Stroke or TIA

What is a stroke or TIA (transient ischaemic attack)?

Stroke is the second commonest cause of death in the UK. A stroke or TIA, the latter commonly known as a ‘mini-stroke’, occurs when the blood supply to the brain is interrupted.  The presentation of stroke or TIA will depend on the area of the brain affected.

What are the symptoms of stroke?

Stroke commonly presents with a facial droop, arm weakness, leg weakness or a impairment of speech. A TIA is a temporary phenomenon, usually lasting less than an hour but lasting less than 24 hours by definition.  A stroke on the other hand presents with symptoms lasting more than 24 hours.

The FAST test is a useful acronym to remember the common presentations of stroke:

Facial weakness.        Can the person smile? Is there drooping of the eye or mouth?

Arm weakness.           Can he/she raise both arms?

Speech difficulty.         Is his/her speech clear?  Can he/she understand you?

Time to act.                 If you see any of these signs it is time to call 999.

Should you experience any of these symptoms then it is important that you seek medical attention immediately.

What causes a stroke?

The interruption of blood supply can result form a blood clot ‘ischaemic stroke’ (the most common form) or a bleed ‘haemorrhagic stroke’. A blood clot can form in the blood vessels supplying the brain or can travel from elsewhere in the body and lodge in the brain, known as an embolus.

Common causes of ischaemic stroke include: advancing age, hypertension, atrial fibrillation, diabetes, high cholesterol, smoking and obesity.  Many of these causes are either preventable or can be treated in order to prevent the risk of stroke.

How is a stroke treated?

The sooner a stroke is treated then the better the outcome, so recognising the symptoms of stroke is key. If a patient with a stroke is identified quickly and meets a number of criteria then stroke thrombolysis, a ‘clot-busting’ therapy, might be indicated. Otherwise the mainstay of stroke management involves identification of the underlying cause and possibly commencement of Aspirin or an anticoagulant (blood thinner) alongside physiotherapy.