Stroke

Also called Cerebrovascular accident, CVA, Brain attack

Blood supply to part of the brain cut off. Around 1.9 million neurones die every minute. Time is the treatment.

What it is

A stroke happens when the blood supply to part of the brain is cut off, either by a clot or by a bleed. Around 100,000 strokes happen in the UK each year, and there are approximately 1.3 million stroke survivors.

The phrase that should be on every wall is time is brain. In a large vessel stroke, roughly 1.9 million neurones die every minute treatment is delayed. Clot-busting drugs and mechanical clot retrieval both work, and both have narrow time windows.

A transient ischaemic attack, where symptoms resolve within 24 hours, is not a lucky escape. It is a warning, and the risk of a full stroke in the following days is high enough that it needs assessment within 24 hours.

Signs you might notice

Use FAST. Face dropped on one side. Arms, unable to lift both and keep them there. Speech slurred or muddled. Time to call 999.

Also: sudden loss of vision in one or both eyes, sudden severe headache with no cause, sudden confusion, sudden loss of balance or co-ordination, and numbness down one side.

Symptoms that resolve are still a 999 or urgent 111 matter, not a wait-and-see.

How it can affect day-to-day life

Recovery is not confined to the first six weeks, which is what many people are told. Improvement continues for years with the right rehabilitation, and being told otherwise causes people to stop trying.

The invisible effects usually outlast the visible ones: fatigue, aphasia, emotional lability, memory and concentration difficulty, and depression, which affects around a third of survivors.

The drop-off after discharge is the biggest structural failure. Intensive therapy in hospital, then very little at home, at exactly the point where practice in real life matters most.

Supporting someone well

Call 999 immediately for any FAST symptom. Do not phone the GP, do not wait to see if it passes, and note the exact time symptoms started because it determines what treatment is possible.

After a stroke, push for the therapy the guidelines specify and ask what is actually being delivered in minutes per day.

Treat fatigue as a symptom to be planned around rather than pushed through.

For communication difficulty, get speech and language therapy and use AAC in the meantime. Fiducia Talk is free, needs no assessment, and gives somebody a way to be asked what they want on day one rather than in month six.

Watch for low mood and ask about it directly, because aphasia hides it.

Prevent the next one: blood pressure, atrial fibrillation, cholesterol, smoking and anticoagulation where indicated. Secondary prevention is where the biggest gains are.

Fiducia Guardian holds the medicines, therapy plans and care team through a discharge that otherwise hands a family a folder and a phone number.

Where to get help

999, always, for suspected stroke.

The Stroke Association helpline is 0303 3033 100, and they run communication support groups that address the isolation therapy alone does not.

Ask about a six-month review, which you are entitled to and which is often not offered.