Cardiology
The signs and symptoms of a stroke are subtle and – unlike a heart attack – don’t involve any pain, but that doesn’t mean they can be ignored says Dr Alex Landmann, a neurologist at Mediclinic Sandton.
What is a stroke?
A stroke is an injury to brain tissue related to blood vessels. There are two types: ischaemic (which may be either thrombotic or embolic) strokes, due to a lack of blood caused by a blockage, and hemorrhagic strokes, which are when there’s a bleed on the brain.
Who are more likely to suffer from them?
The primary risk factors for stroke are generally linked to poor overall cardiovascular health. Age plays a role, so the older you are, your likelihood increases. Ischaemic strokes tend to affect men at an earlier age, but generally, strokes affect men and women who suffer from high blood pressure, high cholesterol, diabetes and those who smoke to excess. A stroke is a sporadic event, not a hereditary one, although the risk factors mentioned may have a genetic link. High levels of stress can also worsen the risk factors, as can substance addiction, especially if you’re addicted to stimulants like cocaine, ecstasy and amphetamines as they increase blood pressure and can cause a hemorrhagic stroke.
What are the signs and symptoms of stroke?
A headache is not a warning sign that you’re having a stroke and it’s vital to realise that there’s no loss of consciousness experienced during a stroke. Migraines and epilepsy can cause stroke-like symptoms, but there are a few more concrete warning signs to watch for. The first is a transient ischemic attack or TIA, which is a short-lived episode of neurological dysfunction. Symptoms of a TIA mostly affect only one side of the body and include: muscle weakness, a loss of or change in sensation, the loss of sight or a sudden inability to speak. These symptoms are momentary and the patient seems to return to ‘normal’ functioning after only a few minutes. But, just because the symptoms of TIA have gone away doesn’t mean they should be ignored – you should still seek medical attention, as there’s a high risk of stroke within a week of a TIA. A stroke can happen without you being aware of it, depending on where the affected site is within the brain and how extensive the damage is (referred to as a ‘silent stroke’), but a suspected stroke is an emergency and may be reversed if the patient receives treatment within four hours of the onset of symptoms. Thrombotic strokes are more likely to occur at night so it’s often not possible to know the exact time of onset. It’s recommended that if you suspect you or someone else are experiencing stroke-like symptoms to take an aspirin straight away (no more than 300mg) and seek medical care.
What’s the long-term prognosis for stroke patients?
It depends on the severity of the stroke and the prognosis will vary from case to case. Large strokes with extensive neurological damage have a low survival rate. Medium-sized strokes usually leave patients with a level of disability that may be permanent, so their lifestyle will be affected and rehabilitation will be required. Doctors expect that some function will be regained within the first two weeks and the most improvements possible within the first six months. Small strokes can leave no deficit whatsoever.
Important notes:
Heart attack warning signs
Symptoms in women are often different than in men. Women are more likely to experience nausea, dizziness and anxiety.
Symptoms may include:
- Heavy pressure, tightness, crushing pain or unusual discomfort in the centre of the chest.
- Sweating, sickness, faintness or shortness of breath may be experienced.
- This may feel like indigestion, spread to shoulders, arms, neck or jaw and/or last for more than 15 minutes. It may stop or weaken and then return.
- There may be a rapid, weak pulse.