Stroke – Risk Factors and Symptoms

 
Suffering a stroke is one of the most devastating medical emergencies that can happen to a person. Strokes can be classified into two main types: ischaemic and haemorrhagic. Ischaemic strokes occur when a blood clot blocks a vessel in the brain and can frequently lead to severe disability or even death. Haemorrhagic strokes occur when a blood vessel in the brain bursts or ruptures.1 For example, patients with an irregular heart beat (known as atrial fibrillation) are at increased risk of stroke. The upper chambers of the heart, the atria, do not contract properly, causing a disorder of the heart’s pumping function. As a consequence, the blood isn’t completely pumped from the atria into the main heart chambers. Blood pools within the atria, and as it is not moving as it should, it can form a blood clot. 
 
The risk: If one of those clots comes loose it can move through the blood stream to the brain and block one of the main arteries. 
The impact: During a stroke parts of the brain are cut off from oxygen supply and nerve cells are no longer functioning and die. 
 
Alarm signals of a stroke include temporary trouble seeing or speaking; numbness or weakness of one side of the face (drooping mouth), one arm or one leg; paralysis especially on one side of the body; sudden severe headache or dizziness. If any of these symptoms occur, you should immediately call an ambulance. 

Risk factors

Not every patient has the same risk of suffering a stroke. What matters is the individual health history. If additional risk factors are present, the possibility of having a stroke is significantly increased:

Consequences

Stroke by numbers: 17 million people worldwide suffer a stroke every year. One-third of these people die as a consequence and another third are left permanently disabled.2 Time is the most critical aspect for acute stroke care, as every minute after a stroke, approximately 1.9 million brain cells can be lost permanently.3
 
In short, time is brain! The fate of the patient depends on whether the blocked arteries can be opened again quickly. There is a simple test that can help everyone identify the most common symptoms of a stroke.

The FAST test

If symptoms such as paralysis, speech disorder or loss of sensation arise, you should immediately call an ambulance. The more time passes, the more brain tissue can die and the more severe the irreversible damage to the brain will be. Guidelines recommend that people who have had a stroke should be treated in a specialized stroke unit by a dedicated team. Treatment should be initiated as quickly as possible after the onset of symptoms - ideally within 60 minutes after arrival at the hospital.4,5 The following applies: the less time it takes to first treatment, the greater the chance for a long-term therapy success.
 

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  • Face

Ask the person to smile. If one side of the face droops and the smile only appears on the other side of the face a facial paralysis is present.

  • Arms

Ask the person to raise both arms. If the person suffers a stroke one arm drifts downward or even cannot be raised. 

  • Speech

Ask the person to repeat a simple phrase. The person affected may not repeat the words correctly or may use slurred or even strange phrases.

  • Time

If you observe any of these signs, call an ambulance immediately. Remember to note the time of the first symptoms and tell the doctor that you suspect a stroke. This is an important information which can affect treatment decisions and therefore the person’s life. 

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F.A.S.T.

Recognising the symptoms of a stroke

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Angles Initiative

 

Angels Initiative

The ‘Angels Initiative’ launched by Boehringer Ingelheim in partnership with the European Stroke Organisation (ESO) and the World Stroke Organisation (WSO) is a unique healthcare initiative to improve acute stroke care across Europe and in emerging markets. The aim of the ‘Angels initiative’ in Europe is to build a community of at least 1,500 stroke centres and ‘stroke ready’ hospitals. The initiative wants to advance stroke care by improving acute stroke networks, treatment procedures and sharing knowledge with hospitals on how to work as a stroke-unit. The programme provides doctors, nurses and hospitals with the necessary resources, training and support they need to achieve this and provide better care to stroke sufferers wherever they live in Europe.

For more information on the initiative, please visit: www.angels-initiative.com (link is external).

References

1 National Heart, Lung, and Blood Institute. Types of Strokes. http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/types.html (accessed August 2017).
2 World Stroke Organization. http://www.worldstrokecampaign.org/ (accessed August 2017.)
3 Saver J. Time is Brain – Quantified. Stroke 2006;37:263-266.
4 Jauch E, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke. Stroke 2013;44:870-947.
5 ESO Guidelines 2009 Update. www.eso-stroke.org (accessed August 2017).