Stroke

What is a stroke?

A stroke can be a life-threatening condition. It happens when the blood supply to the brain is suddenly interrupted, either by an artery blockage or a burst blood vessel. Urgent medical attention is essential.

Strokes are the leading cause of disability in the UAE, and the third leading cause of death. But immediate emergency medical treatment can limit the damage caused by a stroke and ultimately save a person’s life.

By recognizing the signs of a stroke, and ensuring treatment is received as quickly as possible, you can reduce the likelihood of permanent damage and save a life. If you think someone is having a stroke, you need to BE FAST.

What are the symptoms of a stroke?

The main warning signs of a stroke can be easily remembered by the words B.E. F.A.S.T:

• Balance: Is the person experiencing a sudden loss of balance or coordination?
• Eyes: Is the person having difficulty focusing or are they experiencing double vision? Can they see clearly?
• Face: Is the person able to smile fully? Is their face drooping on one side?
• Arms: Can the person raise both arms or does one arm drop?
• Speech: Is the person able to speak? Is their speech slurred or strange?
• Time: Time is of the essence. Call 999 immediately if you see any of these signs.

Are there different types of stroke?

There are two main ways in which a stroke happens:

Ischemic stroke: This is the most common type of stroke, where something blocks the blood vessels in the brain, preventing blood flow. Ischemic stroke can happen in different ways:

• A blood clot forms in the brain.
• A part of a clot from elsewhere in the body breaks away and travels to the brain and becomes stuck.
• A blockage in the small vessels can occur in people with long-term high blood pressure that is left untreated, people with diabetes, and people with high cholesterol.
• Unknown reasons.

Hemorrhagic stroke: The most serious type of stroke, where a blood vessel in the brain bursts and causes a bleed on the brain.

What is a mini stroke?

Called a transient ischemic attack (TIA), a mini stroke happens when the blood supply to the brain is temporarily interrupted, anywhere from a few minutes to 24 hours. A TIA won’t cause permanent damage to the brain, however, it should always be treated immediately and considered as a warning sign of a possible full stroke in the future.

What causes a stroke?

Ischemic strokes are usually caused by blood clots, which can happen as a result of:

• Atherosclerosis
• Atrial fibrillation (especially if it is a result of sleep apnea)
• Clotting disorders
• Heart defects (ventricular septal defect or atrial septal defect)
• Microvascular ischemic disease

Hemorrhagic stroke can be caused by a number of things, including:

• Brain aneurysms
• Brain tumors
• Diseases which weaken or cause changes in brain’s blood vessels (for example, moyamoya disease)
• High blood pressure (especially when uncontrolled and/or long-term).

There are a number of other conditions that can increase the risk of stroke, including:

• High blood pressure (hypertension) can contribute to all types of strokes as blood vessel damage makes a stroke more likely).
• High cholesterol
• Migraine headaches
• Obesity
• Diabetes.
• Smoking and tobacco use.

In the UAE, the average age of a stroke patient is 45. This is up to 20 years younger than the global average. The early onset is believed to be caused by the high prevalence of modifiable risk factors (things we can change) in UAE adults, such as obesity, smoking, and diabetes. It is estimated that 25% of all adults in the UAE are living with high blood pressure, one of the major risk factors for stroke, putting our population at high risk.

How is a stroke diagnosed?

If your doctor suspects a stroke, they will perform a number of diagnostic tests, which may include:

• Blood tests
• Computerized tomography scan (CT scan)
• Electrocardiogram (ECG/EKG)
• Electroencephalogram (EEG)
• Magnetic resonance imaging scan (MRI scan).

How is a stroke treated?

The treatment and medication given to someone who has had a stroke will depend on many different factors. If someone has had an ischemic stroke, treatment aims to restore blood circulation to the affected areas of the brain as quickly as possible. In people who have had a hemorrhagic stroke, the aim is to reduce blood pressure to reduce the amount of bleeding.

Treatments may include:

• Thrombolytic drugs: These dissolve existing clots and are only given in the first few hours after a stroke.
• Blood pressure management
• Clotting support: Drugs are given to help make clotting easier.
• Surgery: This may be necessary to relieve pressure in the brain.

Life after a stroke

Recovery from a stroke is different for every patient. Many people recover completely, while others are left with physical limitations, such as difficulty walking, speech problems, and the ability to perform daily activities. Rehabilitation after a stroke can help overcome these limitations. Physical, occupational, and speech therapists are trained to help stroke patients get back as much independence as possible. By building strength, mobility and confidence, they help patients to live their lives to the fullest.

Read more about life after a stroke here.