing problems (dysphagia).
  • Cognitive Therapy: Addresses cognitive impairments, such as memory loss, problem-solving difficulties, and impaired judgement, through exercises and strategies to improve mental function.
  • Psychological Support: Counselling, support groups, and mental health services are important for addressing the emotional and psychological impact of a stroke, such as depression and anxiety.

Prevention

Preventing a stroke involves managing risk factors and making healthy lifestyle choices. Key prevention strategies include.

  • Managing Blood Pressure: Keeping blood pressure under control is one of the most important ways to reduce the risk of stroke. Regular monitoring and medication, if necessary, can help maintain healthy blood pressure levels.
  • Controlling Diabetes: Proper management of diabetes through diet, exercise, and medication can help prevent complications that increase the risk of stroke.
  • Cholesterol Management: Lowering cholesterol levels through diet, exercise, and medication can reduce the risk of atherosclerosis, a major cause of ischaemic stroke.
  • Quitting Smoking: Smoking cessation reduces the risk of stroke by improving overall cardiovascular health.
  • Healthy Diet and Exercise: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins, combined with regular physical activity, can help maintain a healthy weight and reduce stroke risk.
  • Limiting Alcohol Consumption: Reducing alcohol intake can lower the risk of high blood pressure and atrial fibrillation, both of which are risk factors for stroke.
  • Monitoring Heart Health: Regular check-ups to monitor heart conditions, such as atrial fibrillation or heart disease, are important for stroke prevention.

A stroke is a medical emergency that requires immediate attention to minimise brain damage and improve outcomes.

Understanding the types, symptoms, and treatment options for stroke is crucial for recognising the signs early and seeking prompt medical care. Additionally, adopting a healthy lifestyle and managing underlying risk factors can significantly reduce the risk of stroke. If you or a loved one are experiencing symptoms.

Helping to Restore Your Quality of Life

We are experts in the diagnosis and treatment of a range of neurological conditions. We offer the latest evidence-based medicine with the goal of helping you get back to doing what you enjoy.

Book an Appointment Today

Cutting-Edge Diagnostic & Therapeutic Neurology​

We offer the latest evidence-based diagnostic and therapeutic neurological care, spanning the fields of neurophysiology, electroencephalogram (EEG), and botox treatment.

Get in touch to make a booking.

Contact Us

Phone

Locations

Team

Our Services

Clinic Info

Careers

Copyright Canberra Neurology 2024