Stroke happens when the brain’s blood supply is disrupted, and it’s a life-threatening emergency. Make sure you know the signs – recovery often depends on how fast someone gets medical help. And there’s a lot you can do to prevent stroke from happening in the first place.
Stroke – why it happens and help for recovery
31st May, 2024 • 7 min read
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Medically reviewed
In this article
A stroke happens when the blood supply to a part of the brain is cut off, so the cells there can’t get the oxygen and nutrients they need, and begin to die.
The damage can be life-threatening, and those who survive a stroke are often left with long-term effects. Around the world, 15 million people have a stroke every year.
There are 2 main types:
- ischemic – blood supply to the brain is blocked by a blood clot. This type of stroke accounts for nearly 90% of cases
- hemorrhagic – a blood vessel to the brain bursts, putting pressure on nearby brain cells and damaging them.
A transient ischemic attack (TIA), also known as a mini-stroke, happens when blood flow to the brain is blocked temporarily. Although symptoms go away when the blockage clears, a TIA is still a medical emergency because it can be a warning sign you’re at risk of a full stroke.
What are the symptoms?
Symptoms of a stroke or TIA usually come on suddenly and include:
- numbness or weakness in the face, arm or leg, typically down 1 side of the body
- confusion, and trouble speaking or understanding speech
- vision problems in 1 or both eyes
- difficulty walking, loss of balance, and dizziness
- severe headache that doesn’t have another clear cause.
You can remember the key symptoms of a stroke or TIA with the word FAST:
- Face – someone’s face may droop on 1 side, or become numb, and they may not be able to smile evenly
- Arms – 1 arm may be weak or numb, and raising it may be difficult
- Speech – may be slurred or garbled
- Time – call an ambulance immediately if you or someone else has these symptoms. Paramedics can start treatment for a suspected stroke right away, before you get to the hospital.
What causes a stroke?
Causes of the 2 types of stroke are as follows:
- an ischemic stroke can happen due to a blood clot blocking the flow of blood and oxygen to the brain, in areas where the arteries have become narrowed over time by fatty deposits (atherosclerosis). Other medical conditions, including atrial fibrillation, can also contribute to blood clots
- a hemorrhagic stroke is caused by sudden bleeding when an artery in or on top of the brain bursts. The leaked blood results in swelling in the brain, which can damage brain cells.
Who can be affected?
Both types of stroke share many of the same risk factors that make having a stroke more likely.
Risk factors you can change or manage include:
- underlying medical conditions that aren’t well managed, such as high blood pressure (hypertension), diabetes, high cholesterol, and atrial fibrillation
- smoking
- a diet high in calories, unhealthy fats and salt, and low in nutrients
- inactivity – it raises your risk of stroke and other factors linked to it, such as high blood pressure
- obesity
- drinking too much alcohol.
Certain groups of people may have an increased risk of stroke, including:
- age – stroke is more common in people over 55
- family history of stroke in a close relative, especially before the age of 65
- race – people with African, Caribbean, or south Asian ethnicity are at higher risk, partly because these groups also have higher rates of diabetes and high blood pressure, both linked to stroke
- gender – women have more strokes than men, which is thought to be due to a number of factors, including hormone changes and the fact women tend to have a longer life span
- a history of a stroke, TIA or heart attack.
When to see a doctor
A stroke or TIA is an emergency, so if you’re experiencing the FAST symptoms, or someone else is, call an ambulance immediately.
If you’re concerned or unsure about your risk of stroke, see a healthcare professional. They can assess you, identify any factors that may raise your risk, and talk to you about steps you can take to protect yourself.
How is it diagnosed?
Healthcare professionals diagnose stroke based on symptoms, medical history, and a physical exam.
They’ll also carry out imaging tests such as MRI (magnetic resonance imaging) and CT (computed tomography) scans to look at the brain, which will help them figure out the type of stroke and its location. They may also run other tests, including blood tests and an echocardiogram.
What are the treatments?
You’ll normally be treated in a specialized stroke unit in hospital. Treatment depends on a number of factors, including the type of stroke, its severity, and the area of the brain affected.
Treatment usually involves a combination of short-term medicines to treat the current stroke, and other treatments that aim to prevent it from happening again.
You may also be given supportive treatment in hospital, such as intravenous fluids, oxygen, and compression stockings to prevent blood clots in your legs.
Treatment for ischemic strokes
Treatment for an ischemic stroke may include:
- medicine to prevent another clot, including aspirin, is usually given straight away
- ‘clot-busting’ medicine is given as soon as possible to dissolve the clot that caused the stroke and restore blood supply to the brain. It should only be given once the diagnosis is confirmed, as it can worsen bleeding in hemorrhagic strokes
- some people need a surgical procedure – for example, to physically remove the clot
- anticoagulants can help to lower the risk of future blood clots in patients with an irregular pulse (atrial fibrillation)
- medicines are often prescribed to treat underlying conditions, such as high blood pressure and cholesterol levels.
Treatment for hemorrhagic strokes
Treatment for a hemorrhagic stroke may include:
- blood pressure medicine can reduce the pressure on the blood vessels in the brain
- you may need to stop any medicines that can contribute to bleeding, such as anticoagulants
- medications, for instance vitamin K, are sometimes given to help stop bleeding
- sometimes, a healthcare professional may recommend surgery – for example, to remove blood that’s leaked onto the brain and repair damaged blood vessels, or to treat any swelling.
Recovery after a stroke
Some people make a good recovery, but for others, strokes can cause a range of long-term disabilities depending on which part of the brain was affected. The recovery process can take months or years, though some people do recover quickly.
In the time after your stroke, a team of different healthcare professionals will work with you to support your recovery and prevent future problems, which may include:
- taking medication and following lifestyle advice, as guided by your healthcare professional, to reduce your risk of another stroke
- rehabilitation to help improve or manage any difficulties resulting from the stroke, which may include physiotherapy and speech therapy
- psychological support – depression and anxiety are common after stroke.
How to lower your risk of stroke
You can change many of the risk factors, whether you want to prevent a stroke in the first place, or reduce your chance of having another one:
- quit if you smoke
- eat a healthy, balanced diet, high in fresh fruit, vegetables, and whole grains; and low in salt, added sugar, cholesterol, saturated fat, and trans fat
- maintain a healthy weight
- be physically active
- limit alcohol intake
- follow your healthcare professional’s guidance to treat or manage underlying conditions connected to stroke.
Where to get support
If you’ve had a stroke or you’re at risk of one, there are many organizations that can help with information, resources and support groups. These include:
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.